Medicine: The Right Pill for the Pain

Outside Magazine, February 1995


Medicine: The Right Pill for the Pain
By Dorothy Foltz-Gray


With the introduction several months ago of Aleve, the first new over-the-counter pain reliever to appear since ibuprofen products made their debut in 1984, there seem to be as many little pills waiting to cure your aches as there are long-distance carriers vying for your phone patronage. But without Candice Bergen or bonus miles to sway your decision, how do you know which product is best for you? Here's a rundown to help ease the pain. And keep this in mind: That's all these drugs are good for -- squelching discomfort, not acting on whatever's causing it. The ultimate danger of relying on relief in pill form is that you're masking the pain, which is your body's way of alerting you to an injury that demands some attention.

Naproxen (Aleve)
Pros: A 220-milligram dose (one tablet) lasts eight to 12 hours, four to six hours longer than other products.

Cons: Because naproxen is a more slowly metabolized first cousin to ibuprofen, its drawbacks are the same, and they are risky over a longer period: Both decrease blood flow to the kidneys -- and so does exercise. Dosing within two hours before starting time or right after a workout puts these vital organs at risk.

Ibuprofen (Advil, Motrin)
Pros: Widely popular with athletes for muscle aches, tendinitis, inflammation of the joints, swelling from bruises, and particularly for reducing delayed-onset muscle soreness after a hard-charging day.

Cons: Same as naproxen, but you have to take it more often. If you're allergic to aspirin, there's a good chance you're allergic to ibuprofen -- and naproxen -- too.

Acetaminophen (Tylenol)
Pros: The easiest pain reliever on your stomach lining, with fewer side effects than the others.

Cons: It's less effective for muscle aches than naproxen, ibuprofen, or aspirin, and it doesn't relieve inflammation. Beyond the recommended dosage, acetaminophen is highly toxic and can ultimately shut your liver down. Don't take more than 12 tablets in 24 hours.

Aspirin
Pros: It's appreciably cheaper ($2 for 100 tablets) than Aleve ($8 for 100), Advil ($9 for 100), or Tylenol ($7.50 for 100), even when they're on sale. Buffered or enteric-coated versions of the classic, such as Bufferin and Ecotrin, respectively, won't irritate the stomach lining as they dissolve.

Cons: Like naproxen and ibuprofen, aspirin decreases blood flow to the kidneys and can interfere with proper blood clotting.

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