Over-the-counter (OTC) pain medications are effective, serious medicine. Take as low a dose as needed, for as short a period as possible, to control your pain. Cut back when you feel better.  Keep track of what you take.

Non-Steroidal Anti-inflammatory drugs (NSAIDs)

  • Relieve pain by relieving inflammation;. There are many brands on the market.
  • Tylenol (acetaminophen) is NOT an NSAID
  • Pick the ONE that’s most convenient and works for you; none of them are “better” than the

Ibuprofen = Advil = Motrin

OTC Pills                                  = 200 mg each

Prescription strength pills           = 800 mg each

Maximum dose/day       = 2400 mg = 12 Advil/day

For severe pain take      up to 4 pills, 3 times a day

For mild pain take          1-2 pills, 1-2 times a day

—-OR—-

Naproxen = Aleve = Naprosyn

OTC Pills                                  = 220 mg each

Prescription strength Pills           = 500 mg each

Maximum dose/day             = 1000mg = 4 Aleve

For severe pain take            2 pills, 2 times a day

For mild pain take               1 pill, 1-2 times a day


Common NSAID side-effects:

  • DO NOT take NSAIDs if you’ve had a stomach ulcer, kidney disease, take blood thinners, or have another fragile health condition. Patients over 65 have to be especially cautious, and only take NSAIDs if followed closely by their Primary-Care Physician.
  • Stomach upset, nausea—Eat frequent, small meals and healthy snacks throughout the day. Some prescription NSAIDs, like meloxicam or Celebrex, are easier on the stomach and might be a better choice for you.
  • High blood pressure—Follow your blood pressure readings carefully. If it goes up, you may have to stop the NSAID.
  • Kidney failure—if you have kidney problems, are dehydrated or have poor circulation, avoid all NSAIDs. If you retain fluid and your hands and feet swell, stop the NSAID.
  • Most healthy patients can handle NSAIDs without problems. If you are conscientious about using these drugs, you’ll feel better while you keep an eye out for side effects.

Acetaminophen = Tylenol

  • Acetaminophen is NOT an NSAID.  It is pain reliever only.  It’s considered safer because it does not irritate your stomach, raise your blood pressure, damage your kidneys or interfere with blood clotting.
  • Each pill contains =
    • 325 mg, Regular Strength, up to 3 tabs, 3x/day
    • 500 mg, Extra Strength,     up to 2 tabs, 3x/day
    • 650 mg, Arthritis Strength, up to 4 tabs/day
    • Maximum dose/day           = 3000 mg
  • Acetaminophen is found in many OTC and prescription pills; be careful and take less than 3000 mg/day. Read the labels and do the math!
  • Vicodin tabs = 5-10 mg hydrocodone (an opioid pain medication) and 325 mg acetaminophen, each.

Combine NSAIDs and Acetaminophen Safely

  • NSAIDs and Acetaminophen (Tylenol) work differently in your body for the same result: pain relief. Take both together to add up their benefits, but lower the risk of side effects by taking less of each.
  • Try these combinations with a small dose of each medicine. This leaves room to take more as needed for a flare-up:
    • 2 Advil + 2 Tylenol, up to 3x/day   OR
    • 1 Aleve + 2 Tylenol, up to 2x/day  OR
    • (1 Meloxicam each day) + (2 Tylenol up to 3x/day)
    • Take them together, or alternate each drug every 4-6 hours.

NOTE: watch for cold-and-sinus remedies that also include these drugs!