Over-the-counter, or OTC, medications are drugs that can be bought without a prescription. They account for 60 percent of all medication use in the United States, according to an article written by Dr. Ronald Black in the June 2003 issue of the journal "American Family Physician." The University of Chicago Center for Peripheral Neuropathy reports that OTC pain medications are the most commonly purchased drugs.
Acetaminophen
Acetaminophen works well as an antipyretic, or fever-reducer, but does not help in reducing swelling or inflammation. It can provide mild analgesia, or pain relief, by increasing the amount of discomfort the body can tolerate before signaling the sensation of pain. Deemed safe for general consumption and even for pregnant women, acetaminophen still has known toxic effects. People who drink a lot of alcohol and those with liver problems should consult a health professional before starting acetaminophen because it can cause further liver damage. The American Chronic Pain Association states that the maximum recommended dose for acetaminophen is 4 grams in 24 hours. Heavy alcohol users should limit their daily dose to half of this to decrease the chances of liver toxicity. Users must also be cautious when using acetaminophen in combination with other medicines, which may already contain acetaminophen. APAP, which stands for N-acetyl-para-aminophenol, is another name for acetaminophen.
Nonsteroidal Anti-Inflammatory Drugs
Nonsteroidal anti-inflammatory drugs, or NSAIDs, comprise a variety of medications available in both OTC and prescription strengths. These drugs work well in fighting inflammation in addition to providing analgesic and antipyretic effects. NSAIDs reduce the body's formation of an enzyme known as prostaglandin, which sends pain signals to the brain. Adverse reactions to NSAIDs include upset stomach, worsening of high blood pressure, increased risk of bleeding and kidney damage.
Dr. Black's article describes acetylsalicylic acid, or aspirin, as one of the most commonly used OTC pain relievers. Not only a reliever of minor aches and pains, aspirin also has benefits in preventing cardiovascular disease. According to the National Institutes of Health, children should not take aspirin because of its association with a potentially life-threatening condition known as Reye's syndrome, in which sudden brain damage and liver failure occur.
Other OTC NSAIDs include ibuprofen and naproxen.
Topical Pain Medications
Topical pain medications are available in gels, creams, lotions and patches. The Mayo Clinic reports on three commercially available types: counter-irritants, salicylate based and capsaicin compounds. Counter-irritants contain ingredients such as menthol or eucalyptus oil, which make the skin feel hot or cold and cause a distraction from pain sensations. Salicylate-based products have similar analgesic and anti-inflammatory actions similar to those of oral aspirin. Capsaicin compounds deplete a chemical called substance P, which is important in sending pain signals to the brain.
Adverse effects of topical pain medications include local skin irritation and strong odor. People with a known allergy to aspirin and those taking blood thinners should consult their doctors before using salicylate-based products.
References
- University of Chicago Center for Peripheral Neuropathy: Treatment and Therapy---Pain Medication
- Medline Plus: Pain Medications
- American Chronic Pain Association: ACPA Consumer Guide to Pain Medication & Treatment, 2010 Edition
- "American Family Physician"; Over-the-Counter Medications in Pregnancy; Ronald Black, M.D. and D. Ashley Hill, M.D.; June 2003
- Mayo Clinic: Arthritis pain relief-Creams and gels for aching joints
