What you should have in your medicine cabinet

For a week George, an avid weightlifter, complained about the pain in his elbow and the swelling that would not go away. He claimed to be following his physiotherapist's advice, which included taking Aspirin. Finally, someone asked, "Are you sure you're taking the Aspirin?" George responded, "Well, I'm taking Tylenol, but it's the same thing, right?" No, George, not the same thing at all.

George's confusion about his over-the-counter (OTC) pain medication is not surprising. Pharmacies contain a flood of OTC medications -- and most people have no idea what, if any, the differences are between products in the same general category. Instead they often just reach for a familiar brand name or the on-sale item, which may not be what the doctor ordered.

Larry Boggio, a past-president of the Ontario College of Pharmacists, has been a pharmacist in Port Colborne, Ont., for 25 years. Over that time he and his staff have helped many families choose the OTC medications they need to stock in their medicine cabinets to deal with their aches, coughs and colds. "With all that's on the shelves, it's hard for people to know where to start," he says. We asked Boggio to help Canadian Living Magazine compile a basic guide to stocking the family medicine cabinet.

1. Pain relievers: Those that reduce inflammation.
Two types: a) ASA and b) ibuprofen

a) Generic name/category: ASA (acetylsalicylic acid)/non-narcotic analgesic

Brand names: Anacin (contains ASA and caffeine); Aspirin; Bufferin; Entrophen (coated Aspirin)

What they do:
ASA is an anti-inflammatory (which decreases the redness, swelling and burning often associated with sports-related injuries, other soft-tissue injuries such as sprains, and arthritis). It also reduces fever and relieves pain and headaches. In small doses it helps prevent blood clots from forming.

Not recommended for:
People who have bleeding disorders or peptic ulcers; who are pregnant; who use anticlotting drugs or have a known allergy to salicylates. Not recommended for children under 18.

Side-effects:
Stomach irritation. Prolonged use of large doses may also cause gastrointestinal bleeding, blood-clotting defects and liver and kidney damage. Some people may experience asthmalike or other allergic reactions, such as rashes. ASA may also cause Reye's syndrome in children, a rare brain and liver disorder that can result in death. Note: Coated ASA passes through the stomach to the intestine before dissolving, helping prevent stomach irritation.

b) Generic name/category: Ibuprofen/nonsteroidal anti-inflammatory drug (NSAID)

Brand names: Advil; Motrin

What they do:
Ibuprofen is also an anti-inflammatory, pain and headache reliever and fever reducer. It is less likely to cause gastrointestinal bleeding than ASA in recommended doses.

Not recommended for:
Pregnant women; women who are breastfeeding; children under age 12; or anyone who has an active peptic ulcer, suffers from kidney, stomach or intestinal disorders or has a known allergy to ASA or similar medications.

Side-effects:
Dizziness, ringing in the ears and skin rash.

2. Pain relievers: Those that do not reduce inflammation (contain the active ingredient acetaminophen).

Generic name/category: Acetaminophen/non-narcotic analgesic

Brand names: A.F. Anacin; Tempra; Tempra Drops for Children; Tylenol

What it does:
Acetaminophen, which is a nonsalicylate pain reliever, can be administered safely to nearly everyone, from infants to the elderly. It relieves headaches, as well as earaches and muscle pains. Is used to safely bring down fevers. Has less of a blood-thinning effect than ASA, so is easier on the stomach. Because of its wide applicability, acetaminophen is available in an assortment of tablets, capsules and liquids. Some are flavoured to make them more palatable, especially to children.

Not recommended for:
Those who exhibit hypersensitivity to acetaminophen, a rare reaction indicated by the presence of hives or skin rash.

Side-effects:
Used as directed, acetaminophen appears to be free of significant side-effects.

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