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| A collection of over-the-counter headache pain medications line the shelves of a CVS Pharmacy. But what's the difference between them? |
Aspirin, Ibuprofen and Acetaminophen
What's the Difference Between Aspirin, Ibuprofen and Acetaminophen?
BY ALIA HOYT
The
average headache or backache often
sends people reaching willy-nilly for the nearest bottle of pain reliever, but
for best results it's smart to match the particular problem with the perfect
pill.
That's because
the wide variety of pain relievers (known in medical circles as analgesics)
available today are each effective at different problems and come with
different risks.
There are two
categories of pain pills suitable for home use — nonsteroidal anti-inflammatory
drugs, more commonly referred to as NSAIDs,
and acetaminophen.
Both also are
considered antipyretics,
which means that they can reduce fevers.
Most people
know acetaminophen better by the popular brand name Tylenol, but there are
other brands as well (like FeverAll).
The category
of NSAIDs is broader, as aspirin, ibuprofen and naproxen all fall under the
umbrella (there are others, but these three are some of the most widely used).
Each has its
own range of brand names associated with it.
So, which one
is best to use? It all depends on what you're taking it for. We'll clue you in
on all these pain relievers below:
Acetaminophen
Brand name: Tylenol
What it is: Acetaminophen
was approved by the U.S. Food and Drug Administration in 1951,
but how it works is still not clearly understood.
Nevertheless,
certain facts have been worked out over the years.
"Acetaminophen
does not decrease inflammation, but works in the hypothalamus to reduce
fever," explains pharmacist Tara Thompson, Pharm.D., V.P. of clinical
services at Innovation
Compounding in an email interview.
Additionally, "it
may work peripherally to block the generation of pain."
When to take
it: "Those with fever, flu-like pain symptoms, or pain
from headaches may benefit from taking acetaminophen," Thompson says.
It also can help with the pain from
inflammatory diseases like arthritis and menstrual cramps but note: It'll
only mask the pain without
treating the underlying inflammation problem.
When NOT to
take it: Acetaminophen should never be taken while consuming
alcohol.
It can be hard on the liver even when
stone-cold sober, and much worse when consuming alcohol.
Most serious liver problems have been
reported following large doses (the highest amount that's considered safe
is 3,250 milligrams
per day or 10 regular-strength tablets.)
However, there have been instances when liver
damage occurs after medicating with moderate or even small doses over a long
time.
Acetaminophen
should be taken carefully in conjunction with other medications, as many
headache and cold meds (like Nyquil) already have the analgesic in them.
This can lead
to accidental overdoses. Anyone taking one of these "extras" should
carefully read labels and follow dosing instructions to the letter.
Acetaminophen
is considered safe enough to take by just about everyone, but
occasionally side effects are
experienced.
Most often,
those are nausea, rash and headache, which is ironic since many people take it
to treat the latter!
NSAIDS
Brand names: Bayer,
Advil, Motrin, Aleve
What they are: You know
how acetaminophen doesn't do a darn thing to reduce inflammation? Well, NSAIDs
pick up that dropped ball and run all the way into the endzone with it. Short
for nonsteroidal anti-inflammatory drugs, the category of NSAIDs include a
variety of analgesics, like aspirin (one brand name is Bayer), ibuprofen
(Advil, Motrin) and naproxen (Aleve). Although there's some variation by
particular type, NSAIDs in general treat inflammation by blocking the
production of chemicals called
prostaglandins, which encourage fever, pain and inflammation.
Incidentally, steroidal meds also reduce inflammation, which is why this
category goes out of its way to denote "nonsteroidal" in the name
because it's a major distinction.
When to take
them: "NSAIDs such as aspirin, ibuprofen, and naproxen
have specific mechanisms of action in the body which decrease inflammation, so
those with inflammatory conditions such as osteoarthritis, rheumatoid
arthritis, menstrual pain, or muscular pain would benefit from an NSAID,"
Thompson notes.
"Naproxen
tends to work longer in the body (about two times longer!), so those with gout
or more chronic pain conditions may see more pain relief from using naproxen
versus ibuprofen."
However,
ibuprofen provides quicker relief than
naproxen and is less likely to cause an upset stomach, so might be more
appropriate for acute pain.
Aspirin has
long been used as a daily supplement of sorts for people at risk of heart
attack and stroke because it inhibits potentially tragic blood clotting for
roughly four to seven days.
One important
caveat, however, is that people consuming aspirin for that purpose should use a
lower dosage aspiring (under 325 milligrams per
day) than those using it for pain relief purposes.
Thompson says
that aspirin is more commonly used nowadays for inhibiting blood clotting than
for relieving pain, due to intestinal bleeding risks, which brings us to...
When NOT to
take them: Women who are pregnant or trying to become pregnant are
typically advised to avoid use of
NSAIDs because they are believed to cause fertility issues, early
miscarriage and even birth defects.
In particular, they should not be taken in
the third trimester because they could cause premature closure of
the ductus arteriosus (a blood vessel in the developing baby).
People with gastrointestinal problems might
also steer clear of NSAID use.
"NSAIDS are known for their potential
negative GI side effects, which can include ulcers or intestinal
bleeding," Thompson says.
This occurs because prostaglandins, those
fever- and inflammation-encouraging chemicals that are wrecked by NSAIDs,
aren't all bad.
In fact, prostaglandins protect the stomach
lining and help with blood clotting. When those functions are
inhibited, the risk of bleeding and ulcers goes way up.
"Although this is more likely in those
who take large doses for long periods of time, patients often turn to acetaminophen
[from NSAIDs] for pain relief, since it does not cause intestinal issues," says
Thompson.
Still confused
about which to take?
"Your
local pharmacist at any retail pharmacy can help recommend the best medication
and dose to take for your particular condition, and can help you find the right
product on the shelf," she adds.
NOW THAT'S HELPFUL
Have a
hangover? Skip the acetaminophen in favor of an
NSAID.
Although
nothing short of time, rest and lots of hydration can completely cure a
hangover, the anti-inflammatory properties that NSAIDs boast are believed to be
helpful at combating the effects of alcohol-related ethanol.
However,
taking an NSAID on an upset stomach (so common with hangovers) can make nausea,
gastritis and related discomfort worse.
Alia
Hoyt
CONTRIBUTING
WRITER
Alia
is an Atlanta-based freelance writer who has contributed content to
HowStuffWorks for going on a decade now, with a specialty in health writing.
She’s also been published by TLC, Animal Planet, and a number of corporate
clients. She holds a bachelor’s degree in journalism from the University of
Georgia (Go Dawgs!), and might someday get around to setting up a professional
website. Until then, check her out on LinkedIn.
She and her husband are proud parents to three handsome, too-smart-for-their-own-good boys. Alia is a passably not terrible tennis player, lover of all things dance and music, brownie-obsessed, avid reader and off-key car singer. Her two favorite types of people are those who have a healthy sense of humor and those who actually read articles in their entirety before posting comments.
She and her husband are proud parents to three handsome, too-smart-for-their-own-good boys. Alia is a passably not terrible tennis player, lover of all things dance and music, brownie-obsessed, avid reader and off-key car singer. Her two favorite types of people are those who have a healthy sense of humor and those who actually read articles in their entirety before posting comments.
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