Ibuprofen, aspirin, naproxen, and diclofenac are popular OTC NSAIDs, but sometimes prescription anti-inflammatories are needed
Aspirin | Ibuprofen | Naproxen | Diclofenac | Best OTC anti-inflammatories | Side effects | Prescription vs. OTC anti-inflammatories
If you experience minor aches and pains, an anti-inflammatory medicine may be the first thing you look for at the pharmacy. There are many different over-the-counter (OTC) drugs that can help relieve inflammation and pain, and they typically fall under the same class of medications called nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen and aspirin are just a couple of the most popular NSAIDs.
It’s important to note that not all OTC anti-inflammatory drugs are the same. They may differ in effectiveness, cost, and side effects. If an OTC anti-inflammatory isn’t enough to treat your pain or inflammation, you may need a stronger prescription drug. It’s best to consult a healthcare provider for medical advice on the best treatment option, especially if you have underlying medical conditions or take other medications.
Continue reading to learn more about the best OTC anti-inflammatory drugs.
Common OTC anti-inflammatory medications
NSAIDs are the most common OTC anti-inflammatory medications, and they work by blocking the body’s production of certain chemicals called prostaglandins. These chemicals are involved with pain, inflammation, and fever.
NSAIDs are often used to treat aches and pains caused by toothaches, headaches, muscle aches, and menstrual cramps, among other types of pain. Unlike other pain relievers like Tylenol (acetaminophen), NSAIDs are effective for treating pain and discomfort caused by inflammatory conditions like arthritis. Acetaminophen is not an anti-inflammatory drug.
Aspirin is a widely available NSAID used to treat minor aches and pain, as well as fever. Brand names include Bayer and Ecotrin. Aspirin, also known as acetylsalicylic acid, can usually be found over the counter as a generic drug. It is not recommended for use in children under 12 or people with bleeding disorders.
The dosage of aspirin will vary depending on the symptoms being treated. Higher doses are typically needed for pain and inflammation. On the other hand, low-dose aspirin is often taken as a blood thinner to prevent blood clots and reduce the risk of strokes and heart attacks in people at high risk.
Ibuprofen is a common NSAID used for pain and fever in adults and children. It is available in different formulations, including tablets, capsules, and liquids, and in brand-name and generic forms. The brand names of ibuprofen include Advil and Motrin.
Ibuprofen is usually dosed every four to six hours as needed for pain relief. It is one of the most common NSAIDs used in younger children, as there are different forms of ibuprofen made specifically for children.
Naproxen is another common NSAID found over the counter, and it is available in generic and brand-name forms. The brand name of OTC naproxen is Aleve. Unlike other NSAIDs, naproxen is only available as an oral tablet or capsule.
Naproxen lasts longer than other NSAIDs, as it is usually dosed every eight to 12 hours. It is only approved for adults and children over the age of 12. There are two different types of naproxen: regular naproxen and naproxen sodium. The most common form of naproxen is naproxen sodium because it is absorbed more quickly than the regular form.
Diclofenac is an NSAID known under the brand name Voltaren. It is applied as a topical gel to the joints of the hands, feet, or knees as needed for pain due to arthritis.
The topical gel was initially approved as a prescription drug in 2007. However, in 2020, the FDA approved Voltaren as an OTC drug. As a result, it is now more accessible for treating joint pain and swelling caused by arthritis. It is also available as a delayed-release oral tablet with a prescription.
Best OTC anti-inflammatory drugs
The best OTC anti-inflammatory drug will depend on your overall health condition, the type of pain being experienced, and other factors. In addition, some OTC drugs may be cheaper than others. However, with a prescription from a healthcare provider, coupons and discount cards may help lower retail prices.
