NSAID VS. Acetaminophen: what you need to know before your next headache

Most households have a stash of hidden analgesics for surprise headaches or stubborn cramps.

But some may not realize that all analgesics are not created the same, and not everyone treats the same type of pain.

Types of analgesics

Free sales analgesics (OTC) are divided into two main categories, according to Medline Plus.

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The first is NSAIDs (non -steroidal anti -inflammatory medications) such as ibuprofen and naproxen.

“These reduce both pain and inflammation, but they can irritate the stomach if it is not taken with food,” said Dr. Jessica Oswald, MD, MPH, anesthesiologist and specialist in pain management at UC San Diego Health, to News Digital.

The other medicine, acetaminophen, also helps with pain and fever, but does not reduce inflammation, Oswald said.

Dr. Min “Frank” Wu, a doctor from Adventhealth in Littleton, Colorado, explained how these drugs work differently in the body.

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NSAIDs are effective in treating fever and pain relief, the doctor told News Digital.

These medications can relieve a variety of symptoms related to arthritis, infection, back injuries, headaches and muscle tension, along with other acute and chronic conditions that cause pain and inflammation, he said.

“NSAIDs work inhibiting cyclooxygenase (COX-1 and COX-2) enzymes throughout the body,” he said, which means that they inhibit the production of “biological mediators” that cause inflammation and coagulation of the blood.

Acetaminophen, on the other hand, works by “inhibiting COX enzymes and modular the endocannabinoid system in the central nervous system (brain and spinal cord) to exert its effects,” Wu said.

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As analgesic, acetaminophen is effective for migraines, according to the doctor.

“In combination, many European agencies recommend acetaminophen/caffeine as a frontline agent,” he said.

However, the effectiveness of acetaminophen for arthritic pain is small and not clinically important, according to WU.

“It has not been shown to be effective for light or root pain (nervous pain) in general,” he added.

The power of the combination

Wu said that acetaminophen seems to increase the properties of pain relief from other medications.

“It has been shown that the combination of acetaminophen and NSAID is more effective than any of the medications only,” Wu said.

Oswald also talked about this method, which she calls a “multimodal” approach.

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“In many cases, combining different types of analgesics may be more effective than using only one,” Digital News told News.

For example, a NSAIDs like ibuprofen along with acetaminophen and a topical cream “can work together to relieve pain more effectively,” Oswald said.

Risks and precautions

The research has shown that NSAIDs have multiple adverse effects and should be used with caution, both doctors said.

“It has been shown that they cause gastrointestinal problems, and in severe cases they can cause ulcers and bleeding,” Wu said.

These side effects seem to depend on the dose size, the doctor added.

“In many cases, combining different types of analgesics can be more effective than using only one.”

There is evidence of greater gastric effects, renal deterioration and heart disease at higher doses. The United States Food and Medicines Administration (FDA) has also issued warnings about cardiovascular risk.

At dose high enough, it can (less frequently) cause liver damage, which can be fatal, according to WU.

Oswald recommended that people with certain health conditions, such as kidney problems, heart problems or stomach ulcers, should talk to a doctor before using NSAIDs.

Acetaminophen has been related to a potential risk of liver lesion and allergic reactions, according to FDA. Rare but serious skin reactions have also been reported.

“Acetaminophen is generally safer for most people, provided they remain less than 3,000 milligrams per day,” added Oswald.

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After weighing the benefits and risks, the doctor said that people should “absolutely” maintain both types of OTC medications at home.

“Having some different options allows you to handle pain more effectively by attacking it in different ways,” he said.

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Ultimately, if the pain does not improve or continue to return, it is better to consult a health professional who can evaluate the cause and discuss other treatment options, including prescription medications.