Corydalis – Alternative: O-T-C Oral Analgesics

Alternative: Over-the-Counter Oral  Analgesics

Recently corydalis herbal remedy has been receiving well-deserved attention as an excellent pain reliever. Consumers may be curious, though, about other analgesic products and pain control methods on the market today. Such treatments as oral analgesics, topical pain relievers, hot- or cold-packs and so-called “natural” methods may be helpful in certain cases.

Among over-the-counter oral analgesics there are four major categories: aspirin, acetaminophen, ibuprofen and naproxen.  Each of these, with its own potency and duration of action, will bring along a specific set of benefits and drawbacks.


Generic term:

acetylsalicylic acid, ASA — nonsteroidal anti-inflammatory drug (NSAID)

Major side effects:

Stomach irritant, ringing in the ears, prolonged bleeding time. Aspirin may provoke allergic reaction for individuals with salicylic acid sensitivity.  It can cause stomach bleeding or worsen existing ulcers.  Drinking alcohol is likely to exacerbate the situation even further.  Before taking aspirin, be certain that your doctor or pharmacist knows if you are also taking any of these medications:

  • a blood thinner
  • probenecid
  • ticlopidine
  • dipyridamole
  • sulfinpyrazone
  • cortisone
Information and precautions:

Check with your health care provider before using aspirin if you are pregnant or breastfeeding. Ask for advice also if you have asthma, kidney problems, gout or a history of ulcers.  Do not use aspirin if you have experienced a previous allergic reaction to it or other pain/arthritis medication. Avoid aspirin if you have an active stomach ulcer or any kind of bleeding problem.

Drink a full 8-ounce glass of water with each aspirin intake unless your doctor tells you otherwise.  Do not lie down for at least ten minutes after you have taken this drug.  If stomach upset occurs, you may take aspirin with food or milk.

Because of its anti-platelet effect, aspirin is sometimes recommended prophylactically to reduce the risk of heart attack or stroke.

Aspirin seems to be as effective as ibuprofen in relieving headaches and migraine pain and in reducing fevers. It may not be as helpful, though, when treating soft tissue injuries, dental pain and menstrual cramps.

alert:   Never give aspirin to children or teenagers with fever, chickenpox, symptoms of the flu or viral infection. With youngsters, aspirin can cause a serious disease called Reye’s syndrome.


Brand names:

APAP, Tylenol, Panadol, paracetamol. Centrally acting analgesic and antipyretic agent with little to no anti-inflammatory property. Thought to reduce pain by acting on receptors in the brain.

Major side effects:

Hypersensitivity reactions, serious skin reactions. There is potential for liver damage especially with high-level intake or overdose, prolonged/chronic use or use along with alcohol or other liver-damaging drugs. Unlike NSAIDs, acetaminophen has no activity in the stomach. It generally does not cause problems with gastric pain or acid reflux.

Information and precautions:

Ask a doctor or pharmacist if it is safe for you to take acetaminophen if you are pregnant or breastfeeding. Consult with the healthcare team also if you have liver disease or a history of alcoholism.

Experts consider acetaminophen to be better than ibuprofen for treating headaches and arthritis. It is also less likely to cause GI irritation.  In fact, of all the oral analgesics, acetaminophen is the least likely to be a stomach irritant.

alert:  Taking more than 325 mg of acetaminophen at a time, taking more than one type of medication that contains acetaminophen or taking it with alcohol can lead to severe liver damage. Such consequences may eventually require a liver transplant or can even result in death.


Brand names: 

Motrin, Advil — NSAID. Blocks an enzyme needed for synthesis of prostaglandins thus reducing inflammation, pain and fever.

Major side effects:

Severe stomach bleeding (ulcers), heartburn, GI upset and constipation.  In rare cases prolonged use may lead to kidney damage, heart attack and stroke.  Like other NSAIDs, ibuprofen reduces the ability of blood to clot and thus can increase bleeding after an injury.  Unlike aspirin, though, its blood-thinning effect is relatively mild. If you have conditions where loss of platelets would be a concern, then ibuprofen may be the better choice.  Asthma sufferers are more likely to experience allergic reactions to ibuprofen and other NSAIDs.

Information and precautions:

Avoid taking ibuprofen before and after heart surgery; do not use it if you are allergic to aspirin or any other NSAIDs. Individuals with kidney concerns should consult with a healthcare provider before taking ibuprofen. So should people with bleeding disorders, stomach ulcers, nasal polyps and liver disease.  Risk is higher among people with a history of prolonged usage and those who are elderly. Also at risk are people who suffer from poor health, who smoke and/or drink regularly or who have a past diagnosis of stomach ulcer.

Because of its low levels in breast milk and its short half-life, ibuprofen may be the best choice for nursing mothers.  It is routinely prescribed for infants in doses much higher than those excreted in breast milk. If you are pregnant or breastfeeding, though, always check first with your healthcare provider before taking ibuprofen or any other NSAID.

Ibuprofen appears to be slightly stronger than aspirin when treating soft tissue injuries, dental pain and menstrual cramps.  It is more effective than acetaminophen for treating fevers, menstrual cramps or pain caused by inflammation (e.g., backache or dental pain).  The effects of ibuprofen do not tend to last as long as do those of naproxen. Ibuprofen may need to be taken every four to six hours up to six times a day. It is better to take ibuprofen with food or milk to minimize stomach upset.


Brand names:

Aleve, Naprosyn — NSAID. Works by blocking an enzyme essential for synthesis of prostaglandins. These hormone-like substances cause inflammation and pain in the body.

Major side effects:

Can cause even more gastrointestinal irritation and stomach/intestinal bleeding than aspirin. It should be taken in fewer doses (no more than three times daily, every eight hours) and always with a large amount of water. Naproxen is best taken with food to minimize upset stomach. This NSAID is, however, associated with the smallest overall cardiovascular risks.

Information and Precautions:

You should not use naproxen if you have a history of allergic reaction to aspirin or other NSAIDs. Naproxen may increase your risk of heart attack or stroke, especially if you use it long term or have pre-existing heart disease. Do not use this medicine just before or after heart bypass surgery.

Ask a doctor or pharmacist if it is safe for you to take naproxen if you fall into any of these categories:

  • pregnant or breastfeeding
  • history of nasal polyps
  • heart, stomach, liver or kidney condition
  • inflammatory bowel disease
  • high blood pressure
  • asthma
  • abnormal bleeding condition
  • current or past cigarette smoker

Tell your doctor if you have ever been advised to follow a low sodium diet. Avoid drinking alcohol while taking naproxen. Do not give this medicine to a child younger than two years old without medical advice. Elderly people are more likely to have side effects; so, individuals over age 65 should take the lowest possible effective dose.

Many experts consider Naproxin to be the most powerful OTC pain reliever available without a prescription.

caution: with naproxen, avoid sunlight exposure and tanning beds because you can sunburn more easily.