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The right way to take over-the-counter painkillers? Read the labels

AYESHA RASCOE, HOST:

If you get a headache in the middle of the day, what's your first line of defense? For a lot of Americans, the answer is over-the-counter painkillers like Tylenol or Advil. But let's be honest, we're not always good at following the label. One 2018 study found that nearly 1 in 5 people that take NSAIDs - that is, nonsteroidal anti-inflammatory drugs like Aspirin or ibuprofen - exceed the daily recommended dose, and that could lead to big health problems. Life Kit's Andee Tagle is here to tell you what you need to know about OTC painkillers. Good morning.

ANDEE TAGLE, BYLINE: Good morning, Ayesha.

RASCOE: We've all had that terrible headache that doesn't let us sleep, or if I have the slightest headache, I just grab whatever's in the medicine cabinet. Is that a bad idea?

TAGLE: The thing about the two main types of OTC painkillers - there are those NSAIDs you just mentioned, Motrin or Aleve, and then there's acetaminophen, most commonly known as Tylenol - is that there's a limit to how much pain they can treat. If you take more than the recommended dosage, you're not necessarily getting any additional pain relief, and you're increasing your risk of side effects.

RASCOE: Yeah, that sounds kind of bad.

TAGLE: Oh, yeah. I talked about this with Dr. Trisha Pasricha. She's an instructor of medicine at Harvard Medical School. And as a gastroenterologist, she also has a lot of concerns about NSAID use specificall because you don't even always need to misuse these meds to experience serious side effects like damage to your kidneys or gastrointestinal bleeding from chronic long-term use.

TRISHA PASRICHA: You can take that appropriate safe amount no more than what is the daily recommended dose, and there can be damage over time, even when you do everything that's supposedly correct. My advice is that always take the smallest amount that you need for the shortest interval possible.

TAGLE: And starting low and slow also applies for acetaminophen because it can be hard on your liver.

RASCOE: So you mentioned acetaminophen and NSAIDs. Those are the two big options for over-the-counter pain killers. When should you use one over the other?

TAGLE: So the main difference between the two is how they work on your body to treat pain. Acetaminophen or Tylenol is understood to work by raising your body's pain threshold and regulating your body temperature, so it's very effective for fevers especially and is also used for pain relief in lots of other meds. Now, NSAIDs - brand names Motrin or Aleve - work throughout your body to reduce inflammation, and unlike acetaminophen, there are a lot of different types to choose from.

So for example, say you have chronic pain from an old injury that flares up. You might reach for naproxen because it has a longer release time, meaning less pills, longer relief throughout the day. But if you have the flu, you might want quicker hits of pain relief more often, so you go for ibuprofen, maybe. Often, people find NSAIDS more effective than acetaminophen for pain relief, but there are also more potential side effects, specifically to your heart and your gut.

RASCOE: So Andee, is the takeaway here just to avoid over-the-counter painkillers, like, altogether?

TAGLE: Absolutely not, Ayesha. Over-the-counter drugs have been regulated and approved by the FDA for use by the general public, so they're safe. You don't have to be scared. You just have to actually use as directed. That said, Pasricha says to remember, pills aren't your only pain relief option. Many NSAIDS are available in topical form, for example, like gels or patches, and those can offer similar relief without all the potential side effects.

PASRICHA: Just explore what the other options are for you that might actually even control your pain more reliably.

TAGLE: There are also entirely nonmedicated remedies, like cold packs or heating pads to ease back pain or yoga for headaches and stress relief.

RASCOE: Life Kit's Andee Tagle, thank you so much for joining us.

TAGLE: I hope it's helpful.

(SOUNDBITE OF SONG, "EVERYBODY HURTS")

R E M: Everybody hurts sometimes. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Ayesha Rascoe is a White House correspondent for NPR. She is currently covering her third presidential administration. Rascoe's White House coverage has included a number of high profile foreign trips, including President Trump's 2019 summit with North Korean leader Kim Jong Un in Hanoi, Vietnam, and President Obama's final NATO summit in Warsaw, Poland in 2016. As a part of the White House team, she's also a regular on the NPR Politics Podcast.
Andee Tagle
Andee Tagle (she/her) is an associate producer and now-and-then host for NPR's Life Kit podcast.
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