With a temperature above 98.6 F, headache, sweating, chills, dehydration, weakness, and aches and pains you know you have a fever. Over-the-counter (OTC) fever reducers and pain relievers (also known as internal analgesics) are medicines that treat both fever and minor pain.
Internal analgesics are intended for internal use and are either taken by mouth in the form of pills and liquids or inserted into the rectum in suppository form. These come in a variety of different forms, including tablets, capsules, liquid solutions, and syrup.
There are two basic types of OTC medicines that work as pain relievers or fever reducers:
- Nonsteroidal anti-inflammatory drugs (NSAIDs), which include the following active ingredients:
NOTE: For information about the updated cardiovascular warning on non-aspirin NSAIDs packaging, click here.
Before choosing an OTC medicine to treat your fever, you should first consider the type of symptoms you have and then determine the best course of treatment.
Consumers should be aware that pain-reliever and fever-reducer active ingredients may also be found in medicines that treat multiple symptoms of the common cold, sleeplessness, or symptoms related to menstruation. It is important to check your medicine labels and be sure to take only one medicine containing the same kind of active ingredient (acetaminophen or NSAID) at a time.
Check out this tool to learn more about the things you need to keep in mind when choosing and using an OTC pain reliever. And remember to always read and follow the Drug Facts label, and talk to your healthcare professional if you have questions or concerns before taking an OTC medicine to treat your pain or fever.
What Over-the-Counter Analgesics Are
Over-the-counter (OTC) analgesics are a class of medicines that relieve pain. Depending on the dosage form, some may also reduce fever. There are two different categories of analgesics: internal and external. Internal analgesics are pain relievers and fever reducers. These medicines are intended for internal use and are either taken by mouth in the form of pills and liquids, or inserted into the rectum in suppository form. External analgesics are topical pain relievers and are not intended to reduce fever. These medicines are for external use only and are applied directly to the outer body surface in lotions, sprays, and other forms. Before selecting an OTC analgesic medicine, you should first consider the type of symptoms you are experiencing and then determine the best course of treatment.
What Topical Pain Relievers Are for
Topical pain relievers, or external analgesics, are a group of different medicines that are used “externally,” which means on the skin. Some are intended to relieve minor body aches and pains such as backache, muscle ache, and arthritis. Some products soothe sunburn and minor burns, while others are used for itching and skin irritations due to eczemas, contact allergies, and insect bites.
How Topical Pain Relievers Work
Topical pain relievers, like all OTC medicines, contain certain active ingredients that make them work in the human body. The product’s active ingredients, including how much of a substance is in each dose, are listed first on the Drug Facts label.
Depending on the active ingredients, topical pain relievers are intended to treat a number of different conditions, including inflammation, minor aches and pains of joints and muscles, sunburn and other minor burns, and itching and irritation. Many products are available to consumers over the counter in spray, lotion, cream, gel, ointment, patch, and medicated wipe form.
Below is a list of the active ingredients in topical pain relievers and how they work:
- Benzocaine – Numbing action reducing itching, burning, and pain on skin
- Camphor – Cooling action reducing itching, burning, and pain on skin, as well as joint and muscle aches
- Capsaicin – Warming action reducing joint and muscle aches
- Diphenhydramine – Reduces itching and redness on skin
- Hydrocortisone – Reduces itching and redness on skin
- Lidocaine – Numbing action reducing itching, burning, and pain on skin
- Menthol – Cooling action reducing itching, burning, and pain on skin, as well as joint and muscle aches
- Methyl salicylate – Relieves joint and muscle aches
- Pramoxine – Numbing action reducing itching, burning, and pain on skin
- Trolamine salicylate – Relieves joint and muscle aches
Acetaminophen Safe Use Tips
- Always read the Drug Facts label carefully. The label tells you what you need to know about the medicine, including the ingredients, what you are supposed to use it for, how much you should take, and when you should not take the medicine
- Acetaminophen is in more than 600 OTC and prescription medicines. Because it is found in so many different medicines, you may be taking more than the recommended amount without realizing it
- Acetaminophen may be written as “APAP” on prescription drugs, but it is the same ingredient
- Pay attention to how much acetaminophen you are taking and do not take more than one medicine that contains acetaminophen at the same time
- Taking more acetaminophen than directed is an overdose and can cause liver damage. Never exceed the maximum daily dose of 4,000 milligrams of acetaminophen in a 24-hour period
