10 Things to Know About Pain Relievers

  • Choose Wisely
    Naproxen, acetaminophen, aspirin—if navigating the pain reliever aisle has given you a headache, you're not alone. But it's important to choose wisely. Both over-the-counter and prescription painkillers are serious medicines that can actually cause pain and other harms if not used properly. Here's what you need to know.



  • 1. Too much acetaminophen can harm your liver.
    Acetaminophen, the active ingredient in Tylenol, is a leading cause of liver failure. Large doses—more than 4 grams (12 regular strength or eight extra strength Tylenol)—pose the greatest risk. But some people might be harmed by smaller amounts. Your risk is higher if you drink alcohol regularly or if your liver isn't healthy.



  • 2. Many other products contain acetaminophen.
    Tylenol is the best-known brand name. However, this ingredient often shows up in over-the-counter cold and headache medicines, including extra strength Excedrin (250 mg). Percocet, Vicodin, and other prescription pain relievers also contain acetaminophen. Read labels closely to make sure you get less than 4 grams per day.



  • 3. Anti-inflammatories can hurt your stomach.
    Many painkillers​ fall into a category called nonsteroidal anti-inflammatory drugs (NSAIDs). This includes ibuprofen (Advil), naproxen (Aleve), and the prescription drug celecoxib (Celebrex). They fight pain but can have serious side effects, including stomach bleeding. Talk with your doctor about these risks.



  • 4. Taking anti-ulcer medications with NSAIDs can help.
    If you're prone to stomach woes, you can still take NSAIDs. Your doctor may recommend you take another medicine at the same time to keep your stomach from producing acid. Options include omeprazole (Prilosec) or other drugs known as proton pump inhibitors.



  • 5. Painkillers can increase your heart risk.
    One prescription NSAID—Vioxx—was pulled from the market because it was shown to harm the heart. Other formulas, including ibuprofen and Celebrex, have also been linked to cardiovascular side effects. Naproxen seems to be the safest NSAID for your heart, but ask your doctor if you have concerns.



  • 6. Take your daily aspirin first.
    Your doctor may have recommended a small daily dose of aspirin to prevent blood clots and decrease heart risks. If so, take it at least 30 minutes before you swallow ibuprofen or naproxen for pain. There's some evidence that these drugs interfere with aspirin's heart-healthy effects.



  • 7. Pain drugs can cause blood pressure hikes.
    Acetaminophen and many NSAID painkillers can boost your blood pressure. And though the harms are greatest if you already have hypertension, even people with normal blood pressure may be affected. But low-dose aspirin may actually lower blood pressure, especially if you take it at night.



  • 8. Stopping NSAIDs suddenly can cause harm.
    If you take NSAIDs regularly, don’t quit them cold turkey. Talk with your doctor about gradually decreasing your dosage and potentially taking a low-dose aspirin. Otherwise, harmful blood clots can form.



  • 9. Some NSAIDs can also cause kidney damage.
    While acetaminophen harms your liver, NSAIDs are harder on your kidneys. In extreme cases, they can cause these important organs to fail completely. Talk with your doctor about your kidney health. If you’re at risk, aspirin and ibuprofen tend to be the safest choices.



  • 10. Stay smart—but don’t panic.
    It’s important to be aware of the risks linked to pain medicines. However, taking the occasional Advil or Aleve to relieve a minor ache isn’t likely to cause harm. Most serious side effects emerge only after long-term or heavy use.



10 Things to Know About Pain Relievers
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Last Review Date: 2019 Jun 20
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