The 9 Best OTC Pain Relievers of 2020

Nix aches and more with these drugstore solutions

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Our Top Picks

Best First-Line Defense: Tylenol Regular Strength at Amazon

"Acetaminophen can be useful for treating headaches, muscle aches, menstrual cramps, sore throats, cold symptoms, and fevers."

Best Extra-Strength First-Line Defense: Tylenol Extra-Strength Tablets at Amazon

"Offers the recommended extra-strength dose of acetaminophen in one tablet."

Best Second-Line Defense: Advil Coated Pain Reliever and Fever Reducer Tablets at Amazon

"Some reviewers go as far as to note that Advil’s Coated Pain Reliever and Fever Reducer Tablets actually taste good—”like candy.”"

Best Second-Line Defense Runner-Up: Aleve Pain Reliever & Fever Reducer Caplets at walgreens.com

"Naproxen works well to relieve pain, fever, inflammation, and cold symptoms."

Best for Nighttime Use: Tylenol PM Extra-Strength Pain Reliever & Sleep Aid Caplets at walgreens.com

"Each tablet offers the recommended extra-strength dose of acetaminophen, along with 25 mg of diphenhydramine HCl."

Best for Targeted Pain Relief: Aspercreme with Lidocaine Maximum-Strength Pain Relief Cream at Amazon

"It's a fast-acting numbing cream that you can apply topically to reduce pain and discomfort."

Best for Joint Pain: Voltaren Topical Arthritis Pain Relief Gel at walgreens.com

"Instead of simply numbing your skin, diclofenac can alleviate pain from the inside out."

Best for Burning, Tingling, and Numbness: Capzasin HP Pain Relief Creme at Amazon

"Capsaicin works by depleting the neurotransmitter responsible for signaling pain."

Best for Muscle Aches: Icy Hot Cream with Lidocaine at Amazon

"It’s non-greasy, so wearers won’t have to worry about the cream becoming slippery or sticky."

Over-the-counter (OTC) pain relievers can be incredibly helpful in treating minor aches and pains. They can help relieve fevers, headaches, and other common ailments, and can be purchased at most drug stores and pharmacies.

But OTC pain relievers are not intended for long-term use. Taylor Butler, PharmD, Clinical Pharmacist at Vanderbilt University Medical Center, tells Verywell Health that you should talk to a doctor if you’re taking OTC pain relievers regularly (several times a week for several weeks). Some OTC options can present serious side effects when used habitually, and your doctor may want to monitor your health while you're taking them.

Let your doctor know if the OTC pain relievers you’re taking aren’t alleviating your symptoms, because you may need a stronger medication—or a different treatment method entirely. Your doctor should be aware of any other medications you're taking in order to prevent potentially harmful drug interactions.

Our Top Picks

1

Best First-Line Defense: Tylenol Regular Strength Caplets

Tylenol Regular Strength

 Courtesy of Target

When people approach Butler looking for an over-the-counter pain reliever, he says his first line of defense is acetaminophen. Acetaminophen can be useful for treating headaches, muscle aches, menstrual cramps, sore throats, cold symptoms, and fevers. It’s the active ingredient in a number of name-brand drugs (like Tylenol and Dayquil) and according to Butler, tends to present fewer side effects than some of its alternatives.

When seeking out OTC pain relievers, Butler says you’ll want to pay attention to the active ingredient, as well as its recommended and maximum doses. According to Butler, the recommended regular-strength dose for acetaminophen is 325 milligrams (mg). He recommends taking one to two tablets, as needed, every four hours. The maximum dose for acetaminophen is 3,000 mg per day—that’s about nine regular-strength tablets. To make dosing easy, Butler recommends looking for an OTC medication that offers the active ingredient at its recommended dose. Tylenol’s Regular-Strength Pain Reliever does exactly that, offering 325 mg of acetaminophen in each tablet.

If you have liver issues, Butler recommends consulting with your doctor before you take acetaminophen. They may instruct you to take a pain reliever with a different active ingredient, or they may recommend a lower maximum dose of acetaminophen.

Butler says that in many cases, there is no real difference between a name-brand pain reliever and its generic alternative. Often, when the active ingredients and doses are the same, the options are virtually interchangeable. For this reason, he recommends seeking out generic options whenever possible, as they tend to be less expensive than their name-brand counterparts.

2

Best Extra-Strength First-Line Defense: Tylenol Extra-Strength Tablets

There are many regular-strength acetaminophen options out there. But if you want a stronger, more concentrated version of the active ingredient, you can look for OTC pain relievers that offer acetaminophen at its extra-strength dose. 

While the recommended regular-strength dose for acetaminophen is 325 mg, the recommended extra-strength dose is 500 mg. If you’re taking extra-strength acetaminophen, Butler recommends taking one to two tablets, as needed, every six hours. The maximum dose for acetaminophen—whether you’re taking regular-strength or extra-strength tablets—is 3,000 mg per day, or six extra-strength tablets.

