3 Nonopioid Analgesics
Learn how acetaminophen, NSAIDs, and topical pain relievers work in common use, along with the major risks and steps for using them safely.
Nonopioid pain relievers
Nonopioid analgesics relieve pain without opioids. Common examples are and , including ibuprofen, naproxen, aspirin, and diclofenac. Topical medicines such as diclofenac and may help with some localized pain.
The appropriate medicine and safe way to use it depend on a person’s health conditions, other medicines, and the product directions. Being available without a prescription does not by itself mean a medicine is safe for everyone.
and duplicate ingredients
appears in many prescription and over-the-counter products, including combination medicines. Before taking a cold medicine along with , check both products’ active-ingredient lists; different brand names do not rule out duplicate ingredients.
Taking more than one -containing product can cause an overdose and severe liver injury. Follow each product’s own label directions. The stated adult daily maximum is 4,000 mg from all medicines combined, but product labels may set a lower limit. This maximum is not a target dose.
A person who may have taken more than directed should get medical help or contact Poison Help right away, even if they feel well. Serious effects may not be apparent at first. In the United States, Poison Help can be reached at 1-800-222-1222.
NSAID risks and precautions
can cause gastrointestinal ulcers or bleeding, kidney problems, fluid retention, and cardiovascular events. Risk may be higher with certain health conditions, other medicines, or longer use. Someone taking an anticoagulant, or with a history of stomach ulcer or bleeding, kidney disease, or heart disease, should consult a health professional before using an over-the-counter NSAID such as ibuprofen or naproxen.
Use an NSAID only as directed, at the lowest effective dose for the shortest necessary time. Check active ingredients in all medicines, including combination products, and do not combine unless a health professional specifically advises it. Taking multiple can increase the risk of harmful effects without being a safe way to improve pain relief. Ask a pharmacist or clinician before adding another pain reliever.
For someone who is 20 weeks pregnant or later, FDA advises avoiding unless a health professional specifically advises their use. If treatment is considered necessary, the clinician determines whether it is appropriate and how to limit risk. Topical are still and should not be assumed to be risk-free.
Aspirin for children and teenagers
Aspirin may increase the risk of in children and teenagers, particularly during or after viral illnesses such as influenza or chickenpox. Ask a health professional before giving aspirin to a child or teenager.
A prescribed low-dose aspirin regimen should not be stopped on one’s own just because another pain reliever is needed. Ask a pharmacist or clinician about medicines and possible interactions.
Topical pain relievers
may cause burning, redness, or irritation at the application site. Follow the product directions and avoid contact with the eyes. Do not swallow a topical medicine if application to the skin is uncomfortable.
can still have important NSAID warnings and interactions. Use it as directed and check with a health professional when unsure. Topical medicines may help some localized pain, but they are not necessarily appropriate for every type of pain.
A safer medicine routine
Keep a list of medicines, including prescription and nonprescription products and supplements. Check active ingredients before adding an over-the-counter product, and review medicines with a pharmacist or clinician when a health condition, pregnancy, or possible interaction is involved.
Do not exceed label or prescribed directions or increase a dose on your own if it does not work quickly. If pain persists, worsens, or requires repeated medicine use, seek professional advice.