What’s in your medicine cabinet? - Pain Medications
By: Deborah Palmer
Welcome to our second edition of “What’s in your medicine cabinet?.” It’s important to know what medications you're taking, just because a medication is over-the-counter does not mean it’s without risk. All medications have potential side effects and some medications (prescription and/or over-the-counter) should not be taken together. Please always disclose any over-the-counter medications you’re taking with your doctors. If you have questions about your medications please reach out to a physician or local pharmacist.
This week is all about pain medications (analgesics). An analgesic, or pain reliever, is a medication that reduces pain.
There are three main types of analgesics:
Acetaminophen
NSAIDs
Opioids
Today we are focused on those medications (Acetaminophen and NSAIDs) that are readily available for purchase over-the-counter.
By comparison opioids are powerful painkillers that are derived from opium and are available by prescription. They can cause addiction and respiratory depression, so they should only be used under the guidance of a physician when other options have failed.
What is Acetaminophen?
Acetaminophen is a pain reliever that is found in over-the-counter medications like Tylenol. Acetaminophen is a type of medication that is commonly used to treat pain and fever.
Acetaminophen is generally considered to be safe and effective. However, it can also cause some serious side effects, such as liver damage.
What is an NSAID?
NSAIDs, or Non-steroidal Anti-Inflammatory Drugs, are a type of medication commonly used to treat pain, inflammation, and fever. These medications include Ibuprofen (Advil, Motrin), Naproxen (Aleve) and Aspirin (salicylates).
NSAIDs are the most commonly prescribed medications in the world. NSAIDs that are only available by prescription include Celecoxib (Celebrex), Etodolac (Lodine), Fenoprofen (Nalfon), Indomethacin (Indocin), and Ketorolac (Toradol). Prescription NSAIDs are more potent than over-the-counter NSAIDs and can cause more serious side effects. It's important to talk to your doctor about the risks and benefits of taking any of these medications before you start taking them.
Are over-the-counter medications safe?
While over-the-counter medications are generally considered safe, they are not without risks, they can cause serious side effects in some people. So it's important to talk to your doctor about the risks and benefits of taking any over-the-counter medications, including acetaminophen and NSAIDs. Always ensure you take medications as directed.
When are NSAIDs contraindicated?
Although NSAIDs are effective for treating a variety of conditions, they can also have some serious side effects. NSAIDs can increase your risk of gastrointestinal problems such as heartburn, stomach ulcers and bleeding. They can also increase your risk of heart attack and stroke.
NSAIDs are contraindicated in patients with active gastrointestinal (GI) bleeding, peptic ulcer disease, kidney disease, those with a history of heart attack or stroke or those taking high-dose aspirin or other NSAIDs (this including the prescription medications as listed above).
Avoid taking NSAIDs on an empty stomach.
When is Acetaminophen contraindicated?
Acetaminophen is metabolized but the liver, so if you have liver problems or heavy alcohol use you should not take acetaminophen without talking to your doctor first. Even normal doses on acetaminophen in those with liver disease can have serious side effects.
What other medications to look out for?
Cold medications are a big culprit for hidden pain medications. Many medications will contain acetaminophen for pain/headache/fever relief, though there are a growing number of cold medications that now have ibuprofen instead. Always be sure you read labels and follow dosage instructions carefully.
Please note that care for acute vs. chronic pain differs, if you are looking for personalized recommendations for your symptoms give Freedom Doctors a call and we can schedule a visit.
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