The Tripod

Dear Annie,

When I walk in to the pharmacy to find something to help me with a headache or sore joints after sports, I am overwhelmed by the variety of painkillers! What is the difference between all of these brands?

-- Henry Headache

Dear Henry Headache,

Most common over-the-counter painkillers are made from one of four ingredients: ibuprofen, naproxen, aspirin (acetylsalicylic acid), and acetaminophen (parecetamol). Most common painkillers, with the exception of acetaminophen drugs (commonly Tylenol and Excedrin), fall under the group of Non-Steroidal Anti-Inflammatory drugs (NSAIDs.) According to MedicineNet, "As a group, NSAIDs are non-narcotic relievers of mild to moderate pain including injury, menstrual cramps, arthritis, and other musculoskeletal conditions." All NSAIDs pose a risk of stomach bleeding or kidney problems if taken inappropriately. These drugs also have potential allergens so you should be familiar with your allergies before taking these or any other over-the counter medicine. Although many people take these pain-relieving drugs interchangeably and some have a specific brand that they believe works for them, there are slight differences of which a savvy consumer should be aware.

Advil, Motrin, and Nuprin are three common drugs that contain ibuprofen. Ibuprofen is a NSAID, and works to reduce moderate pain, fever, and inflammation. The typical dose for an ibuprofen drug is 200-400 milligrams every four to six hours. According to www.MedicineNet.com, "Pain, fever, and inflammation are promoted by the release in the body of chemicals called prostaglandins. Ibuprofen blocks the enzyme that makes prostaglandins (cyclooxygenase), resulting in lower levels of prostaglandins. As a consequence, inflammation, pain and fever are reduced."

Naproxen, another NSAID, is made available in the form of Aleve. Naproxen works in the same way as ibuprofen, blocking the enzyme that causes the release of pain and fever-inducing prostaglandins. The recommended dose for naproxen is 250-500 milligrams, twice daily. It's recommended that naproxen be taken with food; this reduces side effects like an upset stomach. For me, Aleve has been the most helpful when dealing with muscle injuries from physical activity.

Aspirin is another category of NSAID. Usually a drug that contains aspirin will be labeled clearly (like Bayer Aspirin). Because of its blood thinning properties, it is common for those with high blood pressure or risk of heart attack to use aspirin to regulate their blood pressure and prevent heart attacks or recurrent strokes. Those who need to be concerned about their blood consistency should stay away from aspirin. Aspirin is very helpful in relieving arthritis pain, and any other pain. It is also the source of one of my favorite jokes … if you fall on your tuchus, you should take some ass-pirin. Get it?

The last main category of painkillers is acetaminophen (parcetamol). This drug is commonly available as Tylenol or Excedrin, and is classified as an analgesic, a pain reliever, and an antipyretic, or fever reducer. It is not used to reduce inflammation. According to MedicineNet, "Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before a person feels it. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body's temperature when the temperature is elevated." The common dose is 325-650 milligrams every four to six hours. In my experience, the best drug to take for a headache is Excedrin, because Excedrin contains caffeine which speeds up the whole pain-relieving process.

Midol is another type of pain reliever, used specifically for menstrual cramps. The regular Midol contains acetaminophen and caffeine, just like Excedrin. There are different versions of Midol that contain additional chemicals. Midol Cramps and Body Aches contains ibuprofen, and Midol Extended Relief contains naproxen. In my experience, any pain reliever is helpful in dealing with cramps.

The pain relievers mentioned above are by no means an exhaustive list; they are only used as a guide to the most commonly used type of over the counter drugs.

Remember: the best way to use painkillers is to carefully follow the instructions written on the box. Problems usually occur when someone consumes more than the recommended doseage in hope of expedited relief.

Taking painkillers with alcohol is never a good idea as it could result in potentially severe side effects ranging anything from vomiting to liver failure , or even death.

Ask Annie is a consumer-related advice column. Please send any questions you have to Anne.Benjamin@trincoll.edu. Any question is valid and I would love to help you.

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