Paracetamol, one of the most prescribed drugs in the USA and probably the most popular over-the-counter pain reliever, has been recently subject to shortages due to increased demand in recent months. In the last 1-2 years, clinics and healthcare providers have advised many patients to purchase paracetamol over the counter to reduce the cost of prescribed medications.

In this post, We will discuss drug alternatives to paracetamol. Firstly, I will list some common combinations of drugs that may be used in standard paracetamol tablets or capsules. Secondly, I will review alternatives to paracetamol analgesics commonly available in the USA.

Paracetamol Approved Uses

Paracetamol, generally known as acetaminophen, is a widely used medicine with several uses. Here are some of the most popular applications for paracetamol:

  • Paracetamol is typically used to alleviate mild to moderate pain. It can help with headaches, toothaches, muscular aches, menstrual cramps, and pain from soft injuries.
  • Fever Reduction: Paracetamol is also used to treat fever in adults and children. It aids in lowering raised body temperatures caused by infections, colds, or flu.
  • Cold and flu symptoms: Paracetamol might relieve cold and flu symptoms such as sore throat, nasal congestion, and sinus pain.
  • Post-Vaccination Discomfort: It is usually suggested to relieve pain and discomfort after obtaining vaccinations.
  • Osteoarthritis: Paracetamol can be a therapy strategy for those with mild to moderate osteoarthritis. It can help alleviate joint discomfort and increase mobility.

While paracetamol is typically safe and well-tolerated when used carefully, following the recommended dosage and exceeding the maximum daily limit is critical to avoid potential adverse effects or liver damage.

Paracetamol: Legal Limits On Purchase

Paracetamol (acetaminophen) has no strict legal limits on purchase quantity in the USA. The recommended daily dosage for adults is 4,000 milligrams (mg). Some states or retailers may have restrictions to discourage misuse. Paracetamol is widely available over-the-counter for pain relief, fever reduction, and cold/flu symptoms. It can also be used for post-vaccination discomfort and mild osteoarthritis. Responsible use is crucial to prevent potential side effects or liver damage. Follow the recommended dosage and avoid exceeding the daily limit.

Here are some common forms of paracetamol:

  • Tablets
  • Capsules
  • Syrup
  • Suspension
  • Effervescent Tablets
  • Suppositories

10 Best Alternatives to Paracetamol

Here are some drug names and reasons why the following drugs can be considered as alternatives to paracetamol (acetaminophen), along with information on their availability and prescription requirements:

1. Ibuprofen

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID), like paracetamol, that can relieve pain and reduce inflammation. It is available over the counter (OTC) in various strengths and forms, such as tablets, capsules, and liquids. Higher doses may require a prescription.

2. Ibuprofen Gel

Ibuprofen gel is a topical formulation commonly used for localized pain relief, such as muscle or joint pain. It can be directly applied to the affected area on the skin. Ibuprofen is an anti-inflammatory drug that helps reduce swelling and inflammation. It is important not to overuse the gel and to follow proper guidance for its use. Ibuprofen gel is available over the counter and comes in two strengths: 5% and 10%. Various brands of ibuprofen gel are available, including supermarket brands like Tesco Ibuprofen gel 5% and 10%, which are often more affordable than other brands.

3. Ibuprofen and Pseudoephedrine

Nurofen Cold & Flu (known as Nurofen Sinus Relief) combines ibuprofen for pain relief and pseudoephedrine for nasal congestion relief. It is available over the counter (OTC) in the United States, but higher-strength versions may require a prescription.

Nurofen Cold & Flu is designed to alleviate congestion and take advantage of ibuprofen’s anti-inflammatory properties. It can be used as an alternative or in conjunction with paracetamol if appropriate for the individual.

Pseudoephedrine, the decongestant component of Nurofen Cold & Flu, is a pharmacy-only medicine. This means it can be purchased from pharmacies or online chemists but not from general retailers. Pseudoephedrine is an effective oral decongestant for relieving cold symptoms, particularly sinus-related symptoms like congestion, sinus pain, and pressure.

It is important to note that pseudoephedrine may not be suitable for everyone, especially individuals taking certain medications or those with specific underlying conditions. Additionally, pseudoephedrine should not be used continuously for more than 7 days, and there is typically a limit of one box per customer when purchasing it.

4. Naproxen

For several reasons, Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is considered an excellent alternative to paracetamol (acetaminophen). First, Naproxen relieves pain by reducing inflammation and its analgesic properties. This makes it particularly beneficial for arthritis, menstrual cramps, and musculoskeletal pain. Second, Naproxen has a longer duration of action than paracetamol, meaning it can provide relief for a more extended period, reducing the need for frequent dosing. Lastly, Naproxen may be more suitable for individuals who do not achieve sufficient pain relief with paracetamol alone.

In the United States, Naproxen is available over the counter (OTC) and by prescription, depending on the strength and formulation. Lower-dose Naproxen is available OTC, typically in strengths of 220 mg, while higher-dose versions may require a prescription. OTC naproxen products are commonly marketed under brand names like Aleve, while a healthcare professional may prescribe prescription-strength Naproxen for specific conditions and higher pain intensity.

5. Naproxen

For several reasons, Naproxen, a nonsteroidal anti-inflammatory drug (NSAID), is considered an excellent alternative to paracetamol (acetaminophen). First, Naproxen relieves pain by reducing inflammation and its analgesic properties. This makes it particularly beneficial for arthritis, menstrual cramps, and musculoskeletal pain. Second, Naproxen has a longer duration of action than paracetamol, meaning it can provide relief for a more extended period, reducing the need for frequent dosing. Lastly, Naproxen may be more suitable for individuals who do not achieve sufficient pain relief with paracetamol alone.

