Non-opioid pain medicines

Non-opioids control mild to moderate pain. Some can be bought without a prescription. For some examples of common non-opioids used today and their side effects, look at Table 1.

Table 1. Non-opioids -- Acetaminophen and NSAIDs

Brand-name drugs and generic drugs

Drugs may have as many as 3 different names: brand, generic, and chemical. Drug companies give their products brand names, and some products have more than one brand name. You should also know that the same brand name may be used on different drugs, since the name belongs to the company. You will want to read the labels to see what ingredients are in each medicine. Chemical names are long and tend to be hard to pronounce. The Food and Drug Administration (FDA) approves the generic, shortened names by which drugs are usually known. Here's an example:

Brand names: Tylenol, Tempra, Liquiprin, Anacin, Paramol (and many more)
Generic name: acetaminophen
Chemical name: N-(4-hydroxyphenyl) acetamide

Many pain relievers are available under both generic and brand names. We have included some of the more common generic names with their common brand names in parentheses in Table 1. Your doctor, nurse, or pharmacist can tell you the generic and common brand names of any medicines you are taking. It is always good to know both because you may hear either name when talking about your medicines. Knowing both names may also keep you from getting confused when keeping track of prescriptions and pill bottles.

Generic drugs usually cost less than brand-name ones. Sometimes medicines can have the same generic name, but are made by different companies. Because the companies may produce the medicines differently, they may differ slightly in the way they are absorbed by the body. For this reason, your doctor may sometimes prefer that you take a brand-name drug. Ask your doctor, nurse, or pharmacist if you can use a less costly medicine. Pharmacists are careful to get high-quality generic products, so it is often possible to substitute a generic.

Along with the main substance (for example aspirin, acetaminophen, or ibuprofen), some brands contain substances called additives. Common additives include:

• Buffers (such as magnesium carbonate or aluminum hydroxide) to decrease stomach upset
• Caffeine to act as a stimulant and lessen pain
• Antihistamines (such as diphenhydramine or pyrilamine) to help you relax or sleep

Medicines with additives can cause some side effects you wouldn't expect from the main drug. For example, antihistamines sometimes cause drowsiness. This may be all right at bedtime, but it could be a problem during the day. Also, additives tend to increase the cost of non-prescription pain relievers. They can also change the action of other medicines you may be taking or even keep your body from absorbing the other drug. When you start a new drug, always talk with your doctor or pharmacist about what you are already taking to see if the combination can cause harmful effects.

Plain aspirin, acetaminophen, or ibuprofen probably works as well as the same medicines with additives. But if you find that a brand with certain additives is a better pain reliever, ask your doctor, nurse, or pharmacist if the additives are safe for you. Talk with them about any concerns you may have about the drugs contained in your non-prescription pain medicines.