June 2025

When you need an over-the-counter (OTC) pain medicine, the choices may confuse you. All of them relieve pain and reduce fever. If you have trouble choosing among the four main types, this guide can help.

What is acetaminophen?

Acetaminophen is the active ingredient in Tylenol. You can also buy generic acetaminophen. The drug belongs in a class of medications called analgesics (pain relievers) and antipyretics (fever reducers).

According to MedlinePlus.gov, acetaminophen changes the way your body senses pain. It also helps cool down your body to reduce fever.

Acetaminophen has fewer side effects, including stomach problems, compared to other OTC pain medicines. It is also safer for children to take.

What is it used for?

Common uses for acetaminophen include reducing fever and relieving mild to moderate pain from:

• Backaches
• Headaches
• Muscle aches
• Toothaches
• Colds and sore throats
• Menstrual periods
• Osteoarthritis
• Reactions to vaccines

In prescription medicines, acetaminophen is combined with other ingredients to treat moderate to severe pain.

Concerns and cautions

Taking too much acetaminophen can cause serious liver damage and even death. To avoid acetaminophen overdose, always read the labels on all OTC and prescription medicines you take. Follow these recommendations by the FDA:

• Don’t take more than the recommended dose on any product containing acetaminophen
• Don’t take more than one OTC product containing acetaminophen.
• Don’t take a prescription plus an OTC product that both contain acetaminophen.

• If you have liver disease, talk to your doctor before using acetaminophen, or choose a different OTC pain medicine.

What is aspirin?

Aspirin is the active ingredient in Bayer. You can also buy generic aspirin.

Aspirin belongs to a class of medications called salicylates. They are also considered an NSAID, or non-steroidal anti-inflammatory drug. According to MedlinePlus.gov, aspirin stops your body from producing certain substances that cause fever, pain, swelling, and blood clots.

What is it used for?

Aspirin can be used to reduce fever in adults or to relieve mild to moderate pain from:

• Arthritis
• Headaches
• Menstrual periods
• Muscle aches
• Toothaches

Aspirin is also used for heart health, especially in patients who have hada heart attack or stroke. Make sure to talk to your health care professional if aspirin is right for you. The risks and benefits vary for each person.

Prescription aspirin is also used to treat several rheumatic diseases that affect joints, muscles, tendons, ligaments, and bones. This includes lupus and common types of arthritis, such as rheumatoid arthritis (RA) and osteoarthritis.

Concerns and cautions

Aspirin use during viral illnesses, such as fever or flu, has been linked to Reye’s syndrome in children and teens. It’s a life-threatening condition that causes swelling in the brain, liver, and other organs. The American Academy of Family Physicians recommends children and teens younger than 19 should never take aspirin except for approved uses, such as Kawasaki disease and juvenile arthritis.

Always read the label on any OTC product your child takes during a fever or virus to make sure it does not contain aspirin.

What is ibuprofen?

Ibuprofen is the active ingredient in Advil and Motrin. You can also buy generic ibuprofen. Like aspirin, ibuprofen is an NSAID. According to MedlinePlus.gov, ibuprofen stops your body’s production of a substance that causes pain, fever, and inflammation.

What is it used for?

Common uses of ibuprofen include reducing fever and relieving minor aches and pains from:

• Arthritis
• Backaches
• Common cold
• Headaches
• Menstrual periods
• Muscle aches
• Toothaches

Prescription ibuprofen is used to reduce pain, tenderness, swelling, and stiffness in osteoarthritis and rheumatoid arthritis. It is also used for mild to moderate pain, including menstrual pain.

What is naproxen?

Naproxen is the active ingredient in Aleve. You can also buy generic naproxen. It’s also a type of NSAID.

What is it used for?

Naproxen works the same way as ibuprofen and has many of the same OTC and prescription uses listed above. According to MedlinePlus.gov, prescription naproxen is also used for tendinitis, juvenile arthritis, gouty arthritis, ankylosing spondylitis (arthritis in the spine), and bursitis- related shoulder pain.

Concerns and cautions with NSAIDs (other than aspirin)

According to the U.S. Food and Drug Administration, ibuprofen, naproxen, and other NSAIDs (but not aspirin) increase your risk of having a heart attack and stroke. According to MedlinePlus.gov, all NSAIDs may also cause ulcers, bleeding, or holes in your esophagus, stomach, or intestine. These risks are higher if you take NSAIDs for a long time or at a higher dose.

Get help choosing

Still unsure about which to take for your health needs? Talk to your pharmacist. They can do a medication review to see what may work best for you.