At the pharmacy, you may be baffled by all the choices staring at you from the shelves. Don't be! Three OTC pain relief drugs are available in Canada today – ASA (acetylsalicylic acid), acetaminophen, and ibuprofen. These are sometimes combined with other drugs to relieve various symptoms.
For centuries, we have known about a chemical with effects similar to ASA. Roman soldiers used willow bark, which contains salicylates, to relieve pain. The modern form, ASA, was first sold as Bayer Aspirin™. Today, ASA is available in varying strengths, as both uncoated and enteric-coated tablets. Uncoated tablets dissolve quickly and are used for speedy relief of minor pains. Enteric-coated tablets have a covering on the outside that makes the drug easier on the stomach. Arthritis sufferers who take ASA regularly use this version. Your doctor may also recommend enteric-coated ASA to prevent heart attacks.
If any of the following apply to you, check with your pharmacist or doctor before taking ASA.
ASA is not recommended for children or young adults because of a link to Reye's Syndrome, which can be a very serious condition. Pregnant women should only use ASA on the advice of their doctor. Take ASA with food to reduce the chance of stomach upset.
Acetaminophen was first marketed as Tylenol™. It is the most commonly used pain reliever. It can be used by all ages, does not react badly with most other drugs, and of the three OTC pain relievers is easiest on the stomach. It works well for pain and fever, but does not affect inflammation. Some people use it for arthritis as it treats the pain of the disease. Acetaminophen comes in many forms and brands, including liquid for a child's pain and fever, regular tablets and caplets, and a timed-release tablet.
If you have liver disease, are pregnant or take prescription drugs, check with your pharmacist or doctor before choosing acetaminophen.
Ibuprofen became an OTC medication in the late 1980s. Today it is available as Advil™, Motrin™, and in generic form. Ibuprofen is effective for pain and inflammation, and is also available as a liquid to treat a child's pain and fever. Many dentists recommend this drug because it works well for dental pain. As ibuprofen is similar to ASA, many of the same guidelines in the ASA section (page 7) apply. Always take ibuprofen with food. Check with your pharmacist or doctor before taking this medication.
Codeine is available without a prescription in an eight-milligram strength, as long as the tablet contains two non-narcotic ingredients. Caffeine is often one of these ingredients. The other will be either ASA or acetaminophen. Pain relievers containing codeine are only available directly from your pharmacist. Codeine is a drug that can be abused, and large doses can damage the liver and kidneys. Codeine can also cause drowsiness and constipation (trouble moving the bowels). For these reasons, your pharmacist must document the sale of these products to ensure the health and safety of those with pain.
Muscle relaxants are also combined with pain relievers to treat aches, strains and stiff muscles. Methocarbamol and chlorzoxazone are the two most commonly used in Canada. These products should be taken with food and can cause drowsiness. Robaxacet™, Robaxisal™, Robax Platinum™ and Tylenol™ Muscle Aches and Body Pain are all muscle relaxants.
Advil Nighttime is another combination product that has recently been brought to market. It has ibuprofen for pain and diphenhydramine (Benadryl) as a sleep aid. It can be used on a short-term basis if your pain is making it difficult to sleep. If you have glaucoma, chronic lung disease or difficulty urinating due to enlarged prostate, you should not take this product.
Rubs can be an effective way to treat sore muscles or arthritis. They act as counter-irritants. The ingredient in the rub causes a very mild irritation in the skin that the body notices instead of the pain. You can choose a rub with a warming or cooling effect, depending on your preference. Most rubs take rapid effect, except for those containing capsaicin. Capsaicin has an effect that builds over time and must be used regularly. Do not apply heat (including baths or heating pads) or wraps to the affected area while using a rub. This can burn you.
The next time you are looking for pain relief, talk to your pharmacist. While there are few ingredients for pain relief on the market, many brands and dosage forms are on the pharmacy shelves. With your pharmacist's help, you can choose the one that is right for you.