Written By: Mark Rogers, Pharm. D
Acetaminophen is generally effective for mild-to-moderate pain and headaches. Oddly though, we still do not fully understand how it works. Be careful though, acetaminophen is however one of the most dangerous OTC drugs, responsible for thousands of overdoses and hundreds of deaths every year. The reason is that it can be hard to keep track of a daily dose, since it is used in so many combination medicines.
Ibuprofen & Naproxen
Both are mild anti-inflammatory medicines, sometimes referred to as NSAIDs. They are great for general pain like a sore back, headache, muscle pain, and even a sore throat. While generally safe, NSAIDs are not for everyone. People with GI issues such as stomach ulcers or bleeding, are in the last trimester of pregnancy, or are taking “blood thinners”/platelet aggregating drugs, should avoid using NSAIDs.
While technically an NSAID, I wanted to address aspirin separately. Aspirin is generally a safe drug with many uses, but as a pain reliever, I recommend acetaminophen or ibuprofen/naproxen instead. Compared to other NSAIDs, aspirin causes more adverse GI effects. It also has a stronger anticoagulant effect, meaning it can cause excessive bleeding, especially when paired with other similar medications. My recommendation is to use aspirin when recommended by your doctor for heart health. But there are better options for pain relief.
Excedrin is a combination of acetaminophen and caffeine, with some preparations containing aspirin. It can be very effective for headaches and migraines. And yes, caffeine has been shown to decrease headache pain as well.