Last update: Aug 14th, 2021, added Bonus and Bonus 2 info, regarding gel vs pill and expiration dates.

As I was going through the various OTC meds in my cabinet, checking for expiration dates, I decided to once and for all, understand how they work, what are some risks, and determine which to use for for each situation. Btw, I’m not a doctor nor am I giving any medical advice. I simply want to summarize what I found by looking online:

Aspirin / Bayer: Thins blood, anti-inflammation, inhibits pain chemical (prostaglandins) production, can irritate stomach. <18yrs not recommended due to Reye’s Syndrome

Ibuprofen / Advil: Anti-inflammation, inhibits pain chemical production similar to Aspirin but slightly more stomach safe and doesn’t thin blood. Avoid if you have risk of cardiovascular disease.

Acetaminophen / Tylenol: Dulls pain receptors in brain. Reduce pain and fever, most stomach safe, but don’t take with alcohol. Liver damage if >3000 miligrams/day

Excedrin: For Headaches, contains Asprin, Tylenol, & Caffine (narrows blood vessels, headaches widen blood vessels in the brain)

Take Aways

Mensuration or Cramps: Ibuprofen/Advil
Pain Relief during pregnancy: Acetaminophen / Tylenol
Fever: Acetaminophen / Tylenol
Arthritis: Aspirin / Bayer (short term) or Ibuprofen/Advil (longer term) due to GI side effects increasing
Sports Injury: Ibuprofen
Headaches: Excedrin

Bonus: Liquid gel or traditional pills?

Both have the same amount of ingredients and are equally effective, however gel capsules do seem to begin working faster. Here is a well referenced 1991 study which concluded that both forms have equal efficacy (effect/result), however the gelcaps seem to take effect 4-6 minutes faster.

If that’s the case, my not only keep gelcaps? One reason is that they have a shorter shelf-life, meaning they typically expire earlier then traditional dry pills. Second, gelcaps are also typically more expensive.

Take Away II: If you want gelcaps, order them in smaller quantities, else get traditional dry pills at larger quantities, just remember that it can take a few extra minutes to take effect.

Bonus 2: How long can you take OTC meds like ibuprofen and Aspirin after opening or expired?

Most over-the-counter drugs are safe and could simply become less effective after their expiration date.

The vast majority of medications maintain most of their potency years after the posted expiration date. That date is the date after which full potency cannot be guaranteed by the manufacturer.

according to emergency-medicine specialist Dr. Jack Springer

However, some medications and drug types undergo changes during extended storage that can compromise their safety or effectiveness. Liquid medications and some antibiotics are among these.

Though for most OTC medicines in tablet or capsule form, they can be safe to use for many years after their expiration date. For example:
Ibuprofen, Acetominophen, & Aspirin are most potent 4-5 years after opening, and safe to consume (though possibly less potent) after that.
Antibiotics should be taken immediately as prescribed, but can last up to a year later. This does not apply for liquid antibiotics.
Cough Syrup, Nasal Sprays, & Eye drops should be taken by the expiration date, liquid medications break down more quickly than dry medications.
Sleeping Pills have a low risk of expiration but can use their potency over time, and dosage shouldn’t be increased to compensate.
Allergy Medicine in dry pill form can be effective for over a decade after opening, however liquid form should be discarded after their expiration date.

Takeaway |||: Most OTC medications that are in a dry form like pills can last much longer than the stated expiration, however most liquid forms of medications should stick with the stated expiration dates. Reminder, we are talking about OTC/non-prescription drugs.

My personal order

I’m an active male who plays basketball on a weekly basis, i also get the occasional headache, and maybe once a year might get the occasional flu or cold. Based on my needs, I would most often use ibuprofen (sports injuries or strain), then Excedrin (headache), then regular strength Tylenol, and last a very low dose of Aspirin. Most likely, unless it’s a headache, I’d start with a chewable low dose of Aspirin, then go to one of the others if necessary. For all I’d go for a name brand. Btw, for Amazon meds, they don’t actually make their own meds. They select a quality, non-big brand, and relabel it as Amazon. So they are cheaper than the big brands, but you’re basically buying an off-brand. Check out this video example.

Here is my latest order of OTC pain relievers (my first to get everything at once)

Advil/ibuprofen, 200 of 200mg, $14.58
Excedrin, 24×2 250/250/65mg, $7.99
Tylenol/Acetaminophen 100 of 325mg, $6.97 (rather than the typical 500mg)
Asprin low dose chewable 36×3, $9.02

Last, I don’t get PM/night time versions. It’s just more to keep track of, and if I need to sleep, I simply take a chewable/dissolving melatonin at 5mg like this one.

Most Useful Sources:
https://www.healthline.com/health/migraine/Excedrin-migraine
https://my.clevelandclinic.org/health/treatments/12058-pain-relievers
https://www.utmedicalcenter.org/know-the-difference-between-your-pain-relievers/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1368416/pdf/brjclinpharm00062-0085.pdf
https://www.medscape.com/viewarticle/406213
https://www.insider.com/how-long-can-you-take-medicine-after-expiration-date-2019-2

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