Over-the-Counter Pain Relievers and Fever Reducers

Over-the-counter (OTC) medicines that treat pain and fever are some of the most commonly used drugstore treatments. The types available have differences in their safety, interactions, and who should use them. It's important to use them appropriately.

Many pain relievers can help to bring down cold and flu-related symptoms like muscle aches and sore throat. But they probably won't help to relieve symptoms like cough or congestion.

Sometimes you may not be sure which over-the-counter pain reliever or fever reducer is right for you and your symptoms. This article will discuss the differences between the medications and help you learn more about your options.

Popular Medication	Acetaminophen	Ibuprofen	Naproxen	Aspirin
Advil		√
Aleve			√
Bayer				√
Ecotrin				√
Motrin		√
Tylenol	√

Acetaminophen

Tylenol tablets — Scott Olson / Getty Images

Brand names: Tylenol and others

Uses

Acetaminophen is one of the most recommended OTC pain relievers and fever reducers available. It's used for:

If you are using acetaminophen, be careful not to take more than indicated on the label or by your healthcare provider. It is one of the most commonly overdosed medicines. And it can cause liver damage if you take too much or you have certain diseases.

Acetaminophen is often added to multi-symptom cold and flu remedies as well as some prescription medications. That's why you must be especially careful when taking these in addition to acetaminophen.

If you're not careful, you may reach an overdose level accidentally. Such multi-symptom products should not be given to children under 6 years of age in any case.

Contraindications

The American Academy of Pediatrics states that acetaminophen should not be used for an infant under 12 weeks of age unless directed by your healthcare provider. Call your child's healthcare provider for any fever in a newborn or young infant.

Acetaminophen is considered the best pain reliever for those who are pregnant or breastfeeding, but it still should be used carefully. Talk to your healthcare provider before taking it if you fall into either of those categories.

Do not use acetaminophen if you have three or more alcoholic drinks each day. If you plan to drink one or two alcoholic drinks each day while taking acetaminophen, discuss this with your healthcare provider or pharmacist first.

Ibuprofen

Brand names: Advil, Motrin, and others

Uses

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). It helps reduce swelling and pain, but it is not a steroid. Ibuprofen is great for sore muscles, sore throat, and can also be very effective at bringing down fevers. Any of these may be symptoms of the common cold or flu.

Even if you don't have a fever, taking ibuprofen may bring you some relief from the pain caused by your illness.

Contraindications

Some people shouldn't take ibuprofen. This includes those who have ever had an allergic reaction to a pain reliever or fever reducer.

As an NSAID, ibuprofen may raise the risk of heart attack or stroke in those who have risk factors. These risk factors include people who:

Have a history of heart disease
Are smokers
Have high cholesterol
Have high blood pressure
Have diabetes

Do not take ibuprofen:

Before or after heart surgery
Before other surgical procedures

Ibuprofen should not be given to infants under 6 months of age unless directed by their healthcare provider.

Ibuprofen can lead to ulcers or bleeding in the digestive tract. It may also cause side effects such as constipation, diarrhea, gas, dizziness, or ringing in the ears. If you are pregnant, discuss ibuprofen with your healthcare provider before taking it.

Naproxen

Brand names: Aleve and others

Uses

Naproxen is recommended for pain relief, fever reduction, and reducing inflammation. As an anti-inflammatory, it may also help relieve back pain. It can also relieve pain associated with an arthritis-related spine condition such as ankylosing spondylitis and osteoarthritis. Some people may also use it to soothe menstrual cramps.

Like other NSAIDs, naproxen works by blocking the formation of chemicals in the body known as prostaglandins. As a result, it relieves pain. Although naproxen works differently than ibuprofen, it ultimately has the same effect.

Contraindications

You should not take naproxen if you have a history of:

Heart disease
Stroke
Gastrointestinal problems
Liver problems

You shouldn't take naproxen if you are pregnant, especially in the last trimester. Talk to your healthcare provider if you're not sure about the safety of taking naproxen given your medical condition.

Talk to your healthcare provider before giving naproxen to a child under 12 years old. The healthcare provider can help you find the appropriate dosage.

You should also talk to your healthcare provider before taking naproxen if you are 65 or older. A smaller dosage may be recommended. The lower dosage will still be effective, and it is less likely to cause serious side effects in older people.

Aspirin

Brand names: Bayer, Ecotrin, and others

Uses

Classified as a salicylate NSAID, aspirin relieves pain, fever, inflammation, and swelling. But it also reduces the blood's ability to clot. Doctors often prescribe aspirin to treat symptoms associated with:

Many people take low doses of aspirin to prevent heart attacks and stroke.

Contraindications

Talk to your doctor before taking aspirin if you have asthma or you drink three or more alcoholic beverages a day. Aspirin prevents blood from clotting, so do not take it with blood thinners, also known as anticoagulants. You should not take it with ibuprofen either.

Additionally, do not give aspirin or a product containing aspirin or salicylates to a child or teenager under age 19. You should not give them aspirin especially when they have a viral illness, including influenza.

Children and teens who take aspirin may experience a potentially fatal complication known as Reye's syndrome. This serious medical condition causes swelling in the brain, liver, and other organs.

If you are pregnant or breastfeeding, you should not take aspirin. Talk to your healthcare provider if you become pregnant while taking aspirin so that you receive proper monitoring.

Summary

There are various kinds of OTC medications that can treat pain and fever. Not all of them are safe to use if you have certain medical conditions. They may also be unsafe if you take other medications that may interact with them.

Always follow the directions on the medicine label to make sure you can take it safely. Ask your healthcare provider which is the best choice if you're pregnant, breastfeeding, have medical conditions, take other medications, or if you're giving the medication to a child.

A Word From Verywell

While over-the-counter pain relief medicines can help ease certain cold and flu symptoms, they shouldn't replace care from a healthcare provider if you have actually been infected with the flu virus. The flu can have serious complications if not treated in a timely manner. Call your doctor immediately if you believe you've caught the flu.