Stay Safe with Over-The-Counter Pain Medications

07/02/2018 | 2 min. read

Dr. Joseph Pergolizzi

Dr. Joseph Pergolizzi

For millions, managing pain boils down to reaching for a bottle of over-the-counter (OTC) pain medicine—most likely acetaminophen or ibuprofen. It seems simple: You can buy these drugs just about anywhere, and no one regulates how much you purchase.

Yet OTC drugs can be quite dangerous if taken incorrectly. So, you need to know how to manage pain safely if you are including OTC medications in your treatment plan.

Dosage Dangers When Managing Pain

The OTC medication acetaminophen is considered by many to be a safe pain reliever. Physicians even recommend it to treat fevers in children. This drug, however, can be dangerous—even fatal—if you take too much. In fact, acetaminophen overdose is one of the most common causes of poisoning death in the United States.

The recommended maximum daily adult dose of acetaminophen is 4,000 mg (or 4 g) per day. In a typical bottle of OTC acetaminophen, each tablet contains 500 mg. If you take two of those tablets (1,000 mg) every six hours, that equals the maximum dose. Never exceed that amount.

The tricky thing about acetaminophen is that it is found in many other OTC products. If, for example, you also are taking a cold remedy on top of managing pain, be sure to check that your total daily acetaminophen intake never exceeds 4,000 mg.

Long-Term Consequences to Consider

Another downside of acetaminophen is that it may not be appropriate for long-term use because it can cause liver damage. This is something you need to discuss with your doctor, particularly if you already have liver damage.

Due to its impact on the liver, some physicians believe acetaminophen should not be used by, or should be limited for, patients who regularly consume alcohol. My opinion? Don’t take acetaminophen if you drink alcohol because of the added stress it puts on the liver.

Like acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are quite common for managing pain, and there are many commercial products on the market. Again, you always need to check labels to determine the maximum daily dose of these drugs, and do not exceed it. Some NSAIDs have been associated with cardiovascular or circulatory risk, as well as stomach and other health problems. So, check with your doctor about using these pain relievers.

The Bottom Line: When managing pain with OTC medications, always remember to:

  • Read the label! Take all OTC medications only as directed.
  • Check for acetaminophen in any product you're taking, so you don't exceed the recommended daily amount.
  • Tell your doctor if you take OTC remedies for managing pain. Your doctor should know what you’re taking to be sure it is appropriate for you and does not interact with other drugs you take. Plus, it can help your doctor to better understand your pain.
  • Do not take an OTC product longer than recommended on the product label. Many of these drugs are only safe for short-term use.

More Dr. Pergolizzi Advice on Managing Pain

Dr. Joseph Pergolizzi

Meet Dr. Joseph Pergolizzi

Dr. Joseph Pergolizzi is an internationally recognized expert in pain medicine who has spent much of his career studying what pain is, why it occurs, and how best to treat it. That experience has led him to believe strongly that there are often ways to relieve or manage pain which are overlooked or discounted, and that the most effective treatment approaches are always multi-modal.

More About Dr. Joseph Pergolizzi