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Pain Relievers and Fever Reducers

What Over-the-Counter Analgesics Are

Over-the-counter (OTC) analgesics are a class of medicines that relieve pain, and depending on the dosage form, some analgesics also may reduce fever. There are two different categories of analgesics: internal and external. Internal analgesics are pain relievers and fever reducers. These medicines are intended for internal use and are either taken by mouth in the form of pills and liquids, or inserted into the rectum in suppository form. External analgesics are topical pain relievers and are not intended to reduce fever. These medicines are for external use only and are applied directly to the outer body surface in lotions, sprays, and other forms. Before choosing an OTC analgesic medicine, you should first consider the type of symptoms you have and then determine the best course of treatment.

What Pain Relievers and Fever Reducers Are For

OTC pain relievers and fever reducers, or internal analgesics, are medicines that treat both pain and fever. OTC pain relievers and fever reducers decrease fever and relieve minor aches and pains such as headache, backache, muscle aches, toothache, menstrual cramps, minor pain of arthritis, and aches and pains due to the common cold. Some pain relievers are also labeled for migraine.

How Pain Relievers and Fever Reducers Work

Pain relievers and fever reducers, like all OTC medicines, contain certain active ingredients that make the products work in the human body. These active ingredients, including how much of a substance is in each dose, are listed first on the Drug Facts label.

There are two basic types of OTC active ingredients that work as pain relievers or fever reducers:

Pain-reliever and fever-reducer active ingredients also may be found in medicines that treat multiple symptoms of the common cold, sleeplessness, or multiple symptoms related to menstruation.

*Not all products sold under a brand contain the same ingredients. Please read the OTC Drug Facts label carefully for active ingredient information for specific products.

Tips for the Safe Use of OTC medicines Containing Acetaminophen

  • Always read the OTC Drug Facts label carefully. The label tells you everything you need to know about the medicine including the ingredients, what you are supposed to use it for, how much you should take, and when you should not take the product.
  • Acetaminophen is in more than 600 OTC and prescription medicines. Because it is found in so many different medications, you may be taking more than the recommended amount without realizing it.
  • Pay attention to how much acetaminophen you are taking, and do not take more than one medicine that contains acetaminophen as you may be taking too much.
  • Never exceed the maximum daily dose of acetaminophen listed on the label. Taking more acetaminophen can cause an overdose and may lead to liver damage.
  • If you think you have taken or given too much of a medicine, contact your doctor or the national poison control helpline at 888.222.1222 immediately.
  • Talk to your doctor or another healthcare professional before using more than one medicine with acetaminophen at the same time. Acetaminophen may be written as “APAP” on prescription drugs, but it is the same ingredient.
  • If you are pregnant or breastfeeding, talk to your doctor before use.
  • Talk to your doctor before using an acetaminophen product if you have liver disease.
  • If you are taking the blood-thinning drug warfarin, speak with a healthcare professional before using an acetaminophen product.
  • Talk to your doctor or healthcare professional of you consume three or more alcoholic drinks a day.

Tips for the Safe Use of All OTC Medicines Containing NSAIDs

  • Always read the OTC Drug Facts label carefully. The label tells you everything you need to know about the medicine including the ingredients, what you are supposed to use it for, how much you should take, and when you should not take the product.
  • Do not take an NSAID for longer than what the label instructs unless you are under the supervision of a doctor.
  • Talk to a healthcare professional before using more than one pain reliever/fever reducer product at the same time.
  • Stop use and contact your doctor if your fever gets worse or lasts more than three days or if your pain gets worse or lasts more than 10 days.
  • If you have signs of stomach bleeding, such as feeling faint, vomiting blood, bloody or black stools, or stomach pain that does not get better, contact your doctor.
  • If a severe allergic reaction occurs and you experience symptoms such as hives, facial swelling, asthma (wheezing), shock, skin reddening, rash, or blisters, seek medical attention immediately.
  • Do not take more medicine or for a longer period of time than what the label recommends unless you are under the supervision of a doctor.
  • Ask a doctor before use if you have high blood pressure, heart disease, liver cirrhosis or kidney disease.
  • If you are pregnant or breastfeeding, talk to a doctor before using an NSAID.
  • If you are a woman in the last three months of pregnancy, do not use an NSAID unless you are specifically told to do so by a doctor.

Learn more about the recent FDA hearing and how to safely use OTC medicines containing NSAIDs here.

Tips for Parents

All of the tips for the safe use of OTC pain relievers and fever reducers in this section also apply to children. But there are some additional considerations when it comes to treating kids with these medicines.

  • Acetaminophen-containing medicines are available in different dosage strengths. Do not give a pain reliever or fever reducer containing acetaminophen to a child that is only intended for use in adults.
  • Severe liver damage may occur if your child takes more acetaminophen than the maximum daily dosage in 24 hours or takes acetaminophen with other medicines containing acetaminophen.
  • Ibuprofen-containing medicines are available in different dosage strengths. Do not give a pain reliever or fever reducer containing ibuprofen to a child that is only intended for use in adults.
  • Talk to a doctor before giving a child an OTC medicine containing ibuprofen if the child has not been drinking fluids, has lost a lot of fluid due to vomiting or diarrhea, or is taking a diuretic.
  • Never give an aspirin- or salicylate-containing medicine to a child or teenager with chicken pox or flu symptoms due to a rare illness called Reye’s syndrome, which is reported to be associated with these ingredients.
  • Only use the measuring device that came with the medicine.
  • If your child has a severe throat that lasts for more than two days, or is accompanied or followed by fever, headache, rash, nausea, or vomiting, stop use and contact a doctor immediately.
  • If your child’s fever or pain gets worse or lasts for more than three days, stop use and contact a doctor.
  • Pay attention to the concentration (or strength) of infants’ single-ingredient liquid acetaminophen when treating your child. The makers of infant single-ingredient liquid acetaminophen have changed the medicine from a highly concentrated dose to a less concentrated dose (80 mg/0.8 mL to 160 mg/5 mL). During this transition, old medicines could still be on store shelves and in your home. To avoid dosing errors, consumers, parents, and caregivers should carefully read the Drug Facts label on the package to identify the concentration of the liquid acetaminophen (in mg/mL), dosage, and directions for use. Parents and caregivers should ask a healthcare professional if they have any questions.
Additional tips by ages—Be sure to read the entire list for medicines that may or may not be labeled for your child:
  • Talk to a healthcare professional before giving a pain reliever or fever reducer containing ibuprofen to an infant six-months-old or younger.
  • Talk to a healthcare professional before giving a pain reliever or fever reducer containing acetaminophen to a child under the age of two.
  • Do not give a pain reliever or fever reducer containing naproxen sodium or aspirin to a child under the age of 12 unless you are under the advice and supervision of a doctor.

Keep all medicines out of the reach and sight of children.

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