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Ibuprofen —

Ibuprofen falls into the class of drugs known as NSAIDs (nonsteroidal anti-inflammatory drugs). Sold under brand names including Motrin or Advil, it's used to treat minor aches and pains and reduce fever. It may be prescribed in stronger doses. It comes in tablet form as well as in chewable tablets, liquid suspensions and concentrated liquid drops. People who take NSAIDs may have a higher heart attack or stroke risk than those who do not, according to the National Institutes of Health. The medication can also cause ulcers, bleeding or holes in the stomach and intestine for some people. The risk may be higher if you take NSAIDs for a long time, are older or in poor health, and have three or more alcoholic drinks per day.

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Acetaminophen —

This compound can ease minor muscle, back, tooth and joint pain and reduce fever. Sold under brand names such as Tylenol, Liquiprin and Panadol, it works by regulating the part of your brain that controls your body's temperature and inhibits the synthesis of prostaglandin in the central nervous system. A study has found that it could reduce pleasure as well. Too much of the drug can cause rashes, liver failure and even death.

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Aspirin —

Aspirin is one of the cheapest and oldest manufactured painkillers on the market. German-born scientist Felix Hoffman is credited with creating and popularizing what was then known as acetylsalicylic acid in 1899 to help ease his dad's arthritis pain. Today, it is used to ease minor aches and headaches. It works by reducing the substance in the body that causes inflammation and fever. Doctors also tell some adults to take an aspirin daily to help prevent a heart attack or stroke. People with bleeding conditions like ulcers or cardiovascular troubles like asthma are often advised to take another painkiller, as it may make those conditions worse. Some Americans are also allergic to aspirin. Americans consume more than 15 billion aspirin tablets a year. Here's a guide to some of the most commonly used pain relief medications:

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Marijuana —

There's been a growing acceptance of marijuana as a legitimate pain reliever. The American Medical Association supports making marijuana a Schedule I controlled substance in order to promote research into its therapeutic abilities. Doctors in some states may prescribe it to ease chronic pain that comes from arthritis, migraines, Crohn's disease or other ongoing pain issues where other medicines have failed. It works by blocking the pain sensations felt by peripheral nerves. The cannabinoids in marijuana bind to endocannabinoid receptors throughout the body and can reduce pain (but also give the feeling of being high). Some research shows that it can also slow cancer development and increase appetite. Forty states and the District of Columbia allow some legal uses of marijuana, mostly for medicinal purposes.

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Hydrocodone —

Hydrocodone is available only in combination with other ingredients, with different products prescribed for different uses. Some products are used to relieve moderate to severe pain, while others combat a cough, according to the National Institutes of Health. An opiate (narcotic) analgesic, hydrocodone relieves pain by changing the way the brain and nervous system respond to it. It may be habit-forming, and abuse of drugs, including hydrocodone, has become a concern in recent years. In 2014, hydrocodone was moved from Schedule III to Schedule II. Now, in order to use these drugs, patients will have to get a written prescription from a doctor -- instead of one submitted orally by phone. And refills are prohibited; patients would have to check in with their doctors to get another prescription.

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Fentanyl —

Fentanyl is a prescription-only pain medication often given to cancer patients. They must be at least 18 years old to take it, or at least 16 for lozenges branded as Actiq, and they should also be taking regular doses of another narcotic pain medication. Patients must also be accustomed to the effects of narcotics. Fentanyl itself is a narcotic and changes the way the brain and nervous system respond to pain, according to the National Institutes of Health. This drug comes in the form of a lozenge, a tablet under the tongue, a film and a buccal (between the gum and cheek) tablet, as well as in injectable form. It is designed for sudden episodes of pain and should not be used more than four times a day. Overdose can cause drowsiness, dizziness, confusion, breathing problems or smaller pupils. The FDA has said there is growing concern about illicit fentanyl use, particularly in conjunction with heroin.

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Morphine —

Patients take morphine for moderate to severe pain. It is an opiate (narcotic) analgesic and changes the way the brain and nervous system react to pain. Forms of morphine include tablet and solution, which are taken every four hours, as needed. Controlled- or extended-release tablets and controlled- or sustained-release capsules are for patients who need around-the-clock pain relief. Morphine can also be found as a morphine sulfate injection, as added to an IV fluid that drips through a needle or catheter, or injected into a large muscle. Morphine overdose can cause serious consequences such as breathing problems, loss of consciousness, sleepiness, slow heartbeat, blurred vision, nausea and fainting, according to the National Institutes of Health. Morphine may also be habit-forming.

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Propofol —

Propofol, also known as Diprivan, became infamous when pop star Michael Jackson died after overdosing on the drug while using it as a sleep aid. The drug is typically administered intravenously by medical professionals for anesthetic purposes, such as when a patient is undergoing surgery. It's not approved to treat sleep disorders, according to the Food and Drug Administration. The drug itself does not provide pain relief but renders a patient unconscious. A patient wakes up almost immediately after an infusion is stopped, experts say. Propofol lowers blood pressure and suppresses breathing, so patients' heart function and breathing need constant monitoring, according to the Harvard Health Blog. Abuse of propofol in medical circles, however, has been a concern in recent years.

