We’ve all woken up with a pounding headache, or overdone it at the gym and strained a muscle. Some amount of pain is a normal part of life. Over-the-counter pain relievers can make a big difference in helping to get through a painful day. But which one is best?
The new media web site Vox wrote a great article about the evidence on over-the-counter pain medicines.
The reporter talked to several notable medical experts and cites systematic reviews as well as several randomized, controlled trials. Here are several take-home messages from the article:
- Ibuprofen (often sold as Advil or Motrin) is more effective for relieving pain and reducing fever than acetaminophen (sold as Tylenol.) This conclusion is based on a 2015 systematic review of 85 studies comparing the new medicines.
- Aspirin is the least effective over-the-counter pain reliever.
- Taking too much acetaminophen increases the risk of liver failure. Comparing it to ibuprofen and aspirin, it is the most toxic drug of the three at doses that relieve pain. This was confirmed in a systematic review published in 2014.
- Ibuprofen is effective at treating tension headaches that occur occasionally, and data show the same number of adverse effects as patients who took a placebo pill.
The bottom line: Ibuprofen is the most effective and safest over-the-counter pain medicine. Kay Brune, a professor of pharmacology at Friedrich-Alexander University in Germany, one of the experts quoted in the Vox article, sums up the evidence on acetaminophen pretty clearly: “It’s an old drug, obsolete, and should be avoided altogether.”
One other important note: Ibuprofen is part of a class of drugs found to lead to heart attacks, stroke and stomach bleeding when taken for longer periods of time. While they’re perfectly safe using sporadically, taking them for more than a week at a time can lead to problems.
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