Over-the-counter (OTC) pain medication includes acetaminophen for treating pain and fever and nonsteroidal anti-inflammatory drugs (NSAIDs) for treating inflammatory conditions.
These OTC pain relief medications can help relieve mild to moderate pain.
This article examines the different OTC pain medications available, how to choose a suitable option, and possible side effects.
Acetaminophen (Tylenol or Panadol) is a non-opioid pain medication that can help relieve
Experts theorize that acetaminophen inhibits an enzyme called cyclooxygenase (COX) that creates prostaglandins. The body makes prostaglandins at the site of injury or infection, where they can cause inflammation, pain, and fever.
Acetaminophen is available in tablet, capsule, or liquid form and in various strengths.
A 2022 article notes that the recommended dose of acetaminophen is limited to
The exact dosage may vary for infants, children, adults, and each specific product. Always follow any dosing instructions on the product label.
Side effects and considerations
Generally, acetaminophen is
In high doses, acetaminophen may be toxic to the liver.
People will need to check with a doctor before taking acetaminophen if they:
- are pregnant or breastfeeding
- have a liver condition
- take warfarin
People can take acetaminophen with other painkillers, such as ibuprofen. However, do not take it alongside other medications that contain acetaminophen.
Learn more about combining acetaminophen and NSAIDs:
NSAIDs are a group of medications that help treat pain, fever, and inflammation.
Examples of OTC NSAIDs include:
- ibuprofen (Advil or Motrin)
- naproxen sodium (Aleve)
NSAIDs block the normal function of COX enzymes to reduce prostaglandin levels and relieve inflammation.
Learn more about NSAIDs:
People may take NSAIDs orally, in tablet or capsule form, or apply them as a topical gel.
The following table outlines some examples of
|NSAID||Tablet strength||Dose||Maximum daily limit|
|Ibuprofen||200mg||1–2 tablets every 4–6 hours||1,200 mg|
|Aspirin||325 mg||1–2 tablets every 4 hours, or 3 tablets every 6 hours||4,000 mg|
|Naproxen sodium||220 mg||1–2 tablets every 8–12 hours||660 mg|
The maximum daily limit may be higher for the same medications at prescription strength.
Side effects and considerations
Possible side effects of NSAIDs
- allergic reactions
- gastrointestinal (GI) issues, such as peptic ulcers
- impaired kidney function, which may be more of a risk for people with existing kidney dysfunction
- increased risk of cardiovascular events
- anti-platelet activity, which may only affect people with a history of platelet disorders or GI ulcers
- liver toxicity, although this is rare
NSAIDs can cause an
NSAIDs may also not be suitable for pregnant people, particularly those in their
Aspirin is unsuitable for any child or adolescent recovering from chickenpox or any flu-like symptoms, as it may cause Reye’s syndrome. Reye’s syndrome is a severe disorder that
People can also apply OTC pain medications to the skin in the form of a gel, ointment, spray, or patch. Topical pain medications can help to provide relief from sore muscles and joints.
Topical pain medications can contain:
- menthol, which can create a burning or cooling sensation
- camphor, which can create cold or warm sensations
- capsaicin, which is the main ingredient in chili peppers and causes a warm, tingling sensation on the skin
- lidocaine, which often comes in the form of a patch or cream
A person might want to speak with a doctor, pharmacist, or another healthcare professional to determine which topical pain reliever is best for them.
The amount a person should apply will depend on the product. Always read the package insert and follow the directions provided.
Side effects and considerations
Depending on the product, some people may experience allergic reactions.
People should not use some pain relief patches:
- if they are allergic to any of the ingredients
- in combination with a heating pad
- on wounds or broken skin
It is also important to avoid getting the products in the eyes or mucous membranes.
- headaches or migraine
- minor arthritic pain
- muscle pain
- menstrual pain and cramps
However, acetaminophen does not help reduce inflammation. People with inflammatory conditions, such as arthritis and gout, may find NSAIDs more suitable.
People should also be aware that:
- Acetaminophen may not be suitable for people with a liver condition or who regularly consume alcohol.
may not be suitablefor people with kidney problems or stomach ulcers.
- Parents or caregivers
should not giveaspirin to children.
People who are pregnant, breastfeeding, or taking any blood-thinning medication will need to check with a healthcare professional first.
Here are the answers to some FAQ about OTC pain relievers.
What is the strongest OTC pain medication?
It may not be possible to identify the strongest OTC pain medication. This is because NSAIDs and acetaminophen work in different ways.
A 2016 study evaluated the efficacy of the NSAID naproxen, acetaminophen, and a placebo. The researchers found that while both pain relievers were significantly more effective than the placebo, they did not greatly differ from each other.
If a person requires significant pain relief, they should speak with a healthcare professional.
Which OTC pain medications are safe during pregnancy?
Is alcohol safe to drink alcohol after taking OTC pain medications?
High doses of acetaminophen and alcohol may cause liver damage. It is not safe to take acetaminophen while consuming three or more alcoholic drinks a day.
According to the United Kingdom’s National Health Service (NHS), it is usually safe to consume a recommended daily amount of alcohol while taking OTC pain medications, including acetaminophen, ibuprofen, and aspirin.
However, it is best to check with a healthcare professional before combining alcohol and OTC pain medications. This is particularly important for those with any liver or kidney conditions.
Learn more about combining alcohol and OTC pain medications
OTC pain medications can help to relieve mild to moderate pain and fever. NSAIDs can also help to reduce inflammation. In most cases, OTC pain medications are safe and effective when people take them correctly.
People who are pregnant or have certain health conditions, such as liver, kidney, or stomach problems, will need to check with a doctor before taking OTC pain medications.