The following table lists the most common OTC pain relievers.
|Bayer, Ecotrin (aspirin)
|325-650 mg every 4-6 hours as needed for pain, fever, and inflammation
Maximum dosage: 4,000 mg in 24 hours
|Motrin, Advil (ibuprofen)
|200-400 mg every 4-6 hours as needed for pain, fever, and inflammation
Maximum dosage: 1,200 mg in 24 hours
|220 mg every 8-12 hours as needed for pain, fever, and inflammation
Maximum dosage: 660 mg in 24 hours
|2-4 g applied to the affected area 4 times daily
Maximum dosage: 32 g per day over all affected joints
OTC anti-inflammatory side effects
Despite their popularity, NSAIDs can cause a range of side effects, some of which can be serious or even life-threatening in some cases. However, the side effects of NSAIDs are generally mild and temporary with short-term use and in the recommended doses. Some people won’t experience any adverse effects.
Common side effects of NSAIDs include:
- Stomach upset
High doses and long-term use of NSAIDs can increase the risk of side effects that can be serious. Some NSAIDs may cause fewer side effects than others, depending on the dosage and form. For example, a topical NSAID will cause fewer systemic side effects like heartburn and nausea than an oral NSAID.
NSAIDs can irritate the stomach lining and cause problems in the gastrointestinal tract. That’s because most NSAIDs are nonselective. They block the COX-1 enzyme, responsible for protecting the stomach lining, in addition to the COX-2 enzyme, responsible for making prostaglandins that cause pain and inflammation. In severe cases, the use of NSAIDs can cause stomach ulcers or bleeding.
Risk factors for stomach ulcers and bleeding include:
- Age: Older adults over the age of 65 are at a higher risk than other people.
- History of stomach ulcers: People with a history of stomach ulcers or bleeding are at a higher risk than others.
- High doses: High doses and long-term use may contribute to an increased risk of stomach ulcers and bleeding
- Use of blood thinners or steroids: Taking blood thinners such as warfarin or corticosteroids like prednisone may increase the risk of ulcers and bleeding caused by NSAIDs.
People with risk factors for gastrointestinal problems should avoid or use NSAIDs with caution. A healthcare provider can recommend alternatives to reduce the risk of stomach ulcers.
All NSAIDs, except aspirin, are known to increase the risk of cardiovascular or heart problems. Studies have shown that long-term use and high doses of NSAIDs can increase the risk of heart attack, strokes, heart failure, and other heart problems.
NSAIDs should only be used short-term in the lowest effective doses. It’s important to tell your healthcare provider if you have heart disease, high blood pressure, or other heart complications before using an NSAID.
Other serious side effects
NSAIDs can cause liver and kidney problems over time. However, the risk of kidney problems is higher than that of liver problems. NSAIDs can affect blood flow to the kidneys, disrupting kidney function and leading to kidney damage. People with liver disease or kidney disease should use NSAIDs with caution.
Allergic reactions are possible while taking NSAIDs. Seek immediate medical attention if you experience signs or symptoms of an allergic reaction, such as hives, swelling of the throat or face, or trouble breathing.
Prescription vs. OTC anti-inflammatory medications
Prescription NSAIDs are more potent than OTC NSAIDs and are used for more serious types of pain. A healthcare provider will want to monitor pain and side effects if they prescribe an NSAID for long-term use.
OTC pain relievers are generally taken in lower doses than prescription medications. However, higher doses of OTC NSAIDs are available with a doctor’s prescription. For example, ibuprofen and naproxen are available in higher strengths with a prescription.
Several different types of NSAIDs are available, but not all are available over the counter. Some NSAIDs can only be purchased with a prescription. Examples of prescription-only NSAIDs include:
It’s a good idea to consult with a healthcare provider for the best pain medicine. One drug may be a better choice than another based on your overall health condition and other drugs you may be taking.
The best OTC anti-inflammatory drug will depend on a person’s health condition and symptoms. NSAIDs like ibuprofen and naproxen are the most common anti-inflammatory drugs available over the counter for treating pain and fever.
NSAIDs may cause side effects and drug interactions, so it’s important to seek advice from a healthcare provider. A doctor or pharmacist can provide more information about the benefits and risks of NSAID use. That way, you can make an informed decision about the right treatment option.
Cost can also be a concern when choosing an OTC drug. You can use a SingleCare discount card to save on all of your medications, including brand-name and generic drugs. However, a prescription from a healthcare provider is needed to save on OTC drugs with a discount card. You can browse various medications for the lowest prices at nearby pharmacies.