Over-the-counter pain relief is an advanced success of scientific medicine. Have a headache, body pain, or a pulled muscle, and odds are ibuprofen or aspirin, or acetaminophen will suffice. So, let’s talk about really and effective strong painkillers that are not opiates.
Even better, as opposed to prescription pain meds with opioids, OTC pain relievers aren’t habit-forming, and likely will not leave you groggy, dizzy, or perhaps constipated.
Most importantly, OTC pain relievers are inexpensive and easy to discover. All drug stores carry both trademark name and generic varieties that are cheaper and work as well.
The 20 Strongest Pain Relievers for 2024 (Rating)
To understand the grading by potency of painkillers, we have listed 20 medications in the table, which includes both opioids and conventional painkillers.
| Rank | Painkiller | Strength |
|---|---|---|
| 1 | Oxycodone | Very strong |
| 2 | Hydrocodone | Very strong |
| 3 | Morphine | Very strong |
| 4 | Fentanyl | Very strong |
| 5 | Codeine | Strong |
| 6 | Tramadol | Strong |
| 7 | Naproxen | Strong |
| 8 | Ibuprofen | Strong |
| 9 | Diclofenac | Strong |
| 10 | Ketorolac | Strong |
| 11 | Aspirin | Moderate to strong |
| 12 | Acetaminophen | Moderate to strong |
| 13 | Celecoxib | Moderate to strong |
| 14 | Meloxicam | Moderate to strong |
| 15 | Piroxicam | Moderate to strong |
| 16 | Indomethacin | Moderate to strong |
| 17 | Tylenol | Moderate |
| 18 | Aleve | Moderate |
| 19 | Advil | Moderate |
| 20 | Motrin | Moderate |
Description of the Strongest OTC Pain Relievers
Acetaminophen (Tylenol)
Acetaminophen is best understood for alleviating headaches, minor aches and pains, and lowering fever. Nevertheless, it’s not an anti-inflammatory agent, so it will not reduce swelling and inflammation. Although it’s much easier on the stomach than other OTC painkiller, at very high dosages. Getting your beverage on while taking acetaminophen can also cause liver toxicity. But there’s usually absolutely nothing to stress over, so long as you’re following the directions on the bottle (and avoiding the booze).
Aspirin (Bayer)
Aspirin is typically used for mild to moderate aches and discomforts (headaches, pulled muscles), and is likewise an anti-inflammatory (take that, arthritis!). It’s part of the NSAID family of meds, which work by blocking certain enzymes in the body from making prostaglandins– a hormone-like compound that (among its many skills) notifies you to pain by annoying your nerve endings and activating inflammation. Less prostaglandins indicates less pain and swelling.
Unlike other NSAIDs, aspirin is thought about cardioprotective in patients with particular danger factors by functioning as a blood thinner. Smaller chance of cardiac arrest or stroke. However, using NSAIDs on the regular can cause substantial side effects, he cautions, consisting of gastritis, peptic ulcer disease, and kidney damage. Prostaglandins are also utilized to protect your stomach lining and help preserve kidney function, so in suppressing them to nix pain, you end up trading one concern for another.
Ibuprofen (Advil/Motrin) And Naproxen (Aleve)
Ibuprofen and naproxen are also on group NSAID. These pain relievers are famous for putting the kibosh on menstrual cramps, and are outstanding in dealing with joint, muscle, and everyday wear and tear painl. Both choices are more powerful than aspirin, with naproxen being the strongest painkiller currently readily available without a prescription. But with a more powerful dosage comes an increased threat of side effects. If you have a history of GI or kidney concerns, you need to avoid this class completely. NSAIDs are also not supposed to be blended with alcohol. It’s constantly a good concept to check in with your doc before taking OTCs as a security preventative measure – especially if you’re pregnant, have allergic reactions, or are taking other medications.
Choosing the Right Pain Reliever
So, which OTC pain reliever works best? Below we give you the types of pain and the most effective pain relief options that match them.
Pain type: Joint, Back Or Muscle Pain
Take: Ibuprofen Or Naproxen
Due to the fact that of the anti-inflammatory effect, an NSAID is typically advised for acute pain, state from a recent injury or overuse. How much you require to take boils down to swelling and the type of issue that’s happening. When naproxen is sold nonprescription as Aleve, the normal dose is 220 mg. If you have pain or fever, one Aleve ought to do it, anything more than that– like gout or arthritis – and you might require greater doses as directed by a doctor. That’s since the complete anti-inflammatory effect does not kick in unless you’re taking dosages of around 500 mg of naproxen (or 600 mg of ibuprofen) at a time.
At low dosages, you’re still getting an anti-inflammatory effect, just not as much. Constantly follow the dosage instructions on the bottle unless your medical professional states otherwise.
