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Non-Opioid Pain Medicines

Acetaminophen

(generic; Tylenol ®) tablets or capsules

Acetaminophen (Tylenol ®) is a common over-the-counter pain medicine that comes in tablets, capsules, or chewable tablets.

Which one should I buy?

Acetaminophen (Tylenol ®) is usually sold as tablets or capsules. If you have trouble swallowing, you can ask for it in a liquid or chewable form.

 

The most common tablet/capsule strengths are:

  • 325mg - Regular strength

  • 500mg - Extra strength

How much can I take?

Always check with your doctor, but the usual package instructions are:

  • Regular strength tablets (325 mg): Take 2 tablets (650 mg) every 4 to 6 hours as needed for pain

  • Extra strength tablets (500mg): 1000 mg (2 tablets) every 6 hours as need for pain

Never take more than 3000mg in a 24-hour period. That means no more than 9 regular strength tablets, or 6 extra strength tablets.

How do I take it?

Take acetaminophen with a glass of water or other liquid. You can take it with or without food.

 

Here are some ways you can use acetaminophen together with your opioids to help your pain:

  • If your pain is mild, you can try taking acetaminophen instead of your short-acting (breakthrough) opioid. If your pain doesn’t improve, then try the opioid.

  • If you don’t get enough relief from your short-acting (breakthrough) opioid, try taking acetaminophen.

  • If you find that the acetaminophen is not helpful, stop taking it. It’s better to focus on things that work for your pain.

How does it work?

Scientists are not sure how it works to help pain. It may improve pain by reducing inflammation.

What are the side effects?

This medication does not usually cause side effects. Rarely, a person may develop an allergic reaction with swelling of the mouth or throat, shortness of breath, or rash. If this happens, call 911.

How can I be safe when taking this medicine?

  • Always follow the instructions on your prescription bottle.
    Never take a higher dose of your opioids, or take them more often than prescribed. Instructions on medicine bottles can be confusing. Short-acting opioids are often prescribed with a range of doses you can take. For example: “Take 1-2 tablets every 3 hours as needed for pain.” This means it’s OK to take up to 2 tablets within a 3-hour time window. You can also choose to take less than this, or not take it at all (if your pain is controlled). Take them with a sip of water, with or without food.
  • Take them when you have pain and need quick relief.
    These take about 30 minutes to start working and 1 ½ hour to get the most relief, so take them early on when you feel your pain creeping up.
  • If you don’t have pain, don’t take them.
    If your pain is manageable and you don’t expect it to get worse, you shouldn’t take this medicine. It should be used “as needed” when you have pain.
  • Take them before your pain gets severe.
    Try to “stay ahead” of your pain by taking your short-acting opioid early on when you notice your pain getting worse. If you wait until your pain is severe, it often takes more medication and a longer time to get your pain under control. Pay attention to your body as you learn about your pain and how you react to opioids. Most people start recognizing their body’s signals about when they need to take their short-acting opioid for breakthrough pain.
  • Choose the dose that matches your pain level.
    Most short-acting opioid prescriptions have a range of doses you can choose to take within a given time-period. A common example is take 1-2 tablets every 3 hours as needed. If your pain is severe, start with the higher dose (for example: 2 tablets). If your pain is less severe, you can start with the lower dose (for example: 1 tablet). If your pain isn’t significantly better after 30 minutes to an hour, you can take the rest of the dose.
  • Take them about 30 minutes before painful activities.
    Some people know they will have pain with certain activities, like walking or taking a long car ride. Think of activities that usually worsen your pain. To help you be more active, you may want to take your short-acting opioid 30 minutes beforehand.
  • If your short-acting opioid is not working well, talk to your care team.
    Every person is different and it can take some time to find the right medicines and right doses for you. Your care team might decide to increase the dose of your opioid or change to a different medication. The important thing is to let them know how you are doing.
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