When you have a headache, sore muscles, or other pain, over-the-counter (OTC) pain relievers can often help you feel better. But how do you know which one to take?
Acetaminophen (Tylenol), ibuprofen (Advil, Motrin), and naproxen (Aleve) all help with pain, but they work in different ways and have different risks. The best choice often depends on the type of pain you have, your health history, and other medicines you take.
Quick guide: Which pain reliever should you choose?
| Type of pain | OTC option that may help | Why? |
| Headache | Acetaminophen or ibuprofen | Both can help relieve pain and headaches |
| Fever | Acetaminophen or ibuprofen | Both can lower a fever |
| Muscle aches | Ibuprofen or naproxen | These can help with pain and inflammation |
| Sprain or strain | Ibuprofen or naproxen | May help reduce pain, swelling, and inflammation |
| Period cramps | Ibuprofen or naproxen | Can help lower prostaglandins, the chemicals in your body that contribute to period cramps |
| Arthritis pain | Ibuprofen or naproxen | Can help with pain and inflammation |
| Toothache | Acetaminophen or ibuprofen | Both can provide pain relief; ibuprofen also helps with inflammation |
Keep in mind: This chart is a general guide, not a recommendation for everyone.
Acetaminophen: A classic for pain and fever
Acetaminophen (Tylenol) helps reduce pain and fever, making it a good choice for headaches, toothaches, and general aches and pains.
It doesn't reduce inflammation, but it’s usually easier on the stomach than ibuprofen and naproxen. “The biggest concern with acetaminophen is that it’s hard on your liver and can cause liver damage if you take too much,” explains Sylvia Otto, DO, Carilion Clinic Family Medicine.
If you have liver disease or drink alcohol regularly, talk with your doctor before taking acetaminophen.
Ibuprofen: Helps with inflammation
Ibuprofen (Advil, Motrin) belongs to a group of medicines called nonsteroidal anti-inflammatory drugs, or NSAIDs. In addition to relieving pain and lowering fever, they also reduce inflammation. That makes ibuprofen a good option for things like muscle aches, sprains, arthritis pain, and period cramps.
But ibuprofen can irritate your stomach and may increase the risk of stomach bleeding, kidney damage, heart attack, and stroke in some people.
Talk with a doctor before taking ibuprofen if you have kidney disease, a history of stomach ulcers or bleeding, certain heart conditions, are pregnant, or take blood thinners.
Naproxen: Longer-lasting relief
Naproxen (Aleve) is another NSAID. It works like ibuprofen but generally lasts longer. That can make it helpful for things like arthritis pain, period cramps, or muscle and joint pain.
Like ibuprofen, naproxen also comes with an increased risk of stomach bleeding, kidney problems, heart attack, and stroke, especially at higher doses or with longer use.
What about aspirin?
Aspirin is also an NSAID, but it's not usually the first choice for everyday pain.
Because it acts as a blood thinner, low-dose aspirin is sometimes recommended to help prevent heart attacks and strokes in certain people. Don’t start or stop taking daily aspirin without talking to your doctor first.
Never give aspirin to children or teenagers unless a doctor recommends it.
Can you take acetaminophen and ibuprofen together?
Sometimes. Acetaminophen and NSAIDs work differently, so taking them together or alternating them can be helpful for certain short-term pain.
Don’t combine NSAIDs unless you've been given the OK by your healthcare team. Taking more than one NSAID can increase your risk of side effects.
“It's important to check the ingredients in products like cold and flu medicine. These often contain pain relievers, so you could accidentally take too much if you're also taking it separately,” notes Dr. Otto.
OTC doesn't mean risk-free
Before taking an OTC pain reliever, talk with your doctor or pharmacist if you:
- Take prescription medications, especially blood thinners
- Have kidney, liver, heart, or stomach problems
- Have had a stomach ulcer or gastrointestinal bleeding
- Are pregnant or trying to become pregnant
- Regularly drink alcohol
- Need to take pain medicine frequently
- Aren't sure which pain reliever is safest for you
And always follow the dosing instructions on the package. Taking more than the recommended amount won't necessarily give you better pain relief and can cause serious side effects.
When pain doesn't go away
OTC pain relievers can help manage occasional aches and pains, but they shouldn't be your only plan if you're regularly dealing with pain. If your pain is severe, keeps coming back, or isn't improving, talk with your doctor.
If you have questions about which pain reliever is right for you, reach out to your primary care doctor or pharmacist.
