Over-the-counter (OTC) pain medications are generally safe and effective, but daily or long-term use isn’t recommended. Several factors, including drug side effects and your medical history, can affect whether the medication is suitable for you.
OTC pain relievers are among the most widely used medications in the United States. A 2020 survey found that among the 1 in 4 adults who manage pain with medication only, most use OTC pain relievers. (You can buy OTC pain medications without a doctor’s prescription.)
Medications like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) are easy to find, relatively inexpensive, and often provide quick relief. But when these drugs are taken every day or for extended periods, concerns about safety begin to outweigh their convenience.
OTC pain relievers are meant for short-term use, usually up to 7 to 10 days for pain and about 3 days for fever, unless your doctor advises otherwise. Taking OTC pain relievers every day, especially for weeks or months, isn’t recommended since it may cause serious side effects.
Specifically, taking acetaminophen too often can put extra strain on the liver, especially if you drink alcohol or exceed the recommended daily dose.
Regular use of ibuprofen or naproxen (Aleve) over time may increase the risk of problems like stomach irritation, bleeding, kidney issues, or heart concerns.
If you find yourself relying on OTC pain medications every day, it may signal that something else is going on in your body. Your doctor can evaluate your symptoms and help find a safer, long-term solution for pain relief.
Not all OTC pain relievers are the same. Each works differently in the body and comes with different risks and side effects. The two main types are nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen. The following table compares their typical uses.
| Active ingredient | Common uses | Typical patient population |
|---|---|---|
| acetaminophen | headache, fever, mild arthritis pain, and general aches | commonly used in children or when NSAIDs aren’t appropriate |
| NSAIDs: | ||
• ibuprofen | muscle ache, headache, dental pain, menstrual cramps, and fever | widely used in adults and children |
| • naproxen | longer-lasting relief for arthritis pain, back pain, and sprains and strains | adults and sometimes adolescents; not typically used in young children |
| • aspirin | mild pain and arthritis pain | more commonly used in older adults for heart protection than for pain relief |
The dosage instructions on OTC labels are based on clinical studies that balance effectiveness with safety. While taking more than the recommended amount of an OTC pain medication may seem harmless, doing so increases the chances of serious side effects, including liver damage or gastrointestinal bleeding.
Here’s a list of recommended and maximum dosages for the oral tablet form of common OTC pain relievers in adults and children ages 12 years and older. Dosages are expressed in milligrams (mg).
| Medication | Recommended dose | Maximum dose in 24 hours |
|---|---|---|
| acetaminophen | 500 to 1,000 mg every 4 to 6 hours as needed | 4,000 mg |
| ibuprofen | 200 to 400 mg every 4 to 6 hours as needed | 1,200 mg |
| naproxen | 220 mg every 8 to 12 hours as needed | 660 mg |
| aspirin | 325 to 650 mg every 4 hours as needed | 4,000 mg |
If the recommended dose isn’t working to relieve your pain or fever, do not increase it on your own. First, talk with your doctor or pharmacist about other options for pain relief. In some cases, your doctor may recommend a prescription-strength pain reliever.
To learn more about recommended dosages, see the prescribing information for:
Be mindful not to take a double dose
Multi-symptom cold and flu medications often include these pain relievers as an active ingredient. These combination medications may also contain decongestants, cough suppressants, or antihistamines. Taking one of these along with a separate pain reliever can accidentally lead to “double-dosing.”
In addition, combination pain relievers containing both acetaminophen and ibuprofen are available.
A high level of pain reliever medication in your body can increase your risk of side effects.
Always check the active ingredients section of each label to avoid taking too much of the same drug.
For children
Ibuprofen and acetaminophen are generally safe for infants and children when dosed by body weight. The doctor can determine the right dosage based on your child’s body weight.
However, naproxen is not typically recommended for children under 12 years old unless directed by a doctor.
Children and adolescents, if they have a fever, should avoid Aspirin due to the risk of Reye’s syndrome, a rare but serious condition.
During pregnancy
Acetaminophen is generally considered the safest OTC pain reliever during pregnancy. While concerns have been raised about a possible association between frequent acetaminophen use during pregnancy and increased risk of autism spectrum disorder in children, the evidence isn’t conclusive. Please read “Acetaminophen during pregnancy” for details.
Aspirin and NSAIDs, like ibuprofen and naproxen, are typically avoided in the third trimester due to risks to the baby’s heart and kidneys. Always check with your doctor before taking any OTC pain reliever while pregnant.
Acetaminophen during pregnancy
The Food and Drug Administration (FDA) in September 2025 initiated a label change for acetaminophen citing research that associates use of acetaminophen during pregnancy with an increased risk of neurological conditions, including autism spectrum disorder (ASD), in children.
In a
In a statement, the American College of Obstetricians and Gynecologists (ACOG) described the FDA announcement as a “harmful and confusing message to pregnant patients” that is not backed by scientific evidence. ACOG also noted that pain and fever during pregnancy are “far more dangerous” than any potential risk from acetaminophen use.
If you’re pregnant, talk with your doctor about the benefits and risks of taking acetaminophen.
People with certain health conditions may have an increased risk of side effects or worsening of their condition when taking OTC pain relievers. It’s especially important to talk with your doctor before using these medications if any of the following health issues apply to you:
- current or past liver disease
- chronic alcohol use
- kidney disease
- heart failure
- high blood pressure
- gastrointestinal ulcers (open sores) or bleeding
OTC medications can be part of a pain management plan, but they shouldn’t be the whole plan. A variety of
- exercise and stretching
- heat and cold therapy
- physical therapy
- yoga
- acupuncture
- therapeutic massage
OTC pain relievers are generally safe and effective when you use them as directed. Follow the instructions on the label and limit use to only short periods.
If you need daily pain relief, talk with your doctor about other options that may be safer for long-term use. In the meantime, exploring alternatives such as physical therapy, yoga, or massage may help provide some relief.
Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.