Basic Care’s Extra-Strength Acetaminophen is a generic alternative that uses the same active ingredients as its brand-name counterpart. Both options offer the recommended extra-strength dose of acetaminophen in each tablet, and neither are diluted by unnecessary active ingredients.

3

Best Second-Line Defense: Advil Coated Pain Reliever and Fever Reducer Tablets

Butler says his second line of defense is a nonsteroidal anti-inflammatory drug (NSAID), like ibuprofen or naproxen. NSAIDs work by inhibiting the cyclooxygenase (COX) enzyme, which can be responsible for pain and inflammation (among other things). Butler says he prefers ibuprofen and naproxen to other NSAIDs because they only temporarily inhibit the COX enzyme. Some research has suggested that other NSAIDs, like aspirin, irreversibly inhibit the COX enzyme.

Ibuprofen can be used to relieve pain, fever, inflammation, and cold symptoms. It’s the active ingredient in a number of name-brand drugs—namely, Advil, Midol, and Motrin. Though ibuprofen is common, you’ll want to let your primary care provider know if you start taking it consistently. “We try to use [NSAIDs] just for short-term use,” Butler says. NSAIDs should be used for only 10 days at a time because they can cause serious side effects—like heart attack, stroke, and gastrointestinal bleeding—when used habitually.

The recommended dose of ibuprofen is 200 mg. Butler recommends taking one tablet, as needed, every four hours. He notes that you can increase each dose from one tablet to two tablets if the lower dose is proving ineffective. The maximum dose of ibuprofen is 3,200 mg per day—that’s about 16 tablets.

Advil’s Coated Pain Reliever and Fever Reducer Tablets offer the recommended dose of 200 mg of ibuprofen in each tablet. Some reviewers go as far as to note that the tablets actually taste good—”like candy.”

4

Best Second-Line Defense Runner-Up: Aleve Pain Reliever & Fever Reducer Caplets

Aleve Pain Reliever & Fever Reducer Caplets

 Courtesy of Amazon

Like ibuprofen, naproxen is another second-line defense NSAID recommended by Butler, because NSAIDs tend to be associated with more side effects than acetaminophen.

Naproxen works very similarly to ibuprofen, so the two ingredients have comparable pros and cons. Naproxen can be used to relieve pain, fevers, inflammation, and cold symptoms. But serious side effects—like heart attack, stroke, and gastrointestinal bleeding—can occur, particularly if the pain reliever is used regularly over long periods of time.

The recommended dose of naproxen is 200 mg. Butler recommends taking one tablet, as needed, every eight hours. The maximum dose is 600 mg per day—that’s about three tablets. Naproxen is also commonly available as naproxen sodium, for which the recommended dose is 220 mg. Again, Butler recommends taking one tablet, as needed, every eight hours. The maximum dose of naproxen sodium is 660 mg per day, or three tablets. Aleve’s Pain Reliever & Fever Reducer Caplets offer 220 mg of naproxen sodium in each tablet, making it easy to keep track of dosing.

5

Best for Nighttime Use: Tylenol PM Extra-Strength Pain Reliever & Sleep Aid Caplets

Tylenol PM

Nighttime OTC pain relievers pair standard active ingredients—like acetaminophen, ibuprofen, and naproxen—with antihistamines, which can be used to combat allergies and can cause drowsiness. 

“PM drugs usually contain antihistamines, which are OK to take,” Butler says. “Just be cautious in taking too much with other products or in combination with other sleep aids.” Remember, if you’re already taking any kind of medication, you should talk to your doctor before adding an OTC pain reliever to the mix; different medications can interact in potentially harmful ways.

Tylenol PM’s Extra-Strength Pain Reliever & Sleep Aid Caplets offer 500 mg of acetaminophen in each tablet—that’s the recommended extra-strength dose of acetaminophen, which is Butler’s preferred active ingredient for pain relief. Each tablet also contains 25 mg of diphenhydramine HCl, the active ingredient in Benadryl, which can cause drowsiness that will help you sleep through the night.

6

Best for Targeted Pain Relief: Aspercreme with Lidocaine Maximum-Strength Pain Relief Cream

Oral pain relievers aren’t the only OTC options on the market. For specific kinds of pain, Butler will recommend topical pain relievers, instead. Lidocaine, for example, is particularly useful for treating localized pain.

“If [someone] can point to a spot and say, ‘This is where the pain is,’ we’ll recommend using lidocaine to numb the area,” Butler says. Lidocaine is a local anesthetic, which numbs the area where it’s applied, temporarily blocking some of the nerve signals that indicate pain and discomfort. Butler says you can find lidocaine in a number of different forms: ointments, creams, gels, and patches.

