HEALTHY LIVING
How to Choose the Right Pain BY CHRIS ILIADES, M.D. T
he most widely used over-the-counter drugs, by far, are pain relievers. Acetaminophen
(Tylenol) is the most common, followed by nonsteroidal anti- inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and aspirin. Knowing the difference is the key
to taking a pain reliever safely and effectively. “Nonsteroidal anti-inflammatory
drugs treat both pain and inflammation,” explains Amad Qadeer, M.D., assistant professor in anesthesiology, critical care, and pain medicine at UTHealth Houston McGovern Medical School. “Nonsteroidal means they are not
steroids, which also treat inflammation but cause more side effects.” Making the right choice means
reading the labels. Brand names alone can be confusing. For example, Advil and Motrin are both ibuprofen. Tylenol is acetaminophen. Aleve is naproxen. Advil Dual Action is ibuprofen and acetaminophen. Excedrin has both aspirin and acetaminophen.
80 NEWSMAX MAXLIFE | APRIL 2023 NSAIDs and acetaminophen
are also both commonly found in many cold and cough medicines and combined with some prescription- strength pain medications.
WHEN TO TAKE ACETAMINOPHEN Acetaminophen is called paracetamol in most of the world outside the United States. It was first introduced here as Tylenol in 1955. It relieves pain and reduces fever
without side effects for most people, which is why it is the most widely used drug in the world. Despite its wide use, how it works
is still a mystery. “Its mechanism of action is
unknown, but unlike aspirin it does not increase bleeding, and unlike NSAIDs it does not reduce inflammation,” says Qadeer. “Its effect on pain is about the
same as these other drugs. The best use of acetaminophen is to lower a fever or treat a headache. It may also be used for migraine headache.” Other conditions that respond well
to acetaminophen include back, neck, or joint pain due to osteoarthritis. This type of arthritis is caused by wear and tear over time.
On the other hand, rheumatoid
arthritis is caused by inflammation, so it responds better to an NSAID. Acetaminophen reduces pain and
fever for about four hours and acts quickly. It has fewer side effects than NSAIDs, although some people may experience nausea, vomiting, or a headache. However, acetaminophen has a
dark side if you take too much. Taking more than 4,000
milligrams of acetaminophen in one day can lead to dangerous liver failure. The safest dose is less than 3,000 milligrams. If you are a heavy drinker (three
or more alcoholic drinks per day) or have liver disease, the safe dose may be lower for you, so you should talk to your primary care provider before you take acetaminophen. More than 60 million Americans
take acetaminophen on a weekly basis, so you would think that it must be very safe. In fact, according to the National
Institutes of Health National Library of Medicine, acetaminophen overdose is the second most common cause of liver transplantation, and it results in about 56,000 emergency room visits each year, mostly for children.
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