Pain relievers - Analgesics

Aspirin (Bayer, Bufferin, Anacin)
Excellent for pain relief and fever reduction. Commonly used long-term for osteoarthritis, chronic back pain and headaches.

Ibuprofen (Advil, Motrin, Midol, Nuprin)
Popular for dental pain, menstrual cramps.
Slightly stronger (meaning you need less of it) to treat pain from soft tissue injuries and dental pain.

Do not take if you've consumed three or more drinks because alcohol is a stomach irritant and the combination can cause gastro-intestinal bleeding. Avoid during pregnancy.

Naproxen (Aleve or Naprosyn)
Pain relief and fever reduction. It doesn't have much of an anti-inflammatory effect at the recommended dose. Popular for menstrual cramps.

It is the most powerful pain reliever currently available without a prescription, but can cause even more gastrointestinal irritation than aspirin. As a result, it needs to be taken in fewer doses, and with lots of water.

Ketoprofen (Actron or Orudis)

Celecoxib Celebrex

Topical NSAIDs
Topical NSAIDs may be a good choice if youu're at risk of heart attack or stroke because they allow lower levels of the drug to enter the body than with a pill.
VOLTAREN® GEL (diclofenac sodium topical gel) is a nonsteroidal anti-inflammatory drug (NSAID) for topical use only.

See other topical pain relievers below.

NSAIDs for Pain Relief: Ibuprofen, Aspirin, Naproxen |

Do not use non-steroidal anti-inflammatory drugs (NSAIDs) for the first 24 hours after an injury that caused a bruise. NSAIDs may prolong bleeding under the skin. Children and teenagers who are recovering from a viral infection such as the flu or chickenpox should not take aspirin. It has been linked to Reye’s syndrome, a serious but rare condition that can result in brain, kidney, and liver damage.
NSAIDs could raise the risk of bleeding, especially in the digestive tract for people on blood thinners.
"Many of the patients who need blood thinners are older and therefore at risk for arthritis, so it's not infrequent for a patient to be on both a blood thinner and an NSAID," says cardiologist Dr. Deepak L. Bhatt, a Harvard Medical School professor.

Acetaminophen (sometimes abbreviated as APAP) - Tylenol Excellent for pain relief and fever reduction. Commonly used long-term for osteoarthritis, chronic back pain and headaches.
Acetaminophen is OK for people on blood thinners.
Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.
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.
Acetaminophen relieves pain in mild arthritis but has no effect on the underlying inflammation, redness, and swelling of the joint.

Other: Excedrin contains paracetamol (acetaminophen), aspirin, and caffeine

What is the difference between Advil, Tylenol and Aleve? - tribunedigital-chicagotribune

Type Uses Mechanism of action Side Effects Precautions
Aspirin Pain, inflammation, fever, heart disease/stroke prevention Inhibition of COX-1, & COX-2 Stomach upset, ulceration, bleeding Bleeding; Ringing in the ears or hearing loss; Avoid in children under 18 with viral illness; Avoid in 3rd trimester of pregnncy
Ibuprofen Pain, inflammation, fever Inhibition of COX-1, & COX-2 Stomach upset, ulcer, bleeding Bleeding; Avoid during pregnancy
Acetaminophen Pain, fever Inhibition of the production of brain prostglandins, which sensitize pain and elevate the body temperature regulation set point. Usually well tolerated. Potential liver damage with long term usage or with heavy drinking

COX - cyclo-oxygenase
COX-1 is responsible for the baseline levels of prostaglandins.
COX-2 produces prostaglandins through stimulation. Responsible for inflammatory response.

Topical Pain Relievers
Analgesic Creams, Rubs, and Sprays

If you suffer from back or muscle strain, or joint pain from osteoarthritis, these topical treatments might provide an alternative to swallowing pills.

  • Counterirritants. Ingredients such as menthol, methylsalicylate (oil of evergreen), and camphor are called counterirritants because they create a burning or cooling sensation that distracts your mind from the pain.
  • Salicylates. These same ingredients that give aspirin its pain-relieving quality are found in some creams. When absorbed into the skin, they may help with pain, particularly in joints close to the skin, such as the fingers, knees, and elbows.
  • Capsaicin. The main ingredient of hot chili peppers, capsaicin is also one of the most effective ingredients for topical pain relief.It can be helpful for joint pain and for diabetic nerve pain. When first applied, capsaicin creams cause a warm tingling or burning sensation. This gets better over time. You may need to apply these creams for a few days up to a couple of weeks before you notice relief from pain.
Prescription NSAIDs:
VOLTAREN® GEL (diclofenac sodium topical gel) is a nonsteroidal anti-inflammatory drug (NSAID) for topical use only.


  • Creams
    Creams are usually less greasy than ointments and easier to wash off hands.
    Examples: Tiger Balm Neck & Shoulder Rub, $8, Capzasin HP, $14, and Zostrix Hot & Cold Therapy System, $19.

  • Foams
    Foams are like shaving cream or hair mousse; they spread more easily than creams.
    Example: Salonpas Pain Relieving Massage Foam, $9.

  • Gels
    Gels are usually less greasy or sticky but may dry out your skin if the product is alcohol-based. Also, they may be easier to apply to hairy areas than cream.
    Examples: BenGay Zero Degrees, $11, and Icy Hot Pain Relieving Gel, $7.

  • Roll-ons
    Roll-ons can go on wet and are easy to apply to your skin, especially if you don’t like the feel of creams or gels on your fingers.
    Examples: Aspercreme Max, $6, and JointFlex Ice, $12.

  • Sprays
    Sprays also go on wet but are usually quick drying. They’re ideal for hitting hard-to-reach spots, such as your back.
    Example: Salonpas Pain Relieving Jet Spray, $10.

  • Sticks
    Sticks go on just like solid deodorant and are easy to carry with you and apply.
    Example: Icy Hot Chill Stick, $5.
Sources: Best Topical Pain Relievers - Consumer Reports
Topical Pain Relief: Creams, Gels, and Rubs
Prostaglandins are a group of physiologically active lipid compounds having diverse hormone-like effects in humans and animals. Prostaglandins have been found in almost every tissue. They are derived enzymatically from fatty acids. Prostacyclins are powerful locally acting vasodilators and inhibit the aggregation of blood platelets.

Tramadol Hydrochloride (AHFS Monograph) is a narcotic-like pain reliever used to treat moderate to severe pain.

Opioid (Narcotic) Pain Medications

45 Americans die each day from painkiller ODs
In the last 20 years the rate of hospitalizations for prescription pain pill overdoses increased fivefold among people 45 to 85.

  • morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)
  • hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
  • oxycodone (OxyContin, Oxecta, Roxicodone)
  • oxycodone and acetaminophen (Percocet, Endocet, Roxicet)
  • codeine (only available in generic form)
  • fentanyl (Actiq, Duragesic, Fentora)
  • hydrocodone (Hysingla ER, Zohydro ER)
  • hydromorphone (Dilaudid, Exalgo)
  • meperidine (Demerol)
  • methadone (Dolophine, Methadose)
  • oxycodone and naloxone (Targiniq ER)

should i take tylenol, advil or aspirin? | U. British Columbia, CA

last updated 14 Sep 2016