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.

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Acetaminophen (Tylenol or Panadol) is a non-opioid pain medication that can help relieve mild to moderate pain and reduce fever. It does not have anti-inflammatory properties, so it does not help relieve inflammation.

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 3–3.25 grams (g) in 24 hours. People should not exceed the maximum daily limit of 4,000 milligrams (mg).

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 safe when people take it correctly. Possible side effects may include allergic reactions, resulting in skin rashes and blisters.

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

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:

NSAIDs block the normal function of COX enzymes to reduce prostaglandin levels and relieve inflammation.

Learn more

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 standard dosing for OTC NSAIDs in tablet form is:

NSAIDTablet strengthDoseMaximum daily limit
Ibuprofen200mg1–2 tablets every 4–6 hours1,200 mg
Aspirin325 mg1–2 tablets every 4 hours, or 3 tablets every 6 hours4,000 mg
Naproxen sodium220 mg1–2 tablets every 8–12 hours660 mg

The maximum daily limit may be higher for the same medications at prescription strength.

Side effects and considerations

Possible side effects of NSAIDs may include:

  • 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 increase in blood pressure, so they may not be suitable for those with high blood pressure.

NSAIDs may also not be suitable for pregnant people, particularly those in their third trimester.

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 may cause brain damage.

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:

  • NSAIDs
  • 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.

Both OTC NSAIDs and acetaminophen can help to provide temporary relief from conditions such as:

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:

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?

The Food and Drug Administration (FDA) advises any pregnant person to check with a healthcare professional before taking OTC pain medications.

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

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.