CR.ORG GUIDE TO WELLNESS 47A GUIDE TO OTHER MEDICATIONS
FOR PAIN RELIEF
TYPE OF PILL BEST USE SAFETY SMARTS IMPORTANT TO KNOW
Acetaminophen
Tylenol and its generic
are available over the
counter (OTC).
For mild to moderate pain, such
as headaches and osteoarthritis
(OA). Though not as effective
as OTC drugs such as the
NSAID ibuprofen for most pain,
acetaminophen is gentler on
the stomach, and that makes it
a good option for people with
acid reflux or ulcers. It also won’t
increase heart attack and
stroke risk, as NSAIDs may.CR medical experts recommend no more than
3,250 mg, or 10 325-mg pills, in a day. Taking more
or mixing them with alcohol can damage your liver.In rare cases,
acetaminophen
can cause serious
skin reactions
that could include
blisters or a rash.
If that occurs, stop
taking it and seek
medical attention
immediately.Anti-Inflammatory
Medications
So-called NSAID pain
relievers are available
in OTC and prescription-
strength versions of
aspirin (Bayer, Bufferin,
and generic), ibuprofen
(Advil and generic),
and naproxen (Aleve and
generic). Prescription-only
meds include cele coxib
(Cel ebrex and generic)
and diclo fenac (Cambia,
Voltaren, and generic).
For mild to moderate
pain, such as headaches,
migraines, and muscle
aches, and to manage OA.
If an OTC NSAID doesn’t
bring you relief, your doctor
might prescribe a higher-
dose version.Whether you’re using an OTC or a prescription
NSAID, take the lowest dose for the shortest period
of time—and not for longer than 10 days without
talking to your doctor. If you find yourself using OTC
NSAIDs three or more times per week, ask your doctor
about other pain-relief options. NSAIDs can hike the
risk of stomach and intestinal bleeding and ulcers,
particularly when used regularly in high doses. Don’t
combine NSAIDs with each other; together they
can boost the risk of ulcers and gastrointestinal (GI)
bleeding. Note that although most NSAIDs increase
heart attack and stroke risk a bit, aspirin has been
shown to lower it. So if you have heart disease or risk
factors for it, talk to your doctor.Alert your doctor
if you have burning
stomach pain or
bloody, black, or
tarry stools—signs
of GI bleeding.
If you have GI
bleeding or ulcers
(or you’re at risk for
the condition), ask
your doctor about
low-dose NSAIDs
or acetaminophen.Opioids
These prescription drugs
include fentanyl (Actiq,
Abstral, Duragesic,
Fentora, Onsolis, and
generic), hydrocodone
(Vicodin and generic),
and oxycodone
(OxyContin, Percocet,
and generic).
For severe acute pain after
surgery or from injuries, such
as those sustained after a
bad fall or car accident.Start with the lowest dose possible and use for only
a few days. Even short-term use can cause side effects,
such as abdominal cramps, constipation, headaches,
nausea, sleepiness, vomiting, and a fuzzy-headed
feeling. If your pain persists after a few days, talk with
your doctor about nonopioid alternatives, including
nondrug approaches. Taking these drugs for longer
than about three days can hike addiction and over-
dose risks, and their effectiveness can diminish over
time. Opioids can also impair your immune system’s
functioning and heighten pain sensitivity.For dental
problems, such as
post-extraction
pain, research
shows that OTC
pain relievers work
just as well as—or
better than—
opioids for most
people, with far
fewer side effects.Muscle Relaxers
These prescription drugs
include cyclobenzaprine
(Amrix, Fexmid, and
generic), metaxalone
(Skelaxin and generic),
and carisoprodol
(Soma and generic).
For acute, severe neck
or back spasms; muscle
spasticity associated with
cerebral palsy, multiple
sclerosis, or a stroke; or
if you have liver disease
and can’t tolerate OTC
painkillers.Muscle relaxers can cause sedation and be
addictive, and most studies show that they are only
marginally effective. Carisoprodol, for instance, poses
a high risk for abuse and addiction. So most people
are better off skipping them. For the few exceptions
where muscle relaxers are a preferred option, take
them for no longer than three weeks—less, if possible.
Using them every day or long term for persistent
types of pain, such as lower-back pain and joint pain,
isn’t recommended. Studies have failed to show that
muscle relaxers work well for chronic pain.If you’re 65 or
older, steer clear
of these because
they’re associated
with an increased
risk of falling.