For serious or ongoing pain that includes swelling, such as arthritis, you should check in with your doc – especially if your joint pain is associated with warmth, soreness, or swelling, which could symbolize an infection that requires immediate treatment.
Also learn about the best way to relieve arthritis pain.
Pain type: Fever
Take: Acetaminophen
Acetaminophen is classically used for fever, and it’s still what I suggest. NSAIDs have the very same impact, however acetaminophen is less most likely to trigger stomach problems.
Be careful taking it if you’re also taking OTC cold and influenza medications. These typically include acetaminophen, so if you’re taking max doses of acetaminophen and cold medication, you could be overdoing it and running the risk of liver damage.
Pain type: Menstrual Cramps
Take Ibuprofen Or Naproxen
The primary cause of menstrual cramps is the release of prostaglandins, which causes the uterus to contract. For women with significant menstrual pain and who have predictable durations, IYThealth.com suggests starting ibuprofen or naproxen a day or 2 before your duration starts.
Pain type: Headache
Take: Acetaminophen Or Aspirin
When it comes to which a painkiller strongest for headaches, it’s a private thing – essentially, utilize whichever med provides you better relief. However keep in mind they’re only helpful if utilized a couple of times a week at most: If you’re taking these medications more than that, it can (ironically) lead to a medication overuse headache, which just disappears when you stop taking the medication.
Pain type : Migraine
Take: Acetaminophen And Aspirin
Migraine headaches can be much harder to treat than garden variety tension headaches. If you’re worried that the headache you’re having is a migraine and it’s not responding well to OTC options, there are a lot of prescription medications that can assist treat and avoid migraines.
Side Effects of Non-Prescription Pain Relievers
NSAIDs
All NSAIDs feature the threat of intestinal ulcer and bleeding. A more recent class of anti-inflammatories, the COX-2 inhibitors, was established to lower this risk. It did not, however, remove it. In fact, another significant issue emerged with these drugs: the possibility of severe and fatal vascular problems with long-term usage, including cardiovascular disease and stroke.
Acetaminophen
A lot of users of acetaminophen experience couple of, if any, side effects. However the drug can cause liver damage, particularly when taking excessive or if taken with alcohol. However, we strongly recommend you to quit alcohol in any case.
Other Painkiller Medications
Opioids
Opioid analgesics typically cause sleepiness, dizziness, and respiratory anxiety. Nevertheless, these side effects generally disappear with continued usage. However, irregularity, another common adverse effects, tends to persist. In addition, opioid usage may result in addiction or dependence. Other possible side effects of opioid analgesics include:
- Bliss, dysphoria, agitation, seizures, hallucinations
- Decreased blood pressure and heart rate
- Muscular rigidness and contractions
- Queasiness and vomiting
- Non-allergic itching
- Pupil constriction
- Sexual dysfunction
- Urinary retention
Combined opioid agonist-antagonists
Patients can experience symptoms of opioid withdrawal if a straight opioid analgesic, such as morphine, is taken at the exact same time as an opioid agonist-antagonist drug. A few of these medications include pentazocine (Talwin Nx, Talacen, Talwin Compound), butorphanol, and nalbuphine (Nubain).
Muscle relaxants
The main side effect of muscle relaxants is drowsiness. This may be how they work to “alleviate” pain. In addition, carisoprodol (Soma) usage may result in dependence due to the fact that in the body it is transformed into a drug similar to barbiturates; cyclobenzaprine (Flexeril) can trigger dry mouth, irregularity, confusion, and loss of balance; methocarbamol (Robaxin) stains the urine to green, brown, or black; both metaxalone (Skelaxin) and chlorzoxazone (Parafon Forte, DSC) needs to be utilized with care in those with liver problems.
Anti-anxiety agents
Anti-anxiety drugs likewise bring the threat of sedation, especially if integrated with certain other medications (such as opioid analgesics) or alcohol. Other possible side effects consist of mental changes, headache, queasiness, visual problems, uneasyness, and problems. Chest pain and heart pounding are likewise possible.
Antidepressants
A few of the antidepressants used for pain relief are the older tricyclics. These featured many side effects classified as anticholinergic, including dry mouth, difficulty urinating, blurred vision, and constipation. Other possible side effects consist of lower blood pressure, quick heartbeat, palpitations, weight gain, and fatigue.
A few of the newer antidepressants also minimize pain – and with less risk of anticholinergic problems. Still, the serotonin norepinephrine reuptake inhibitors (SNRIs) may trigger the following common side effects:
- Anorexia
- Asthenia
- Constipation
- Lightheadedness
- Dry mouth
- Ejaculatory difficulties
- Headache
- Insomnia
- Nausea
- Anxiety
- Sweating
Antiseizure agents
Side effects connected with the anticonvulsants used for pain management typically disappear over time. They consist of dizziness, drowsiness, and swelling of the lower extremities.
