Brief guide on common painkillers

Painkillers, one of the various compounds in life that define America. With opioid usage now being heavily scrutinized and avoided, I thought it was appropriate to talk about the most common non-opioid painkillers. While I’m no doctor or pharmacist, I’m utilizing reliable sources, facts and science like how any normal person should be doing. WebMD is reliable and usually easy to read; other reliable sources include, the labeling of the medications, and of course pharmacies and doctors, which always take precedence for you specifically. I encourage you to do further research to get all the necessary details, especially with drug interactions, dosages, and the other various OTC painkillers that exist.

OTC vs Prescription

First, I’m going to make the distinction between Over-the-counter (OTC) drugs and prescriptions (which are only obtained via a doctor via a pharmacy). Most OTC painkillers tend to have a prescription version, like with ibuprofen (aka Advil). Ibuprofen’s OTC dose is 200 mg per pill, with a maximum recommended dose of 1200 mg in 24 hours. As a prescription, it’s normal to see 800 mg per pill with a maximum dose of 3200 mg in 24 hours. I’m strictly going to stick with OTC drugs and/or dosages, since it is the easiest and most common way to obtain them. Prescriptions tend to be case specific and for use in a limited time (those 800 mg ibuprofen pills were definitely appropriate for me when I was recovering from wisdom teeth removal, for example).

NSAIDs (Non-steroidal anti-inflammatory drugs)

The vast majority of OTCs are NSAIDs, which include aspirin, ibuprofen, and naproxen. All NSAIDs have an effect on blood, slowing down clotting time (making it dangerous to use in conjunction with actual blood thinning medication). However they all (except for aspirin) are associated with increased cardiovascular risk, of which is a concern for older people, those with previous cardiovascular attacks or increased rick, and people that aren’t particularly active. All NSAIDs also pose the risk of indigestion and ulcers, especially if they are used quite often (and in high doses) and are paired with other risk factors.

Despite these risks, they work fine for the majority of people, and are generally safe if taken appropriately, which can be found on the labeling (duh). They all tend to have a similar effect in how pain and fever is relieved, and each have their own dosages. Do drink these down with water, as most medication can erode the esophageal lining and cause severe bleeding. In addition, it’s ideal not to take them on an empty stomach (not a necessity, but a way to further reduce risk and reduce discomfort).

Non-aspirin NSAIDs and Aspirin

NSAIDs can be broken down further into two branches: Aspirin, and Non-aspirin NSAIDs. Why? Acetylsalicylic acid, simply known as aspirin is the only NSAID that does not pose cardiovascular risk; in fact, it can be taken for reduce the risk or prevent heart attacks due to its effective blood thinning properties. Aspirin’s regular dosage is 325 mg per pill. The biggest risk of aspirin use is to children and teens is Reye’s syndrome. Reye’s Syndrome is severe inflammation to the brain and liver that is life threatening and is associated with aspirin usage by children while recovering from a viral infection, like the flu or chickenpox.

Another risk are salicylates, which are natural (or synthetic in the case of aspirin) compounds produced by plants, like tomatoes. Most people are unaffected by salicylates, but some people may have a severe allergic reaction or minor discomfort. Non-aspirin NSAIDs include drugs such as naproxen (aka Aleve) and ibuprofen. Ibuprofen is typically effective for several hours (4-6), with each dose being 200 mg, and 1200 mg being the maximum amount in 24 hours. Naproxen works much longer, as one pill (220 mg) can work for 8-12 hours. Only 2 pills (440 mg) can be taken within 12 hours for the first dosage, and a total of only 3 pills (600 mg) over 24 hours.

Acetaminophen (Brand name: Tylenol)

Finally, we get to acetaminophen, which isn’t a NSAID and is instead classified as an analgesic. It still has quite a similar effect to NSAIDs in how it deals with pain and reduces fever, though it does it in a different way. This allows it to not increase cardiovascular risks and not cause damage to the gastrointestinal tract. However, it has the downside of potentially causing liver damage if taken in excess, or if taken with other drugs that can cause liver damage (such as alcoholic beverages). A regular pill contains 500 mg, with 1-2 bring taken every 6 hours.

A maximum of 3000 mg (which 4000 mg being the absolute most) can be taken in 24 hours. Because acetaminophen affects the liver, it can be dangerous for those drinking multiple alcoholic beverages or taking drugs and other drugs that affect the liver. As one who usually drinks multiple times a day, it’s usually only for days I don’t drink. Note that acetaminophen is usually found in NyQuil/DayQuil medication; this certainly provides more of a reason to not drink when sick!