Best OTC Anti-Inflammatories Medicine: Options and Safety Tips
Key Takeaways
- Over-the-counter (OTC) anti-inflammatories can be used to relieve pain, reduce inflammation, and lower fevers. They’re also known as OTC non-steroidal anti-inflammatory drugs (NSAIDs).
- OTC anti-inflammatories are affordable and effective, but should not be used long-term to avoid side effects and other risks.
- If OTC anti-inflammatories are not helping your pain, your provider may recommend a prescription anti-inflammatory or other treatment.
Over-the-counter (OTC) non-steroidal anti-inflammatory drugs (NSAIDs) are a go-to solution for everyday aches, pains, and fevers. They are highly effective and easy to access, but they aren't all exactly the same. They aren't completely risk-free, either. Knowing which medication works best for your specific symptoms can help you get the relief you need while keeping your body safe.
What conditions can over-the-counter NSAIDS treat?
OTC NSAIDs can help reduce fevers and relieve many types of pain. Here are a few things they are commonly used to treat:
- Body aches and muscle strains
- Muscle and joint pain after surgery
- Fever and sore throat
- Headaches, migraines, and sinus pain
- Joint pain or stiffness from arthritis and other inflammatory health conditions
- Menstrual cramps
- Toothaches and jaw pain
Always check the potential side effects and drug interactions before taking NSAIDs.
What are the best anti-inflammatory meds over the counter?
Over-the-counter NSAIDs can come in several forms.
- Oral NSAIDs: These include caplets, tablets, and liquid-filled softgels.
- Other forms: These include topical gels, creams, and suppositories.
Here's how some of the most common OTC NSAIDs stack up against each other:
| Type of OTC NSAID | What It Treats | Forms | Standard Dosing Schedule |
|---|---|---|---|
| Naproxen (Aleve) |
|
| Every 8-12 hours, maximum 3 tablets daily (600 mg naproxen sodium) |
| Ibuprofen (Advil, Motrin) |
|
| Every 4-6 hours, max 6 tablets daily (1200 mg) |
| Aspirin |
|
| Every 4 hours, max 12 tablets daily (4000 mg) |
| Diclofenac (Voltaren) |
|
| Every 4-6 hours, maximum 4 applications daily (32 grams of gel total) |
How do NSAIDS work?
NSAIDs work by preventing enzymes called cyclooxygenases (COX-1 and COX-2) from making prostaglandins. Prostaglandins are hormone-like substances in your body that cause pain, inflammation, and fever.
When NSAIDs block prostaglandin production, they can help reduce your pain and fever.
However, OTC anti-inflammatories are not intended to be taken as long-term pain relievers. If your pain is persistent, talk to your doctor to see if prescription-strength NSAIDs or other treatments are recommended.
Side effects and risks of over-the-counter anti-inflammatory medications
OTC anti-inflammatories are intended for short-term use only, and your risk of side effects increases the longer you use them.
Some of the most common side effects of NSAIDs include:
- Nausea or vomiting
- Diarrhea
- Stomach upset or indigestion
- Gas
- Bloating
- Heartburn
- Constipation
If you experience any serious side effects, stop using the medication right away and get in-person emergency care. Serious side effects of NSAIDs include:
- Stomach ulcers and stomach inflammation (gastritis)
- Feeling faint or fainting
- Severe shortness of breath, wheezing, or difficulty breathing
- Vomiting blood
- Bloody or black stools
- GI bleeding that can cause severe anemia
- High blood pressure (hypertension)
- Kidney problems, especially if you have a history of decreased kidney function, kidney disease, or if you have more than 3 alcoholic drinks per day
- Heart damage
- Slurred speech
- Sudden swelling or weight gain
- Stomach pain that won’t go away
- Chest pain
- Weakness in one side or part of your body
Both ibuprofen and naproxen increase your risk of heart attack and stroke. Talk to your doctor before taking NSAIDs if you are at risk of blood clots, stroke, heart attack, heart failure, heart disease, or other heart problems (or have a history of cardiovascular conditions), as it’s likely that you should avoid these medications.
Tips for using OTC anti-inflammatory medications safely
To take OTC NSAIDs safely and effectively, here are a few tips:
- Check with your healthcare provider: Ensure that NSAIDs will not interfere with other health problems.
- Dose properly: Take the lowest effective dose for the shortest time possible. Talk to your provider before using OTC NSAIDs for more than 10 days or if your symptoms get worse.
- Follow labels: Read ingredient lists carefully before taking OTC anti-inflammatories. Some products contain a mix of NSAIDs and acetaminophen or other medications. These can cause unexpected side effects.
- Prefer topical NSAIDs for localized pain: NSAID gels and creams often relieve specific musculoskeletal or joint pains as effectively as oral tablets, with fewer side effects.
- Avoid double-dosing or combining NSAIDs: Many OTC anti-inflammatories are available in different dosages. Check the dosage label for your specific packaging to avoid doubling up. Do not combine NSAIDs, like gels and oral tablets, unless your provider has recommended it.
