AARP Hearing Center

Aches, pains, fever — older adults are reaching for over-the-counter medications in large numbers to manage these everyday ailments.
A recent report from the University of Michigan’s National Poll on Healthy Aging, supported by AARP, found that two-thirds of adults over 50 with joint pain rely on nonprescription pain relievers to help ease their symptoms. And a previous study, published in the medical journal JAMA, found that nearly half of adults ages 57 to 85 use an over-the-counter medication weekly.
And while these pills and powders are generally considered safe when taken as directed, they are not without side effects and special considerations, especially for older adults.
Just because something is sold without a prescription doesn’t mean it’s risk-free, says Amy Thompson, a clinical professor of pharmacy at the University of Michigan’s College of Pharmacy. “And those risks heighten as we age,” she adds.
Here’s what you need to know before you pop an OTC pain reliever.
Acetaminophen
Also known by the brand name Tylenol
What it is: Acetaminophen is one of the most commonly used drugs in the U.S. and is the top recommended OTC pain relief option for most older adults.
Why it’s used: It can be used to ease headaches and muscle aches and to reduce fever. It’s also good for helping with osteoarthritis — the type of arthritis that comes from everyday wear and tear, says K. Ashley Garling, a pharmacist and assistant director of programs at the University of Texas at Austin’s Center for Health Communication.
What to know: Because too much acetaminophen can cause liver damage, certain people should reduce their dosage or avoid it altogether. Talk to your doctor before taking acetaminophen if you have liver disease or drink three or more alcoholic beverages per day. Alcohol causes the liver to convert more of the acetaminophen into toxic byproducts; if these toxins build up, damage can result.
Otherwise, Garling says, “as long as your overall daily dose is under 3,000 milligrams, it’s usually fairly safe.”
Taking a higher dose than recommended will not provide more relief and can be dangerous, the Food and Drug Administration (FDA) says.
Keep in mind: Keeping your daily dose under 3,000 milligrams can be tricky, especially since acetaminophen is found in hundreds of other medications, including OTC cold and flu relief and allergy medicines.
“And so people might be taking Tylenol for their knee pain and then taking NyQuil for a cold, not realizing there’s Tylenol in both of them. They could easily be exceeding the daily dose without even realizing it,” Thompson says.
Be sure to pay close attention to the label, as overdosing on acetaminophen is the most common cause of drug-related liver injury. Acetaminophen isn’t always spelled out; abbreviations such as APAP, Acetaminoph, Acetaminop, Acetamin or Acetam may be used instead, the FDA says.
What to know about “PM” pain relievers
Older adults should avoid the nighttime version of any pain reliever, says Hillary Lum, a geriatrician and professor of medicine in the Division of Geriatric Medicine at the University of Colorado School of Medicine.
These medicines often contain diphenhydramine, an antihistamine that can aid sleep — thus the “PM” that’s often in the product name, indicating it should be taken at night.
But they can also cause falls, confusion, blurred vision and urinary problems in older adults. What’s more, diphenhydramine has been linked in studies to increased dementia risks. If a nighttime pain reliever is being used primarily as a sleep aid, talk to your doctor about alternatives.
More From AARP
Should You Take a Fish Oil Supplement?
People take it to protect their brain, joints and heart. But does it live up to the hype?
Common Heart Med May Be Ineffective
New research calls into question the benefit of beta-blockers
Tips for Protecting Your Liver Health
Shield your liver with these essential health tipsRecommended for You