What over-the-counter (OTC) medications can I take for pain or allergies?

Over-the-Counter Medications for Pain and Allergies

For pain relief and allergy symptoms, NSAIDs like ibuprofen, acetaminophen, and newer generation antihistamines are the most effective OTC options with favorable safety profiles when used appropriately. 1

Pain Management Options

First-Line OTC Pain Medications

• NSAIDs (non-steroidal anti-inflammatory drugs) are the most effective OTC pain relievers with proven efficacy for mild to moderate pain 1
  • Ibuprofen (200-600mg) is recommended for its effectiveness in treating various pain conditions 1, 2
  • Naproxen (250-500mg) provides longer-lasting relief than other NSAIDs 1
  • Diclofenac (available in some countries as OTC) is effective for inflammatory pain 1
• Acetaminophen/paracetamol (500-1000mg) is recommended for those who cannot tolerate NSAIDs, though it has less efficacy than NSAIDs 1

Safety Considerations for Pain Medications

• NSAIDs should be used at the lowest effective dose for the shortest time needed 2
• NSAIDs carry risks including:
  • Increased risk of gastrointestinal bleeding and ulceration 1, 2
  • Potential cardiovascular risks, especially with prolonged use 2
  • Kidney problems with long-term use 2
• Acetaminophen has a risk of liver toxicity, especially when exceeding 4000mg daily or when combined with alcohol 1

Allergy Management Options

First-Line OTC Allergy Medications

• Second-generation (non-sedating) antihistamines are preferred for allergy symptoms 1, 3:
  • Cetirizine has the fastest onset of action among newer antihistamines 3
  • Fexofenadine causes minimal sedation but has a slower onset 3
  • Loratadine is non-sedating but may be less effective than cetirizine 3
• Intranasal corticosteroids (e.g., fluticasone) are highly effective for allergic rhinitis symptoms 1
  • Mometasone furoate, fluticasone propionate, and fluticasone furoate are preferred for safety reasons 1
  • These require consistent daily use for optimal effect 1

Second-Line OTC Allergy Medications

• First-generation antihistamines like diphenhydramine are effective but cause significant sedation 3
• Nasal decongestants can temporarily relieve nasal congestion but should only be used short-term (≤3-5 days) to avoid rebound congestion 1

Special Considerations

Combination Approaches

• For moderate pain that doesn't respond to single agents, combining acetaminophen with an NSAID may provide better relief 1
• For allergic rhinitis, combining an antihistamine with an intranasal corticosteroid may be more effective than either alone for persistent symptoms 1

Cautions and Contraindications

• Avoid NSAIDs if you have:
  • History of gastrointestinal bleeding or ulcers 2
  • Severe heart, kidney, or liver disease 2
  • Pregnancy beyond 20 weeks 2
• Avoid sedating antihistamines when driving or operating machinery 3
• Consult a healthcare provider before using OTC medications for more than 10 days for pain or 2 weeks for allergies 2, 4

Age-Specific Considerations

• Limited evidence supports OTC medication effectiveness in young children 1, 5
• Older adults should use lower doses of NSAIDs due to increased risk of side effects 1, 2

By following these evidence-based recommendations and being aware of potential risks, you can safely and effectively manage mild to moderate pain and allergy symptoms with OTC medications.