In the United States, Naproxen is available over the counter (OTC) and by prescription, depending on the strength and formulation. Lower-dose Naproxen is available OTC, typically in strengths of 220 mg, while higher-dose versions may require a prescription. OTC naproxen products are commonly marketed under brand names like Aleve, while a healthcare professional may prescribe prescription-strength Naproxen for specific conditions and higher pain intensity.

6. Aspirin

Aspirin, an NSAID, is a versatile medication that can be used as an alternative to paracetamol. It has pain-relieving, anti-inflammatory, and blood-thinning properties. Aspirin is available over the counter (OTC) in various strengths and forms. It is commonly sold as aspirin 300, either on its own or combined with other ingredients like caffeine or paracetamol.

In addition to its pain-relieving properties, a lower dose of 75mg, often called baby aspirin, is taken to prevent cardiovascular diseases such as strokes or heart attacks. Over-the-counter aspirin comes in different forms and brands. Soluble aspirin, like Alka-Seltzer, can provide faster pain relief than standard tablet formulations, making it beneficial for conditions requiring fast-acting medications, such as relieving headaches during a migraine episode.

Using aspirin cautiously and under a doctor’s guidance is important, especially when considering long-term use. Aspirin has various benefits and applications, but it is crucial to know its potential side effects and interactions with other medications.

7. Diclofenac Gel

Diclofenac gel, available both over the counter and by prescription, is a topical NSAID that relieves pain and inflammation when applied to the skin. It belongs to the same class of drugs as ibuprofen – NSAIDs. Diclofenac is generally considered more effective than ibuprofen. Over-the-counter diclofenac is sold as Voltarol gel and is available in two strengths: 1.16% and 2.32% (double the strength).

8. Co-codamol

Co-codamol combines codeine and paracetamol, making it an effective medication for moderate to severe pain relief. It is available by prescription and is the most popular over-the-counter codeine-containing product. Each ‘standard’ co-codamol tablet contains 500mg of paracetamol and 8mg of codeine.

It is important to note that availability and prescription requirements for co-codamol can vary depending on regulations and guidelines in different countries or states. To ensure safe and appropriate use, it is crucial to consult with a healthcare professional or pharmacist for specific guidance based on your individual needs and medical history.

9. Amitriptyline

Amitriptyline is a tricyclic antidepressant sometimes used off-label for chronic pain management. It is available by prescription only and should be taken under medical supervision.

Non-drug Alternatives To Paracetmol

There are several non-drug solutions for pain treatment. These often comprise hot and cold patches, sprays, and different gels. I’ve listed two standard gels used for symptomatic relief of various ailments.

10. Biofreeze Pain-Relieving Gel

Biofreeze Pain Relieving Gel is another non-medicated gel with menthol as an active component. It treats muscular discomfort, arthritis, and back pain. Menthol produces a sense of coldness, suppressing brain pain impulses. It provides long-term pain relief.

If you accidentally apply the drug to areas of the body other than the pain region, wash thoroughly to avoid irritation. You can use the gel on the afflicted part for up to 8 hours.

Final words From AzDrug

Paracetamol is a lifesaver for receiving medicine at any moment in the drugstore. Assume you have slight discomfort or a cold. Take a paracetamol tablet to obtain immediate relief. It is one of the most often utilized medications for therapy and is widely available. There are some locations where the drug may not be available, but here are 18 over-the-counter alternatives.

Each pharmaceutical device provides the most excellent remedies for your circumstances. If you do not receive the required medication, consider other options. Alternatives for improving your health are discussed. To avoid unpleasant side effects, always take the recommended dose from your doctor.

Disclaimer: Please see your healthcare practitioner for any medical queries or concerns. Peer-reviewed research and information from medical societies and government agencies are used to support the articles in Health Guide. They are not, however, a replacement for expert medical advice, diagnosis, or treatment.

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  • Conaghan, Philip G., et al. “Drug-Free Gel Containing Ultra-Deformable Phospholipid Vesicles (TDT 064) as Topical Therapy for the Treatment of Pain Associated with Osteoarthritis: A Review of Clinical Efficacy and Safety.” Current Medical Research and Opinion, vol. 30, no. 4, Nov. 2013, pp. 599–611, https://doi.org/10.1185/03007995.2013.860018. Accessed 11 July 2023.
  • Moore, Andrew R., et al. “Faster, Higher, Stronger? Evidence for Formulation and Efficacy for Ibuprofen in Acute Pain.” Pain, vol. 155, no. 1, Jan. 2014, pp. 14–21, https://doi.org/10.1016/j.pain.2013.08.013. Accessed 11 July 2023.
  • Oncel, Mehmet Yekta, et al. “An Alternative Drug (Paracetamol) in the Management of Patent Ductus Arteriosus in Ibuprofen-Resistant or Contraindicated Preterm Infants.” Archives of Disease in Childhood – Fetal and Neonatal Edition, vol. 98, no. 1, May 2012, pp. F94–94, https://doi.org/10.1136/archdischild-2012-302044. Accessed 9 July 2023.
  • Zhang, John, et al. “Effects of Biofreeze and Chiropractic Adjustments on Acute Low Back Pain: A Pilot Study.” Journal of Chiropractic Medicine, vol. 7, no. 2, June 2008, pp. 59–65, https://doi.org/10.1016/j.jcme.2008.02.004. Accessed 11 July 2023.

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