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Home Pharmacy (cont.)

Pain and Fever

There are three major medication categories available OTC to treat pain and fever;

  1. acetaminophen,
  2. nonsteroidal antiinflammatory drugs (NSAIDs), and
  3. aspirin.

Although the three major categories of drugs listed below are also used to treat the pain of minor trauma, rest, ice, compression, and elevation (RICE) are easy first steps in the treatment for minor injuries, especially the pain associated with sprains and strains.


Acetaminophen is the most commonly recommended OTC medication for fever. It works well for minor aches and pains, especially for people who cannot tolerate antiinflammatory medications such as ibuprofen or aspirin. It is important to read the labels in regard to the recommended dosing of each medication to prevent accidental overdose. This is especially true with infants and children where the proper dosage depends upon the weight of the infant or child.

For an adult, the maximum dose of acetaminophen per day is 4 grams to prevent the complication of liver damage. Many cold medications contain acetaminophen as one of several other ingredients and it is important to read the labels carefully to prevent overdose. Because of the possibility of liver toxicity, acetaminophen should be avoided in patients with liver diseases such ascirrhosis and hepatitis.

There are several brand and generic names for acetaminophen. Common brand names include Tylenol, Panadol, and Tempra.

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Many nonsteroidal antiinflammatory drugs (NSAIDs) used to treat inflammation, fever, and pain are available over-the-counter. OTC ibuprofen (for example, Motrin, Advil) is often recommended by health care practitioners to decrease pain and inflammation from minor orthopedic injuries. It can also be used effectively as part of the treatment for kidney stones and gallstones, where inflammation is part of the process causing pain. Ibuprofen is also frequently recommended for the treatment of fever in all age groups.

Naproxen (for example, Naprosyn, Anaprox, and Aleve) is another NSAID available over-the-counter. The benefit of OTC naproxen is that it is longer lasting than ibuprofen and only needs to be taken twice a day instead of every 4 hours.

NSAIDs should not be taken by individuals with kidney disease, or those who have a history of bleeding from the stomach and bowels because NSAIDS are removed from the body by the kidneys and may increase bleeding in the stomach or bowels. These medications are relatively contraindicated in individuals taking blood thinners such as warfarin (Coumadin), clopidogrel (Plavix), and prasugrel (Effient) because the NSAIDS may increase the chance of inappropriate bleeding.

Salicylic Acid or Aspirin

Salicylic acid or aspirin is a well known medication that has been recommended for generations as a treatment pain, inflammation, and fever. It is also a first line treatment in the prevention ofheart attack and stroke because of its anti-blood clotting properties by making platelets in the bloodstream less sticky.

Because of the many side effects associated with aspirin, other medications such as acetaminophen (Tylenol and others) or ibuprofen may be recommended instead of aspirin.

Aspirin may cause Reye's syndrome in infants and children, which can lead to fatal brain swelling. Therefore, aspirin should not be taken by children younger than 14 years of age.

Some individuals may need to take large amounts of aspirin to manage pain from arthritis, but high doses of aspirin can cause major complications such astinnitus (ringing in the ears), pulmonary edema (fluid build up in the lungs) and kidney failure.

Aspirin can cause irritation of the stomach and may lead to ulcers and bleeding. Individuals with a history of ulcers or other stomach problems should not take aspirin, and those who take blood thinners should use caution when taking aspirin at the same time, as the probability for inappropriate bleeding is increased.

There are several brand and generic names for aspirin. Common brand names include Bayer aspirin, St. Joseph's aspirin, and Anacin.

Medically Reviewed by a Doctor on 8/4/2015

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