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. Appropriate use is also important. While many pain relievers can help to bring down cold and flu-related symptoms like muscle aches and sore throat, they likely won't help to relieve symptoms like cough or congestion.

If you aren't sure which over-the-counter pain reliever (analgesic) or fever reducer (antipyretic) is right for you and your symptoms, continue on to explore the differences and 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 colds, headache, muscle aches, arthritis, backache, and toothaches.

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

As acetaminophen is often included in multi-symptom cold and flu remedies as well as some prescription medications, you must be especially cautious when taking these in addition to acetaminophen or 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 notes that acetaminophen should not be used for an infant under 12 weeks of age unless directed by your physician. A fever in a young infant always needs evaluation by a doctor.

Acetaminophen may not be safe to take if you are pregnant or breastfeeding, so talk to your doctor before taking it if you fall into either of those categories. As well, it should not be used if you have three or more alcoholic beverages each day. Use of alcoholic beverages while taking acetaminophen should be discussed with your doctor or pharmacist.

Ibuprofen

Ibuprofen tablets medicine
Corbis via Getty Images / Getty Images

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 which 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, including those with risks or history of heart disease, smokers, and those with high cholesterol, high blood pressure, or diabetes. It should not be taken before or after heart surgery or before other surgical procedures.

Ibuprofen should not be used by infants under 6 months of age unless directed by their physician.

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 doctor before taking it.

Naproxen

aleve pills
Mario Tama/Getty Images

Brand names: Aleve and others

Uses

Naproxen is recommended for pain relief, fever reduction, and reducing inflammation. As an anti-inflammatory, it may also be helpful for relieving back pain or an arthritis-related spine condition such as ankylosing spondylitis (a form of inflammatory arthritis) and osteoarthritis. It is also used to relieve menstrual cramps.

Like other NSAIDs, naproxen works by inhibiting the formation of chemicals in the body known as prostaglandins to provide relief. Although naproxen works differently than ibuprofen, it ultimately has the same effect.

Contraindications

There are several conditions in which it may not be advised to take naproxen. These include heart disease, stroke, gastrointestinal problems, liver problems, and even pregnancy (especially in the last trimester). Talk to your doctor if you are unsure about the safety of taking naproxen given your medical condition.

Also talk to your doctor before using naproxen in a child under 12 years old. As well, there are concerns for those age 65 and older. A smaller dosage may be recommended as it will be as effective in the older population and less likely to cause serious side effects.ffective and are more likely to cause serious side effects.

Aspirin

Bottle of aspirin
Tetra Images/Getty Images

Brand names: Bayer, Ecotrin, and others

Uses

Classified as a salicylate NSAID, aspirin not only relieves pain, fever, inflammation, and swelling, but it also reduces the blood's ability to clot. It's often prescribed to treat symptoms associated with rheumatoid arthritisosteoarthritislupus, and other rheumatic conditions, and many people take low doses of aspirin to prevent heart attacks and stroke.

Contraindications

Talk to your provider before taking aspirin if you have asthma or you drink three or more alcoholic beverages a day. As aspirin inhibits the ability of blood to clot, it should not be taken with blood-thinners (anticoagulants) or ibuprofen.

Additionally, do not give aspirin or a product containing aspirin or salicylates to a child or teenager under age 19 (particularly when they have a viral illness, including influenza). In this age group, it may cause a potentially fatal complication known as Reye's syndrome, in which fat builds up in the brain, liver, and other organs.

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

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 doctor if you have actually been infected with the flu virus. The flu can have serious complications if not treated in a timely manner, so call your provider immediately if you believe you have contracted it.

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Article Sources
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  1. Cleveland Clinic. The common cold and the flu: Management and treatment. Updated August 2, 2016.

  2. MedlinePlus. Acetaminophen. Updated April 15, 2017.

  3. MedlinePlus. Acetaminophen overdose. Updated January 12, 2019.

  4. American Academy of Pediatrics. Acetaminophen dosage table for fever and pain. Updated April 20, 2017.

  5. MedlinePlus. Ibuprofen. Updated July 15, 2016.

  6. American Academy of Pediatrics. Ibuprofen dosage table for fever and pain. Updated May 23, 2016.

  7. U.S. National Library of Medicine DailyMed. Label: Naproxen sodium (NSAID) fever reducer/pain reliever—naproxen sodium tablet. Updated May 14, 2019.

  8. MedlinePlus. Naproxen. July 15, 2016.

  9. MedlinePlus. Aspirin. February 15, 2018.

  10. American Academy of Pediatrics. Reye syndrome. Updated November 21, 2015.

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