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Pain Relievers

Not that many years ago, back when I was a kid, choosing a nonprescription pain reliever was simple: You could have aspirin or aspirin. Things haven't been so simple, though, since acetaminophen and ibuprofen climbed onto pharmacy shelves. And recently, with the appearance of naproxen sodium, they got even more complicated.

Which one's which and what are they good for? Basically, the four general types of pain killer are about equally effective. But some do work better than others for certain problems, and their side effects differ significantly. Here's what you should know about these medications, along with a few examples of common brand names to help you in your shopping.

Aspirin (Anacin, Ascriptin, Bufferin, Ecotrin, Empirin)

This is the most economical form of relief for pain and inflammation, and it also reduces fever. Generic brands are widely available and are cheaper yet. Aspirin should not be taken by people with aspirin allergy, asthma, bleeding disorders, gout, or ulcers—or by those who are taking blood thinners. Overuse can lead to upset stomach, bleeding in the digestive tract, and ulcers. Children should avoid it because of Reyes syndrome, and women should not take it during the last three months of pregnancy.

Ibuprofen (Advil, Ibuprin, Motrin IB, Nuprin)

Very similar to aspirin in makeup and effects. But you might keep some around for your significant other, because ibuprofen does seem to be more effective than aspirin for menstrual cramps. Side effects, too, are similar to those of aspirin, with the exception that ibuprofen is not associated with Reyes syndrome.

Acetaminophen (Excedrin Aspirin Free, Panadol, Tylenol)

Effective at relieving pain (headache, for example) but does not relieve inflammation (arthritic joint pain, for example) or reduce fever. Used as directed, acetaminophen has no side effects. It may, however, be more toxic in overdose than the other medications discussed here, and alcohol enhances its toxicity.

Naproxen sodium (Aleve)

Very similar to ibuprofen in effects and side effects. This one's a newcomer to the retail shelves, but it has been in use as a prescription drug for some time. Its safety for use at any time during pregnancy has not been determined.

There are, of course, variations on the basic ingredients. Buffered tablets claim to reduce stomach upset, as do enteric-coated pills. The latter may be more effective, but they take longer to relieve pain.

The main thing to remember about any pain reliever is that it's for temporary use. If the pain doesn't go away and stay away, your body is sending a message. See your doctor and deal with the problem, not just its symptoms.

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