Over-the-Counter Painkillers

Drugstores are filled with row after row of over-the-counter medicines designed to ease aches and pains, but Local 4 Dr. Frank McGeorge said many people don't know how to pick which painkiller works best for which type of pain.

All pain medicines are not the same. McGeorge reported there are essentially two main categories of over-the-counter pain medicine, those with anti-inflammatory effects and those without.

Download:Guide To OTC Pain Relievers
Download:Guide To OTC Cold Medicines
Download:Guide To OTC Stomach Medicines

Acetaminophen, also known by its popular brand name, Tylenol, doesn't have anti-inflammatory properties. Acetaminophen works in the brain by blocking the creation of chemicals that allow us to feel pain. It essentially increases your pain tolerance which means it will work for virtually any painful condition, but doesn't affect the source of the pain.

McGeorge reported acetaminophen is a great first choice for headaches, the aches of a cold or the flu, and other generalized discomfort.

In contrast to acetaminophen, the anti-inflammatory pain medicines work at the site of the pain itself to block enzymes that contribute to the pain and inflammation causing it.

Aspirin is the oldest anti-inflammatory drug in use. McGeorge reported aspirin's broad range of activity makes it useful in treating other conditions such as heart disease, but also makes it more prone to side effects and less effective against inflammation compared to similar drugs.

The two most common non-aspirin over-the-counter anti-inflammatories are ibuprofen and naproxen. McGeorge reported both work very well for conditions associated with inflammation like arthritis, back pain or muscle strains.

Naproxen's effects last eight to 12 hours, and ibuprofen lasts six to eight hours.

McGeorge reported most women said ibuprofen and naproxen work best for menstrual cramps, with an edge toward naproxen because it lasts longer.

One of the most important things consumers should consider are the side effects. McGeorge said the anti-inflammatory medicines can all cause stomach irritation and even ulcers if taken in a high-enough dose. This is especially seen with aspirin and ibuprofen. Aspirin also makes it harder for your blood to clot, which can be a problem if you are injured or require surgery.

McGeorge reported acetaminophen doesn't effect blood-clotting or cause much stomach upset, and it's the best choice for pain during pregnancy. But McGeorge cautioned it should not be used by people with liver disease or those who drink more than a few alcoholic drinks a day.

McGeorge said the reality is no two people respond exactly the same way and sometimes finding the pain medication that works best for you is a matter of trial and error.

McGeorge said if you have severe pain that you've never experienced before you should be seen by a doctor, but if you've had similar pain in the past or it's not severe, it may be worth trying something at home first.

Over-the-Counter Stomach Medicines

There are plenty of over-the-counter medicines that promise relief from heartburn, indigestion, diarrhea and gas. Pepto-Bismol is a favorite of many moms, with commercials that promise to ease "nausea, heartburn, indigestion, upset stomach, diarrhea."

Video:How To Pick The Right OTC Medicines For Stomach Trouble

McGeorge said Pepto-Bismol will coat your stomach to ease indigestion and heartburn, but there are definitely better medicines to treat those symptoms.

McGeorge reported to really treat heartburn and indigestion that causes a burning feeling or bloated discomfort after eating, the best medicines are antacids. Fast-acting antacids taste a little chalky, but they immediately neutralize the acid in your stomach. Common ingredients in this group are calcium carbonate (such as Tums), aluminum hydroxide, and magnesium hydroxide, either alone or in combination.

McGeorge said to ease bloating and neutralize gas, look for the ingredient simethicone, sold alone as Mylicon or Gas-X.

There are also over-the-counter medications that work specifically for the pain of stomach irritation, heartburn, or even an ulcer. These are medicines that stop acid from being produced in your stomach and include cimetadine (sold as Tagamet) and ranitadine (sold as Zantac). Less acid means less pain. The so-called "purple pill," Prilosec, is also available over-the-counter, but it should only be used for short periods because it shuts off all acid production. McGeorge said none of these medicines act immediately, so you really need to take them before you get heartburn.

If diarrhea is your chief complaint, McGeorge said this is where the active ingredient in Pepto-Bismol really can make a difference. That ingredient is bismuth subsalicylate, which is well known to have antibacterial action. It also helps decrease secretion of liquid into the intestine, which will make the diarrhea less watery. For that reason, McGeorge reported Pepto-Bismol is a great first-choice for diarrhea after traveling.

Another way to manage the symptoms of diarrhea, including the cramps, is with medications that slow the muscle activity of the intestines like loperamide, sold as Immodium. McGeorge said these medications allow your body more time to absorb water from the intestine leading to less watery stool.

McGeorge cautioned over-the-counter medicines can get you through a simple illness, but if you have severe pain, fever, black or bloody stool or if your symptoms don't improve over a couple of days, you need to see a doctor.

Over-the-Counter Cough and Cold Medicines

When you're suffering from a cold, you'll try anything to get rid of the coughing, runny nose, body aches and fever.

McGeorge said when it comes to easing your symptoms, more is not necessarily better. That's because more active ingredients means more potential side effects. Taking more than one combination product also increases the risk of overlapping active ingredients, which can lead to serious side effects.

Over-the-counter cough and cold medicines all have different active ingredients to target specific symptoms. McGeorge said the secret is figuring out what symptom you want to treat and picking the right ingredient for the job.

There are four major symptoms over-the-counter cold medicines treat: coughs, nasal problems such as stuffy, runny noses and sneezing, congestion in the chest and fever with body aches.

The major ingredient to decrease coughing is dextromethorphan. That's what the "DM" stands for on the box. This is chemically related to some of the narcotic cough suppressants such as codeine but doesn't cause drowsiness. McGeorge said because coughing is a natural reflex, he only recommends cough suppressants at night so you can sleep.

For nasal complaints, there are two main ingredient types to look for: decongestants and antihistamines. Decongestants narrow the blood vessels going to the nose which in turn decreases stuffiness and congestion, hence the name "decongestant." Antihistamines work in the brain to decrease the signals that make your nose run and block the irritation caused by the virus. This irritation is almost like an allergy, which is why these medicines work well against sneezing, a runny nose and itchy eyes.

There are two ways to take a decongestant: by mouth or as a nasal spray. McGeorge reported the oral forms like Sudafed, often denoted by a "PE" or "D" on the box, can cause nervousness and keep you awake, so they're better for daytime use, but if you have high blood pressure, they can make it worse. McGeorge said the spray form won't have that effect, but it can cause the congestion to feel worse after the medication wears off. That's known as a "rebound effect."

Antihistamines such as diphenhydramine, in the multi-symptom or "M" boxes, can be taken orally. McGeorge said they are very effective at drying up a runny nose, but they cause drowsiness. That is why it's usually better to take these at night. There are also "non-drowsy" antihistamines, but McGeorge said they only work for allergies and have never been shown to work on cold symptoms.

McGeorge said chest congestion is caused by excess mucus. This can be treated with an expectorant that thins the mucus, so it can be coughed up more easily. The over-the-counter ingredient to look for isguaifenesin, often denoted by an "E" for expectorant on the box. This medicine does not have many side effects, but research has cast serious doubts on its effectiveness.

Finally, McGeorge said fever and body aches are best treated with either acetaminophen (Tylenol) or ibuprofen.