Over-the-Counter Medications

There are many over-the-counter (OTC) medications to choose from, and it is the patient’s preference as to which one to take. Keep in mind that aspirin is best kept to one daily, as larger doses are associated with a propensity to cause bleeding. Aspirin should also be avoided in the pediatric population as it is associated with Reyes Syndrome, a liver toxicity reaction.

Acetaminophen (Tylenol) is not associated with bleeding and only lasts a few hours, so should be taken in that interval. It is great for reducing fevers and stopping pain, but does not have anti-inflammatory properties. Taking doses of 4000 mgs or greater of acetaminophen is considered dangerous and could cause liver damage. Some recent evidence suggests that maybe half of that dose is safely allowed. Acetaminophen is also in Tylenol #3, Percocet, and many other analgesics, so use caution to include all sources of this medication when evaluating your true intake of acetaminophen.

The non-steroidal anti-inflammatories (NSAIDS) are a large group of medications, which include generic names like Ibuprofen and Naprosyn, which equate to name brands such as Motrin, Aleve, and Advil, to name a few. These all last 4 to 6 hours per tablet, unless otherwise specified and, therefore, should be limited to no more than a few daily. Similar to aspirin, they may be associated with bleeding for those prone to such a disorder. Therefore, they should be avoided in people with stomach ulcers and known bleeding disorders. NSAIDS are great for reducing inflammation, and consequently reducing pain, unlike acetaminophen which only reduces pain.

All of these oral agents bind to proteins in your bloodstream, which may in turn, displace other medications bound to these very same proteins. This is a more critical issue in people taking medications that require tight titration in order to maintain a very defined blood level, such as those on the blood thinner Coumadin, or on antiepileptic medication such as Tegretol. Consulting your doctor is always the best idea if there is any doubt.