Safety concerns for pain medicines for older adults

Review this chart of common types of pain relief medicines, safety concerns for older adults, and tips on taking medicines safely. Remember: all medicines (over-the-counter [OTC] and prescription medicines) can cause side effects. Be sure to discuss all medicines that you take with your healthcare professional and also be sure to ask about any potential side effects or interactions you should know about before you try a new medicine.

Pain Relief Medicines Commonly Used to . . . Potential Safety Concerns Play it Safe
Acetaminophen available in prescription form and as an OTC medicine; this common pain relief medicine is an ingredient in more than 600 medicines, including cough suppressants, cold and allergy medicines, and some sleep aids. Relieve headache, muscle ache, and pain from sinus pressure; reduce fever; promote sleep. Overdose may cause severe liver damage; Risk for liver damage may be increased in people who drink three or more alcoholic beverages a day while using medicines with acetaminophen. Do not combine multiple acetaminophen-containing medicines. Ask your healthcare professional or pharmacist if you are unsure about whether you are taking too much.
Non-steroidal anti-inflammatory drugs (NSAIDs) include ibuprofen, aspirin and naproxen; available in prescription form and as an OTC medicine. Reduce swelling by inhibiting certain chemicals from forming in your body that can make pain symptoms worse. May cause severe stomach bleeding; risk is higher for people age 60 or older and for those with stomach ulcers or bleeding problems or who take a blood thinning or steroid drug; taking NSAIDs for longer than directed or with other drugs containing prescription or nonprescription NSAIDs (aspirin, ibuprofen, naproxen, or others), or having 3 or more alcoholic drinks daily while taking NSAIDs, can increase your risk for stomach bleeding. If you have a history of kidney or heart problems, check with your healthcare professional before taking an NSAID.
Opioid medicines (morphine; oxycodone; and codeine); available by prescription only. Treat moderate-to-severe pain.  Drowsiness; constipation; fatigue. Overdose of opioid medications that also contain acetaminophen may cause severe liver damage. May be safer for older adults than NSAIDs. Risk for addiction is small when taken as directed; dosages vary widely—what is safe for one person may be high enough to cause an overdose in someone else—especially in children.

(Sources: FDA; NCPIE)