When to avoid NSAIDS
Avoid taking an NSAID if any of the following apply to you or have applied to you in the past:
- Blood disease, blood clots, or bleeding disorders
- Chronic acid reflux (GERD)
- Stomach bleeding or stomach ulcers
- Digestive or severe GI issues without stomach-protecting drugs
- High blood pressure
- Liver disease
- Kidney disease
- Unmanaged diabetes
- History of stroke
- History of heart attack, disease, failure, or other cardiovascular problems
- You are aged 60 or older
- Asthma or respiratory disease that can be worsened by NSAIDs
- Long-term or high-dose use of NSAIDs or combined products
Talk to your doctor before taking an NSAID if you are pregnant, planning to become pregnant, or taking a blood-thinning medication like warfarin or heparin.
Children and OTC NSAIDs
If you are caring for a child who is in pain or has a fever, talk to your provider before giving them an NSAID. How much and how often you give the medicine depends on your child’s age, weight, diagnosis, and the type of NSAID.
Guidance on medications and age ranges are below:
- Ibuprofen: Ibuprofen (Advil, Motrin) can be used safely in infants 6 months and older. It may be used in children under 6 months under the guidance of your provider.
- Naproxen: Naproxen (Aleve) can be used by children over the age of 12. Ask a healthcare professional before using naproxen if your child is under 12 years of age.
- Aspirin: Aspirin should never be given to children under 19 unless medically recommended. It can trigger Reye’s Syndrome, a rare but life-threatening condition. This is especially important if your child is recovering from a viral infection like the cold, flu, or chickenpox.
As with adults, NSAIDs can cause kidney damage and GI upset in children. These risks are greater if your child is taking an NSAID in high doses or for longer than recommended. Make sure you read the label and follow the recommended dosages for your child’s age and weight.
Always use the provided cap, syringe, or spoon to measure your child's liquid NSAID, instead of common household teaspoons, which aren't always accurate.
Are there prescription NSAIDs?
Yes, prescription NSAIDs do exist. However, prescription NSAIDs are generally stronger than their OTC counterparts. This means that a licensed healthcare provider must authorize their use.
Some common NSAID prescription medications include:
- Ketorolac (Acuvail/Acular)
- Meloxicam (Mobic)
- Celecoxib (Celebrex)
- Indomethacin (Tivorbex)
- Diclofenac (Flector, Cambia)
- Fenoprofen (Nalfon)
- Flurbiprofen (Ocufen)
- Mefenamic acid (Ponstel)
- Oxaprozin (Daypro)
- Piroxicam (Feldene)
- Sulindac
When should you talk to a doctor?
If you have any pre-existing medical conditions, you may want to speak with your provider before taking NSAIDs.
Be sure to share a full list of your current medications and supplements with your provider. Some can interact with NSAIDs and increase their side effects.
These include, but aren’t limited to:
- Cyclosporine
- Low-dose aspirin
- Warfarin or heparin
- Certain antidepressants (SSRIs)
- Lithium
- Diuretics
Your provider can decide if NSAIDs are right for your specific situation. They can recommend the right dosage and explain side effects and medication interactions.
How Sesame can help you find the right anti-inflammatory treatment
Dealing with pain, inflammation or fever and need medical advice? Sesame can help. Providers on Sesame can assess your symptoms and write or refill a prescription, if appropriate, during a virtual visit.
Browse licensed providers, pick a time slot, and book your telehealth appointment from the comfort of your home. If prescribed, you can arrange for same-day pickup at a pharmacy near you.
Providers on Sesame cannot prescribe controlled substances. For all other medications, getting a prescription is up to your healthcare provider.
Frequently asked questions
What is the strongest anti-inflammatory over the counter?
Naproxen (Aleve) is the strongest anti-inflammatory available over the counter. It can relieve pain longer than similar doses of ibuprofen or aspirin.
What are the differences between acetaminophen, naproxen, and ibuprofen?
Acetaminophen reduces pain and fever, but does not treat inflammation. While treating your symptoms, be aware of the risks. It can affect your blood pressure, and taking too much causes severe liver damage.
Ibuprofen and naproxen are NSAIDs, which means that they reduce inflammation. This makes them highly effective for pain like arthritis or menstrual cramps. However, taking them for too long or at high doses increases your risk of stomach, kidney, and cardiovascular problems.
Does Tylenol help with inflammation?
Tylenol (acetaminophen) is not an NSAID. It reduces pain and fever, but will not help with swelling or stiffness. If you need an OTC anti-inflammatory, ibuprofen, naproxen and high-dose aspirin are better options.
Always take oral NSAIDs with a full glass of water to help the medicine absorb properly.
Are there heart-safer NSAID alternatives?
Because all NSAIDs increase your chance of heart attacks and strokes, always use the lowest effective dose for the shortest time possible.
If you must avoid NSAIDs entirely, talk to your provider about acetaminophen or alternative pain relief treatments. For inflammation-related pain, ask about alternatives like physical therapy or an anti-inflammatory diet.
