Long-term, over the counter medications can negatively impact liver and/or kidney function, cause intestinal tract bleeding, increase the risk of heart attack and stroke, change the ability to absorb and use nutrients,and increase the likelihood of getting cataracts.

Read on for more specific information.

1. Acetaminophen is commonly taken for pain relief and fever reduction. It is frequently used long-term for osteoarthritis, chronic back pain and headaches.

Cautions: Frequent use may affect the liver. Avoid drinking alcohol when using Tylenol. Be cautious if taking prescription medications that contain acetaminophen, such as Vicodin, Percocet and Lorcet, or nonprescription products like Midol Complete, Excedrin or Nyquil, because you can unintentionally overdose and cause liver damage or failure. Acetaminophin, like statin drugs and birth control pills, depletes CoQ10, a nutrient that is essential for cellular health.

Warnings: Pharmacists claim an adult may take 4,000 milligrams daily up to 10 days for pain. Taking more puts you at risk for liver failure. If you’re taking acetaminophen long-term for chronic pain, consider having liver function testing once or twice a year. Then begin looking at other options to help with your pain.

Acetaminophen acts differently in the body than NSAIDs (nonsteroidal anti-inflammatory drugs) in that it does NOT reduce inflammation.

2. Ibuprofen can be effective for pain relief and fever reduction. Motrin and Advil are popular for dental pain and menstrual cramps.

Cautions: Long-term use (3 months or longer) may cause stomach bleeding or ulcers. For this reason ibuprofen should always be taken with food. Limit alcohol consumption as alcohol is a stomach irritant and the combination can cause stomach bleeding. Increased blood pressure, fluid retention and reduced kidney function are also concerns in long-term usage and short-term at higher doses. Another caution is the possibility that long-term use contributes to the formation of cataracts. NSAID’s interfere with the absorption of B vitamins (These essential nutrients help convert our food into fuel.) and affect metabolism.

Who shouldn’t take it: If you are older than 60, or if you take oral steroids or blood thinners. If you have ulcers, Crohn’s Disease, colitis, heartburn or congestive heart failure, talk to your doctor before taking ibuprofen.

Warnings: Do not mix with other pain relievers. Check with doctor or pharmacist for potential drug interactions. The maximum amount for adults is 800 mg per dose with a maximum of 4 doses per day. Do not take for more than 10 days without consulting your physician.

3. Naproxen sodium is said to be effective for pain relief (such as arthritis, tendinitis, bursitis, gout, menstrual cramps) and fever reduction. Naproxen is longer acting than Ibuprofen, so it needs to be taken less frequently.

Cautions: Same as ibuprofen.

Children should NOT take naproxen.

Who else shouldn’t take it: Talk to your doctor or pharmacist before taking Naproxen if you are older than 60, take oral steroids or blood thinners, have ulcers, Crohn’s Disease, colitis,  heartburn, or congestive heart failure.

Warnings: Do not mix with other pain relievers. Check with your doctor or pharmacist for potential drug interactions. Do not take more than 10 days without consulting your physician.

For recommended dosage click here.


Do not combine multiple pain medications without the guidance of both your doctor AND your pharmacist.  Doctors are not pharmacists; and not all doctors are up to date on the latest information about medications, both prescription and over the counter. Be aware that acetylsalicylic acid or salicylate is aspirin (these ingredients are in Alka-Seltzer, Pepto-Bismol, and other over the counter medications). Check the labels of all over the counter medications.

NSAID’s are not your only option for pain relief. Educate yourself about your options. One of these therapies might be the right one for you:

acupuncture heat
aquatic therapy meditation
biofeedback physical therapy
castor oil pack stretching/yoga
Epsom Salt bath weight loss to relieve stress on the joints