The Aspercreme with Lidocaine Maximum-Strength Pain Relief Cream is a fast-acting numbing cream that you can apply topically to reduce pain and discomfort. It's designed to be odor-free and non-greasy, rather than slippery, smelly, or sticky. And it promises to work within minutes.

7

Best for Joint Pain: Voltaren Topical Arthritis Pain Relief Gel

Voltaren Topical Arthritis Pain Relief Gel

 Courtesy of Walmart

Many topical creams numb the area of the skin where they’re applied, working at surface-level. But because joint pain isn’t a surface-level issue, Butler recommends using a topical NSAID, like a diclofenac gel. Like ibuprofen and naproxen, diclofenac works by inhibiting the COX enzyme. However, some research suggests it may target other enzymes, as well. So instead of simply numbing your skin, diclofenac can alleviate pain from the inside out. 

Diclofenac is available in a few different forms, but Butler specifically recommends diclofenac gel. Voltaren’s Topical Arthritis Pain Relief Gel is designed to alleviate pain, increase mobility, and reduce stiffness. Unlike some other topical creams, Voltaren’s Topical Arthritis Pain Relief Gel is non-greasy, so you won’t have to worry about it becoming slippery or sticky.

Because diclofenac is an NSAID, you’ll want to reserve it for short-term use. You’ll also want to watch out for double-dosing; if you decide to pair an NSAID gel, like Voltaren’s Topical Arthritis Pain Relief Gel, with an oral NSAID, like ibuprofen or naproxen, you’ll need to pay careful attention to maximum doses.

8

Best for Burning, Tingling, and Numbness: Capzasin HP Pain Relief Creme

If you’re dealing with burning, tingling, or numbness, Butler recommends seeking out a topical cream with capsaicin as its active ingredient. Capsaicin is a chemical compound found in chili peppers, and research has suggested it can be used to relieve pain. Capsaicin works by depleting the neurotransmitter responsible for signaling pain.

Capzasin HP’s Pain Relief Creme is a capsaicin-based cream designed to offer pain relief. Unlike many topical creams, Capzasin HP’s Pain Relief Creme is odor-free, making it suitable for those who find themselves irritated by strong smells. Reviewers note that Capzasin HP’s Pain Relief Creme is a powerful pain reliever and often offers a warming sensation they appreciate.

Capsaicin may burn when first applied, so you'll want to wash your hands well after use. Some reviewers suggest applying the cream with gloves to avoid getting capsaicin all over your hands.

9

Best for Muscle Aches: Icy Hot Cream with Lidocaine

When treating muscle aches, Butler says a few different active ingredients can do the trick. According to him, menthol, camphor, and methyl salicylate are all great options. Menthol is an organic compound extracted from mint and peppermint oils, which can be used to alleviate pain and irritation. Camphor is an organic compound extracted from camphor wood, which can be used to relieve pain. And methyl salicylate is an organic compound derived from salicylic acid, which can be used to relieve acute muscle and joint pain. Again, Butler says all of these active ingredients can be helpful, and he recommends finding a product based on one of them.

Icy Hot’s Cream with Lidocaine is a pain-relieving topical cream with two active ingredients: lidocaine and menthol. Both lidocaine and menthol can offer surface-level relief by temporarily numbing some of the pain receptors in the area where they’re applied. Icy Hot’s Cream with Lidocaine is designed to be fast-acting and long-lasting. And because it’s non-greasy, wearers won’t have to worry about the cream becoming slippery or sticky.

Final Verdict

For a first-line defense against pain relief, Tylenol Regular Strength Caplets are the safest, most reliable OTC option for mild pain. If you know you're going to need something slightly stronger, Tylenol Extra-Strength Tablets will give you the support you need to knock out that headache (or any ache) once and for all.

What to Look for in an OTC Pain Reliever

Dosage: Dosage varies by ingredient, so be sure to check the recommended daily dosage and ask your doctor for guidance, especially if you're taking any other prescription medications. Most tablet pain relievers on this list will include the recommended dose in a single serving (one or two tablets, depending on the brand), so for minor aches and pains, refer to the product's recommended dosage.

Form: Most pain relievers can be taken orally (like Tylenol and Advil) or as topical creams (like Voltaren or Aspercreme). Depending on the severity and location of your pain, you may want to consider opting for one over the other.

Ingredients: OTC pain relievers aren't a one-size-fits-all treatment. Ibuprofen, acetaminophen, and naproxen are some of the most commonly-used ingredients in oral pain relievers, while lidocaine and diclofenac gels are more common for topical application. Talk to your doctor about which OTC pain reliever is right for you, as each of these can have side effects if used for long periods of time.

Why Trust Verywell

As a seasoned health writer, Lindsey Lanquist understands how vital quality product recommendations can be—especially when you’re navigating tons of different over-the-counter options. Every product in this piece came personally recommended by a licensed pharmacist, based on research, effectiveness, and potential side effects.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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