Corticosteroids
In general, short-term and/or low-dose corticosteroid usage results in few side effects. However taking corticosteroids long-term can lead to extreme side effects, including:
- Adrenal deficiency – a condition in which the body can not properly respond to physical stress
- Atherosclerosis
- Bone death
- Cataracts and glaucoma
- Elevated blood pressure
- Raised blood glucose
- Fluid retention
- Intestinal bleeding
- Mood changes
- Osteoporosis
- Suppression of the body immune system
- Trouble sleeping
- Weight gain
- Damage to local tissues
Maximum Daily Dosage Chart
| Pain Medication | Maximum Daily Dosage for Adults |
|---|---|
| Morphine | 200mg |
| Oxycodone | 80mg |
| Fentanyl | 100mcg |
| Hydromorphone | 24mg |
| Methadone | 40mg |
| Percocet (Oxycodone/Acetaminophen) | 12 tablets (10/325mg) |
| Tramadol | 400mg |
| Vicodin (Hydrocodone/Acetaminophen) | 6 tablets (5/300mg) |
| Codeine | 360mg |
| Methadose (Methadone HCl) | 200mg |
| Oxymorphone | 40mg |
| Dilaudid (Hydromorphone HCl) | 24mg |
| Demerol (Meperidine HCl) | 600mg |
| Tylenol #4 (Codeine/acetaminophen) | 360mg |
| Ultram (Tramadol HCl) | 400mg |
| Oxycontin (Oxycodone HCl) | 80mg |
| Synthadol (Fentanyl Citrate) | 100mcg |
| Nubain (Nalbuphine HCl) | 20mg |
| Butrans (Buprenorphine Transdermal) | 20mcg/hour |
| Zohydro ER (Hydrocodone Bitartrate) | 120mg |
Oral pain medication are effective in providing pain relief. However, oral pain reliever lead to gastrointestinal (associated to the stomach), heart (associated to the heart) or kidney (associated to the kidney) side effects. The very best option to oral pain medication has actually been developed through an unique technology.
Some people get remedy for ibuprophen as otc med, however one shouldn’t take it continuously and long term due to prospective liver damage. Curcumin taken a number of times a day can reduce inflammation, the most likely cause of the joint pain. Likewise, warm baths with 3 cups of epsom salt and a number of cups of baking soda helps a lot of individuals feel much better a minimum of temporarily. The only other long-lasting aid of which I am aware is to minimize considerably one’s intake of inflammation-causing foods: sugar, gluten, and dairy.
OTC pain relief medications such as Ibuprofen and Acetaminophen (Tylenol) are a class of drugs known frequently as anti-inflammatory drugs. They work to eliminate pain by minimizing the body’s stress reaction to trauma or infection. That action being inflammation.
Many commonly, infection or injury will invoke the body’s immune and endocrine systems to produce inflammation to the affected tissues. The body floods the area with secretions such as cortisol, norepinephrine, and numerous types of white blood cells.
The inflammatory reaction sets off recovery as the swollen tissues dilate blood vessels, increases blood circulation, and floods the affected swollen area with T-Cell immune cells to eliminate and avoid infection.
So, it’s a balance. EXCESSIVE inflammation, produces pressure, thus pain. Insufficient inflammation healing is prevented and infection likely. And WAY too much inflammation can eliminate you ie in case of an bacterial or viral infection. This is why Tylenol can help in reducing fevers because it minimizes the body’s inflammatory reaction.
The body’s inflammatory response is a mystical still rather misinterpreted biological system. Lots of scientists are begun to find links of the body being in a state of continuous inflammation can lead to genetic disorders and others particularly cancer.
Does anybody have any experience with NSAID topical solution called diclofenac sodium 2%? Pennsaid is one of the brand. It is advertised for osteoarthritis knee pain. Costly things. A friend utilized it for muscle tendonitis due to the fact that he could not utilize oral NSAIDs due to GI problems, and for him, a little bit helped ease the pain when it flared.
I, at 82, have OA, mainly in the fingers and meta carpals bilaterally, with marked 65% limitation of movement, however especially in the middle finger proximal joints. That on the right was more uncomfortable, and did not respond to medication with Voltarin. X-ray revealed fragmentation of the bone around the joint. So I chose to have surgery. The joint was changed with a much admired plastic joint, followed by physical treatment. It is 8 months now. I am assiduous in keeping up with the workouts. The pain is much less, and is responsive to transcutaneous analgesics and anti-inflammatories, however the movement is still markedly impaired, and has to do with the like the other hand. No treatment, however I won’t knock the treatment.