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Health expert: Over-the-counter pain relievers safe if used wiselyOver-the-counter pain medications can be useful and effective, but knowing which one to take and how it will react with other medication can be confusing, a Texas Cooperative Extension specialist said. "Many older adults have pain that does not go away," said Andrew B. Crocker, Extension gerontology specialist. "Deciding what type of pain medicine to take is not easy." Over-the-counter pain relievers are medicines that can be bought without a prescription, Crocker said. But just because they are considered safe enough to be taken without a prescription, they are still real medicines with real side-effects. "It is important to discuss their use with a health provider, especially if they are being combined with prescription medications," he said. Two main types of over-the-counter pain relievers are acetaminophen (brand name: Tylenol), and nonsteroidal anti-inflammatory drugs including aspirin (Bayer, St. Joseph); ibuprofen (Advil, Motrin); ketoprofen (Orudis KT) and naproxen (Aleve). Acetaminophen seems to relieve pain and reduce fever by working on the parts of the brain that receive pain messages and control the body's temperature, Crocker said. The anti-inflammatory drugs relieve pain and fever by reducing the level of hormone-like substances, called prostaglandins, made in the body. "Prostaglandins cause pain by irritating your nerve endings," he said. "They also help your body control its temperature." Acetaminophen and the anti-inflammatory drugs relieve pain caused by muscle aches and stiffness, and reduce fever, Crocker said. These medicines can be helpful in treating many types of pain, such as arthritis, earaches, backaches and surgery. They can also treat pain resulting from the flu or a cold, sinusitis, strep throat or a sore throat. Acetaminophen may be used safely by most people on a long-term basis for arthritis and other chronic painful conditions, he said. The anti-inflammatory drugs may be helpful for pain from inflammation, such as muscle sprains. "For most people, over-the-counter pain relievers are all they need to control pain or fever," Crocker said. But he advised if one of the drugs has been taken continuously for more than 10 days for pain or three days for fever, a health provider should be consulted. Side effects are not common for healthy adults who only use pain relievers once in a while, he said. However, they may be a concern for people who use pain relievers often, who have health problems or who take other prescription medications. Again, a health provider should be consulted. To reduce the risk of liver problems, never take more than the recommended dose of acetaminophen, Crocker said. Also, be aware of other medicines that also contain acetaminophen, to ensure the overall dose doesn't exceed the recommendation. "Many over-the-counter drugs contain the same pain reliever or contain ingredients found in prescription drugs," he said. "For example, many cold medicines contain acetaminophen. If you were to take one of these products and also take acetaminophen separately, you would be taking much more acetaminophen than you intended." Long-term use of the anti-inflammatory drugs may cause gastrointestinal problems, ranging from upset stomach to ulcers to bleeding, he said. For minor stomach upset, eating some food or drinking some milk before taking the pills may help. The risk of problems goes up with higher doses and extended use. Drinking alcohol may increase the risks with both types of medicines, Crocker said. "You should not take anti-inflammatory drugs if you are allergic to aspirin or other pain relievers," he said. Crocker recommended seeing a health provider before taking anti-inflammatory pain relievers if you: --Take blood-thinning medicine or have a bleeding disorder. --Have bleeding in the stomach or intestines, or have stomach ulcers. --Have liver or kidney disease. --Have three or more drinks that contain alcohol every day If certain drugs are taken at the same time, they can interact with each other and change the way the body processes them, Crocker said. For example, if someone who takes high blood pressure medicine also takes an anti-inflammatory pain medicine, the high blood pressure medicine may not work as well, he said. When choosing an over-the-counter pain reliever, check the drug label for possible side effects or interactions with other drugs--this will appear in the 'warnings' section, Crocker said. "Also, check that you are not taking two medicines that contain the same active ingredient--this will appear in the 'active ingredient' section," he said. "And always read and follow the directions on the label. Be sure you understand the label information before taking the medicine. If you have any questions, ask your health provider or pharmacist." More information can be found on the American Academy of Family Physicians website: http://familydoctor.org/online/famdocen/home/otc-center/basics/otc.html. 9/8/08 Date: 9/2/08
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