- If you think you have taken or given too much of a medicine, immediately contact your healthcare provider or the national poison control helpline at 888.222.1222
- If you are pregnant or breastfeeding, talk to your healthcare provider before use
- Talk to your healthcare provider before using an acetaminophen product if you have liver disease
- If you are taking the blood-thinning drug warfarin, speak with a healthcare provider before using an acetaminophen product
- Talk to your healthcare provider if you consume three or more alcoholic drinks a day
NSAIDs Safe Use Tips
- Always read the Drug Facts label carefully. The label tells you everything you need to know about the medicine, including the ingredients, what you are supposed to use it for, how much you should take, and when you should not take the product
- Do not take an NSAID for longer than what the label instructs unless you are under the supervision of a healthcare provider
- Talk to a healthcare provider before using more than one pain reliever/fever reducer at the same time
- Stop use and contact your healthcare provider if your fever gets worse or lasts more than three days, or if your pain gets worse or lasts more than 10 days
- If you have signs of stomach bleeding, such as feeling faint, vomiting blood, bloody or black stools, or stomach pain that does not get better, contact your healthcare provider
- If a severe allergic reaction occurs and you experience symptoms such as hives, facial swelling, asthma (wheezing), shock, skin reddening, rash, or blisters, immediately seek medical attention
- Do not take more medicine or for a longer period of time than what the label recommends unless you are under the supervision of a healthcare provider
- Ask a healthcare provider before use if you have high blood pressure, heart disease, liver cirrhosis, or kidney disease
- If you are pregnant or breastfeeding, talk to a healthcare provider before using an NSAID
- If you are a woman in the last three months of pregnancy, do not use an NSAID unless you are specifically told to do so by a doctor
- If you take low-dose aspirin for protection against heart attack and stroke, be aware that some NSAIDs, including ibuprofen and naproxen sodium, may interfere
Topical Pain Relievers Safe Use Tips
- Always read the Drug Facts label carefully. The label tells you everything you need to know about the medicine, including the ingredients, what you are supposed to use it for, how much you should use, and when you should not use the product
- Topical pain relievers should only be applied to the outer surface of your body. In case you accidentally swallow a product, immediately contact your healthcare provider or the national poison control helpline at 888.222.1222
- When applying a spray, lotion, cream, gel, or ointment, avoid getting the product into your eyes.
Stop using the medicine if skin irritation develops
- Do not bandage, wrap, or tightly cover any area on which you have applied a topical pain reliever. Covering tightly can trap too much of the active ingredient against your skin
- If your condition worsens, lasts for more than seven days, or clears up and then returns a few days later, contact a healthcare provider
- Do not use more of the medicine than is recommended on the Drug Facts label unless you are under the supervision of a healthcare provider
- Do not use a topical pain reliever containing capsaicin if you are allergic to chili peppers
- Do not apply to wounds or damaged skin
- If you are pregnant or breastfeeding, talk to a healthcare provider before use
Safe Use Tips for Parents
- All of the tips for safe use of OTC topical pain relievers also apply to children. But like most OTC medicines, there are some additional considerations when it comes to treating kids:
- OTC topical pain relievers may contain more than one active ingredient, and the ingredients may come in different concentrations. Some of these concentrations should not be used on children
- Read the Drug Facts label carefully to make sure the topical pain reliever can be used on the child you wish to treat
- Additional tips by ages: Be sure to read the entire list for medicines that may or may not be labeled for your child:
- Talk to a healthcare provider before using an OTC topical pain reliever containing benzocaine, camphor, diphenhydramine, hydrocortisone, lidocaine, menthol, or pramoxine in a child age 2 and under
- Talk to a healthcare provider before using an OTC topical pain reliever containing methyl salicylate or trolamine salicylate in a child age 12 and under
- Do not use an OTC topical pain reliever containing methyl salicylate on a child under the age of 12 if the child has arthritis-like conditions
- If a child under age 12 is experiencing external anal itching, talk to a healthcare provider before using a topical pain medicine containing hydrocortisone on the affected area
- Talk to a healthcare provider before using an OTC topical pain reliever containing capsaicin on a child age 18 and under
Keep all medicines up and away and out of sight of children.
Not all products marketed under a brand contain the same ingredients. Please read the Drug Facts label carefully for active ingredient information.
To learn more about using, storing, and disposing of pain medicines safely, watch these short films by the Alliance for Aging research:
See also: Allergies & Sinus