How Dangerous Are Over-The-Counter Painkillers? Are You at Risk?

6 years ago

Extra Strength Tylenol and Tylenol PMIt has become second nature for most of us to self medicate our headaches, joint pain, and athletic injuries with over-the-counter pain medications. Many of us may have even been directed to do so by a physician. But how safe are over-the-counter painkillers?

It's easy to forget that just because we can buy painkillers like Aspirin, Tylenol (acetaminophen), and Motrin (ibuprofen) over-the-counter, that they can still be dangerous. For the most part, these drugs are safe to use as directed. But many of us feel if a little is good, more must be better... and that's where the trouble begins.

From LA Times -- The ubiquitous but little-understood painkillers:

Used correctly, over-the-counter analgesics can help with acute aches and pains. Even more enticing, growing evidence suggests that some of them might also help fight Alzheimer's and Parkinson's disease, as well as heart attacks and some cancers.

But there are real risks. It's easy to overdose, with dangers that include stomach upset, organ failure, strokes, even death. And the safe upper limits may vary from one person to the next, depending on body size, genes and prior health conditions.

When it comes to over-the-counter painkillers, acetaminophen (brand name Tylenol) is one of the most problematic, since only a very small amount over the recommended dose can have serious complications. And complicating the issue even more, Acetaminophen is in many over-the-counter cold medicines as well.

What about Motrin and Advil (ibuprofen -- also known as NSAIDs)? Are they the safer choice? Not necessarily, especially with long-term use. This is from a 2005 article in Science Daily:

Everyday more than 30 million people take over-the-counter and prescription NSAIDs for pain relief, headaches and arthritis. Currently, there are about 20 NSAIDs available by prescription only. Many, including ibuprofen, naproxen, aspirin and ketoprofen are available over the counter.* Although NSAIDs and aspirin provide great benefit in terms of pain relief and cardioprotective effects, there is an increased risk of gastrointestinal complications ranging from stomach pain to ulcers. Moreover, these drugs are responsible for severe and potentially deadly gastrointestinal problems. Each year, the side effects of long-term NSAID use cause nearly 103,000 hospitalizations and 16,500 deaths. More people die each year from NSAIDs-related complications than from AIDS and cervical cancer in the United States.

I learned this the hard way (a few years ago) when my mother was hospitalized (and nearly died) from complications due to long term use of ibuprofen.

Did you know that there are athletes that routinely take ibuprofen to prevent pain and injury? It turns out that this could be doing more harm than good. From an article in the LA Times -- Over-the-counter painkillers can add to the pain:

After the race, runners who had taken ibuprofen showed signs of mild kidney impairment as well as mild endotoxemia, a potentially dangerous condition in which bacterial toxins present in the large intestine get into the bloodstream, Nieman and colleagues reported in 2006 in the journal Brain, Behavior and Immunity.

The drug also failed to help performance or recovery, the researchers reported in that paper and others. Both groups of runners reported equivalent amounts of pain during the race. Their times were the same. And afterward, their muscles were equally sore.

Most ironic, runners on ibuprofen actually had 50% more inflammation in their bodies after the race, even though athletes often choose to take the drug to fight inflammation.

So... What is the moral of this story?

Be careful. Be very careful. Just because you can buy something over-the-counter, it doesn't mean it can't kill you.  Don't take more than the recommended dose, and be careful with long-term use. Always talk to your doctor about any over-the-counter medication you take routinely.

Do you ever take more than the recommended amount of over-the-counter painkillers? Have you been using any over-the-counter pain medications on a long-term basis? Have you had any adverse reactions to over-the-counter pain medications? Do you worry about potential dangers of other-the-counter medications? Let us know your thoughts in comments.

Contributing Editor Catherine Morgan
Also at

Photo Credit: regesoss | Original for BlogHer

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