What should I take for the pain?

Be sure you're making the right choice

Everyone has them, often nearby, in a purse, medicine cabinet or drawer. We reach for them when we have a pounding headache, an aching joint or muscle pain. But, few people understand the risks.

Over-the-counter (OTC) pain relievers are medicines that can help relieve pain or lower a fever. OTC means you can buy them at a store without a prescription from your doctor. They are helpful in treating many types of pain, including earaches, back pain and pain after surgery. They can also treat pain from the flu or a sore throat. Some can help with swelling or inflammation.

OTC pain reliever basics

There are two main types of OTC pain relievers: acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs). “What works for one person may not work for another,” says Shannon Raschke, senior clinical pharmacist at Wellmark Blue Cross and Blue Shield. “Plus, different types of pain relievers may do a better job of helping a specific type of pain. That’s why it’s important to understand the differences, while also understanding any risks.”

Acetaminophen

Tylenol® and generic is for mild to moderate pain, including headaches and osteoarthritis. It does not reduce inflammation the way other pain medicines do. But, it has fewer side effects and is gentler on the stomach. This makes it safer for long-term use and for children when taken at an appropriate dosage.
NSAIDs

Aspirin, ibuprofen and naproxen are also for mild to moderate pain, such as headaches, migraines and muscle aches. Take the lowest dose for the shortest period of time indicated on the label and not for longer than 10 days for pain without talking to your doctor. That’s because NSAIDS can increase the risk of stomach ulcers and bleeding, especially when used in high doses. It an also elevate cardiovascular risk, especially for people with cardiovascular disease.

Making the right choice

Acetaminophen

Tylenol
Age recommendation	Safe for children when taken at an appropriate dosage.
Things to consider	Some products contain both acetaminophen and aspirin (for example: Excedrin®). These products may contain caffeine, as well. They are good for treating headaches.
Uses	Acetaminophen is helpful for: Reducing fever Relieving headaches Easing common aches and pains Treating arthritis and other chronic painful conditions
Warnings	Do not take acetaminophen if you: Have severe kidney or liver disease Have 3 or more drinks that contain alcohol daily Are already taking another product containing acetaminophen.
Side Effects	Acetaminophen can cause liver damage in some cases. This usually happens if you take too much, or if you take it while drinking alcohol.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

Asprin (Bayer®, Bufferin® and generic)
Age recommendation	Children and teenagers younger than 18 years of age should not take aspirin. It increases the risk of Reye’s Syndrome, a serious illness that can lead to death.
Things to consider	Aspirin has been shown to lower your risk of heart attack, clot-related strokes and other blood flow problems in people with heart disease or those who have already had a heart attack or stroke
Uses	NSAIDs are helpful for: Reducing fever Relieving menstrual cramps Easing pain caused by headaches, muscle aches, and stiffness Reducing inflammation (swelling) Decreasing pain from inflammation (such as muscle sprains)
Warnings	Talk with your doctor before you take an NSAID, especially aspirin, if you: Are allergic to aspirin or other pain relievers Have 3 or more drinks that contain alcohol every day Have bleeding in the stomach or intestines, or have peptic (stomach) ulcers Have liver or kidney disease Have heart disease Take blood-thinning medicine or have a bleeding disorder
Side Effects	NSAIDs may cause upset stomach, so it is recommended to take with food. They can also cause increased bruising or risk of bleeding in the stomach. When taken for a long time, they may cause kidney damage. NSAIDs can interact with blood pressure medicines. If you take one of these medicines and an NSAID, your medicine may not work as well as it should.

How do I safely take OTC pain relievers?

Follow dosing instructions

Take only the amount recommended on the medicine’s label. Don’t assume that more medicine will work better or quicker. Taking more than the recommended amount can be dangerous.
Avoid interactions

If you are taking a prescription medicine, ask your doctor if it’s OK to also take an OTC pain reliever.
Don’t mix pain relievers

Avoid using more than one OTC pain reliever at a time unless your doctor says it’s OK. They may have similar active ingredients.
Check the active ingredients

Before taking other OTC medicines with your pain reliever, check the label for active ingredients. Many OTC medicines for cold symptoms, allergies and sleep aids may contain acetaminophen or ibuprofen. Always check to be sure you’re not doubling your dose.

If you have any questions about how much medicine to take, call your personal doctor or pharmacist.

Questions to ask your doctor

What kind of OTC pain reliever is the best one to treat my pain or my child’s pain?
What are the side effects?
What is the maximum amount I should take a day?
How long should I take the OTC pain reliever?
My pain is not going away. Could I need something stronger?

Need help?

BeWell 24/7^SM is available when you call Eight, Four, Four, Eight, Four, Be Well

If you need help understanding dosage or instructions for your OTC or prescription pain relievers, call BeWell 24/7. Health professionals are available to help you, around the clock. This free service is exclusive to Wellmark members.

Wellmark supports smart opioid management

OTC pain relievers can be taken without a prescription. In many situations, they are all you need for pain. However, for severe, acute pain after surgery or from injury, your doctor may prescribe opioids. If you take opioids for pain, you should understand their potential for dependence and addiction. Opioids act on your brain in powerful and potentially dangerous ways. Opioid abuse is now considered one of America’s foremost health crises, taking lives and negatively impacting communities. Opioid abuse is a leading cause of shortened life expectancy in the United States.

The impact of opioid overuse in America

Every day, 91 people in the United States die from prescription opioid overdose and many more become addicted.

Approximately 37 percent of overdose deaths involved a prescription opioid, a number essentially unchanged from 2012.

More Americans die every year from drug overdoses than they do in motor vehicle crashes, and the majority of those overdoses involve prescription medications.

53 percent received opioids from a friend or relative for free. 15 percent bought or took them from a relative. These stats are among persons aged 12 or older who used prescription pain relievers recreationally in the past year.

215 million prescriptions for opioid pain medications were written by health care providers in 2016 — enough for every American adult to have one bottle of pills.

Source: Centers for Disease Control and Prevention (CDC) - Opioid overdose data

Balancing risk with access

Wellmark’s opioid medication management program emphasizes the lowest possible dose of opioids for the shortest possible amount of time. The physician helps decide whether the benefits outweigh the risk of abuse, addiction or dependence. For patients filling an opioid prescription for the first time, be sure to have a conversation with your pharmacist and follow all instructions when using your prescription.

The program is intended to ensure smaller quantities of opioids are dispensed for short-term pain needs. It is not designed to impact members with chronic pain or those undergoing care for serious illnesses.

Get the details

For more information about using OTC pain meds, and for a more detailed chart about making the right choice, visit Get Relief Responsibly External Site. You can also talk to your pharmacist.