The Early Show

All Painkillers Are Not Equal

By CBSNews.com staff CBSNews.com staff

December 20, 2001 / 9:58 AM EST / CBS

With so many different over-the-counter painkillers to choose from, many people are confused about which ones to use. CBS News Health Contributor Dr. Jordan Metzl shares advice on The Saturday Early Show about which painkillers kill which pains.

Does it really matter which type of painkiller you use, or do they all work the same?

Everyone assumes that their favorite painkiller will work on whatever ails them. But that's not true. So it's important to have several of the most common types of painkillers in your medicine cabinet. Using the wrong one can mean prolonged pain or even new pain caused by the medicine that was supposed to help.

Aspirin: It's sold under names such as Bayer, Bufferin and Ecotrin. It is a pain reliever and anti-inflammatory. It also helps thin blood. Aspirin is best used for mild pain including headaches, fever and joint pains. It is also helpful for those at risk of heart disease.
Like any drug, aspirin does have side effects. Some people have allergic reactions such as an asthma attack. Others can get an upset stomach. It is also a good idea to avoid taking aspirin if you are about to undergo surgery. We strongly recommend against giving aspirin to anyone younger than 19 years old during an episode of chicken pox or influenza because it puts them at risk of Reye's Syndrome, a serious condition that affects the brain and liver.
Acetaminophens: These are sold under the brand names of Tylenol, Datril and Panadol. Like aspirin, they are good for treating body aches and fever. Unlike aspirin, it does not irritate the stomach lining. However, acetaminophens cannot reduce inflammation.
What about negative interactions?
Acetaminophens are the least likely of the over-the-counter pain relievers to cause side effects. However, heavy drinkers and those with liver problems should avoid acetaminophens. In rare cases, overdoses can lead to liver damage and even death.
NSAIDs (nonsteroidal anti-inflammatory drugs): They are sold under the brand names of Advil, Motrin, Nuprin and Aleve. These are very effective at treating menstrual cramps and a recent study found they treated a fever better than aspirin. However, other studies have shown they are not very effective at relieving muscle soreness.
What about side effects?
Like aspirin, NSAIDs can cause stomach irritation when taken regularly. It is also a good idea for heavy drinkers to avoid taking them. And some studies have shown that NSAIDs can irritate ulcers and may exacerbate existing kidney problems.

Is it all right to take the generic forms of these drugs?

Absolutely. They work just as well and are cheaper.

When should you ask your doctor for a prescription?
If you have recurrent episodes of pain (including migraines, arthritis or lower back pain), your doctor may want to give you prescription medication.