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A guide to (legal) pain relief

Story highlights

Acetaminophen is a non-opioid analgesic and is used to treat mild or moderate pain

It's the active in ingredient in Tylenol and many other over-the-counter medications

The FDA has set the recommended daily maximum for adults at 4,000 milligrams

Parents should carefully read drug labels to ensure they are giving the correct dose to kids

CNN —

The Food and Drug Administration recently issued a warning to doctors about prescribing medications with more than 325 milligrams of acetaminophen. Although acetaminophen is harmless in small doses, it can cause liver damage if taken incorrectly.

Here are five things you should know about this popular painkiller:

1. It’s not great for muscle pain

Acetaminophen is part of a class of painkillers called non-opioid analgesics, which are used to treat mild or moderate pain. These include acetaminophen, ibuprofen and aspirin.

Non-opiod analgesics block an enzyme known as cyclooxygenase, or COX, according to Ewan McNicol, an assistant professor of anesthesiology at Tufts University. COX helps the body produce lipid compounds called prostaglandins that cause pain and inflammation when your cells are injured. Blocking this enzyme, therefore, helps prevent prostaglandins from causing you pain.

Most non-opiod analgesics work in the peripheral nervous system, or the nerves not included in your brain and spinal cord. But scientists believe acetaminophen works primarily in the central nervous system, attacking a slightly different form of the enzyme called COX-3.

“What this means to you is that acetaminophen is great for headaches, fever and minor aches and pains but won’t reduce inflammation due to, say, a muscle sprain,” McNicol explained.

2. It’s found in more than Tylenol

Though many people know that acetaminophen in the active ingredient in Tylenol, it’s also found in many other over-the-counter drugs including (but not limited to) some Excedrin, Robitussin and Sudafed products.

Acetaminophen is also used in combination with opioids in prescription pain medications such as Percocet, Vicodin and Tylenol with codeine.

To find out whether your medications contain acetaminophen, read the drug label or the list of ingredients in the patient information leaflet that came with your prescription. Look for the word “acetaminophen” or the letters “APAP,” an abbreviation sometimes used for the drug.

If you are still unsure, contact your doctor or pharmacist.

3. It’s easy to accidentally take too much

The FDA has set the recommended daily maximum for adults at 4,000 milligrams. It’s easier to reach this limit than you might think; one gel tablet of Extra Strength Tylenol, for example, contains 500 mg.

Taking too much acetaminophen can lead to liver failure or death. Overdoses of the popular painkiller are some of the most common poisonings worldwide, according to the National Institutes of Health.

In April 2009, the FDA introduced new labeling requirements for drug manufacturers. Any product that contains acetaminophen must prominently identify the active ingredient on its display panel and must warn consumers about the potential for liver toxicity.

Consumers should not take more than the prescribed dose of any medication that contains acetaminophen, according to the FDA, and should avoid taking more than one acetaminophen product at a time.

4. It’s not the best way to fight a hangover

Most of us have popped a couple of painkillers after a night out to ward off a hangover. But experts say you should choose carefully when opening the medicine cabinet, especially if you’re a chronic heavy drinker.

Taking acetaminophen with alcohol, even in small amounts, can increase your risk of liver damage and/or kidney disease.

Acetaminophen is primarily metabolized in the liver, where it is turned into nontoxic compounds that are eliminated through urination. But the liver needs something called glutathione to do that. If your glutathione levels are low – which can be caused by chronic drinking, an unhealthy diet or fasting – the drug may be metabolized into a more toxic substance, according to the National Institutes of Health.

Liver damage may occur after taking as few as four or five extra-strength pills over the course of the day, one NIH publication on alcohol and metabolism says. And another study showed that taking the recommended dose of acetaminophen with a small to moderate amount of alcohol can increase your risk of kidney disease by 123%.

You may not notice the signs of liver damage right away, the FDA says; some symptoms like loss of appetite and nausea can be mistaken for the flu (or that hangover). If you suspect you’re at risk, contact your doctor immediately.

5. It’s not like “a spoonful of sugar.”

Children can take acetaminophen to fight pain or a fever, but parents should read drug labels carefully to avoid dosage errors.

The “directions” section of the label tells you whether the medicine is right for your child and how much to give, the NIH’s website says (PDF). “If a dose for your child’s weight or age is not listed on the label or you can’t tell how much to give, ask your pharmacist or doctor what to do.”

Liquid acetaminophen for infants and children is now sold in the same concentration: 160 mg/5 mL. That means infants need less; acetaminophen products for infants are usually packaged with an oral syringe instead of a dropper.

Parents should always use the measuring tool that comes with the medication, the FDA says – never a kitchen spoon.

If your child takes too much acetaminophen, seek medical attention right away. You can also call the 24-hour Poison Control Center at 800-222-1222.

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5 things to know about acetaminophen

A guide to (legal) pain relief

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