Aspirin, Ibuprofen, Naproxen, Acetaminophen: What is the Difference Between Over-the-counter Pain Relievers?

Not All Pain Pills Are the Same

�Ask folks who work in an office or factory, and they've no doubt heard the question: "Does anyone have an Advil?" People sometimes name a specific over-the-counter pain reliever even when they don't have a particular brand in mind, just as people ask for a Kleenex when they want a tissue of any brand. But there are differences between over-the-counter pain relievers that consumers should understand. Aspirin, ibuprofen, naproxen, and acetaminophen are different substances whose desired effects (and drawbacks) can be different. So if you're not sure how brand names like Advil, Aleve, and Tylenol are different from each other, read on.

Note: this article does not cover topical analgesics, which are pain relievers applied directly to an affected area, or the more powerful prescription pain relievers (like steroids).

Pain Reliever: Aspirin
Over-the-counter brands: Bayer, Bufferin
Ah, good old aspirin - or acetylsalicylic acid, as the science-savvy call it. The first over-the-counter pain reliever to see mass production, aspirin gets absorbed into the bloodstream and essentially "looks" for prostaglandins, substances that are concentrated where we feel pain. In short, aspirin reacts with our blood chemistry to inhibit the enzyme cyclooxygenase, which in turns limits the volume of prostaglandins. As you undoubtedly know, aspirin is used to treat headaches of all sizes, to quell minor body aches and pains, and to reduce inflammation when we're sore. But what are the problems with aspirin as an over-the-counter pain reliever? Among other things, it's rough on the upper digestive tract (can cause upset stomach, heartburn, and even dyspepsia), it's bad for hemophiliacs (because it's an anticoagulant), and it's not always safe for kids (because it's linked to Reye's syndrome). That said, aspirin is still the most common over-the-counter pain reliever, available in both brand names and generic versions. And now it's also playing a role in the treatment of heart disease.