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Pain Management Health Center

Safe Use of OTC Pain Relievers

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Rule #3 for Over-the-Counter Painkillers: Stick to the Directions and Don’t Over Do

Always follow the directions for use that appear on the label.

As a general rule, doctors recommend taking an over-the-counter medicine no more than 10 days for pain and no more than three days for fever. If you’re still in pain or running a fever, call your doctor.

Experts continue to debate safe maximum dose levels. The current maximum recommended dose for acetaminophen in adults is 4 grams. That’s the equivalent of eight extra-strength (500 milligrams) tablets per day or 12 regular strength (325 milligrams) a day.  People who drink three glasses or more of alcoholic beverages should ask their doctor whether they should take acetaminophen. The combination of alcohol and acetaminophen is particularly dangerous to the liver.

Rule #4 for Over-the-Counter Painkillers: Talk to Your Doctor

If you take over-the-counter pain relievers for chronic or persistent pain, talk to your doctor. Your doctor can recommend the most effective and safest medication and monitor for signs of trouble. Serious liver damage can occur long before you notice any symptoms. You should also talk to your doctor before taking any over-the-counter pain medications or formulas that contain acetaminophen if you:

•         Have liver or kidney disease

•         Have a peptic (stomach) ulcer or suffer from bleeding in the stomach or intestines

•         Take blood-thinning medicine such as Coumadin or have a bleeding disorder such as hemophilia

•         Have three or more drinks containing alcohol every day

Whenever you’re considering taking an OTC medication, check with the pharmacist about potential interactions with other medicines you take.

“A lot of people are reluctant to call the doctor,” says Feinberg, “especially these days, with money worries. They go in and pick up something in the drug store aisle. That’s a real concern.” If you check with the pharmacist, he or she can identify potentially dangerous drug interactions or other problems -- or tell you when it’s essential to see a doctor.

Rule #5 for Over-the-Counter Painkillers: Give Non-Drug Approaches a Chance

The reassuring news is that many people can safely take over-the-counter pain medications for chronic pain, as long as they’re vigilant. “If they’re followed regularly by a physician and have no underlying liver disease or other problems, most people can safely take around 3,000 milligrams (3 grams) of acetaminophen,” says Berenger. To make that dose go as far as possible, he encourages his patients to add other non-drug approaches, like regular exercise, massage, and better sleep habits. Capsaicin cream can be useful for chronic shingles pain. Vitamin D may ease some forms of musculoskeletal pain. “What the latest warnings underscore is that we’ve relied too heavily on over-the-counter pain relievers.”

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