Aspirin, Acetaminophen, and Ibuprofen are the three most commonly used over-the-counter analgesics for pain, fever, and headaches. Which of them is the most effective? Against what type of pain should they be taken? Can they be combined?
Analgesics are among the most widely sold over-the-counter drugs that are used for headaches, fevers, colds, flu, toothaches, and menstrual pains. However, they are not harmless and some are even dangerous if used in excessive amounts or incorrectly. Whatever drug you choose, the first rule is not to treat for more than three to five days. If the pain persists, contact your doctor.
First choice: Acetaminophen
Acetaminophen (Tylenol) offers the best risk-benefit ratio for common pain (headache, fever, toothache, etc.) and in a dose of less than 3 g per day, i.e. three tablets of 1000 mg at four to six-hour intervals. On the other hand, it is toxic to the liver; in high doses (more than 10 g/d) paracetamol is even potentially lethal. Moreover, the combination with alcohol is strongly discouraged.
Second choice: Ibuprofen
Ibuprofen (Advil) is particularly interesting in rheumatic pain, osteoarthritis, tendonitis, lumbar pain, sciatica because it has an anti-inflammatory effect not found with paracetamol. On the other hand, it is not recommended for toothache because it can mask a possible infection. The total daily dose in adults should not exceed 3200 mg. However, ibuprofen has side effects, including intestinal problems (nausea, heartburn, and even ulcers), and is not recommended for patients with kidney failure or the elderly.
Third choice: Aspirin
Aspirin (Alka-Seltzer, Bayer), which is commonly used to treat fever and pain, should not be used for these indications. This drug carries a significant risk of bleeding, even at reduced doses, due to its anticoagulant effects. For the same reason, it should not be taken during menstruation, and it is not recommended during colds or viral infections. On the other hand, in low doses, it is interesting for the prevention of cardiovascular diseases.
Can aspirin be combined with ibuprofen or paracetamol?
Because aspirin and ibuprofen both belong to the class of non-steroidal anti-inflammatory drugs (NSAIDs), they should not be taken together to prevent overdose. However, for acute pain, ibuprofen and paracetamol can be combined (alternating every three to four hours), increasing their mutual efficacy and thus reducing the total dose. However, the maximum thresholds for each must be observed.