美国常见的4类非处方止痛药

在美国,轻微的头痛、肌肉痛、牙痛,大家都会去药房或超市买点止疼片,甚至一些小病去看医生医生也会建议你自己买点止痛片;更多美国家庭常备的 OTC 药物参见这篇文章;大姨妈疼痛的药物、保健品和痛经贴参见这篇文章

止疼药在美国如此常见,在药房里甚至排了整整一个货架的非处方止痛药,到底买哪一种呢?也是有点讲究哦。药房里常见的非处方止痛药有以下四种:

  1. 对乙酰氨基酚(acetaminophen)。
  2. 布洛芬(ibuprofen)。
  3. 阿司匹林(aspirin)。
  4. 萘普生钠(naproxen sodium)。

对乙酰氨基酚 Acetaminophen

对乙酰氨基酚最常见的商品名是泰诺(Tylenol),在国内叫扑热息痛。其镇痛原理尚不明确,但主流看法是它能够抑制引起痛感的前列腺素生成。对乙酰氨基酚可以有效缓解头痛、经痛以及感冒发烧引起的关节痛,也有退热作用,参见下面这篇文章介绍。

美国常见的感冒和退烧药介绍

Tylenol 不刺激肠胃,不会导致雷伊氏综合征(Reye’s Syndrome)。由于其安全性,对乙酰氨基酚是儿童退烧药的主要成分;儿童感冒发烧 106°F 以下通常不用看医生

对乙酰氨基酚最常见的有两种剂型:325mg/片和 500mg/片。325mg/片的叫 regular strength,500mg/片的叫 extra strength;甚至还有一种专门针对关节痛的 650mg/片剂型。大家除了注意看包装上的字样,也要注意看清楚成分表中对乙酰氨基酚的含量,确保买到正确的剂型。

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成人及12岁以上儿童一次服1-2片,隔4小时服用一次,最大剂量一天不可超过 4000mg。大家根据自己买的剂型,计算一下每天最多能吃几片。婴幼儿的服用剂量一定要遵守产品包装说明书,不能简单按照成人剂量减半服用。

对乙酰氨基酚可作为单一成分的止痛药,也可作为其他处方药的成分之一,所以服用 Tylenol 前检查一下自己是否同时还服用其他药物,以免服用超量。长期过量服用 Tylenol 对肝脏有损害,患肝病、酗酒者需征求医生意见。

布洛芬 Ibuprofen

布洛芬常见的商品名有美林(Motrin)和 Advil。布洛芬是一种非甾体抗炎药(非类固醇消炎药),通过抑制前列腺素生成以及干扰疼痛信息传递到大脑而起作用,对于头痛、牙痛、经痛、肌肉痛和关节痛都有效果,它同时也有退热作用。

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布洛芬可能会引起胃部不适、烧心、胃出血,建议餐后服用,不可同时服用阿司匹林和萘普生钠,但在高烧不退和遵守服药间隔的情况下可与对乙酰氨基酚交替使用 — 注意不是一次吃两种!参见这篇文章:《Tylenol 和 Motrin、Advil 的用量与注意事项》。

非处方药的布洛芬是 200mg/片的剂型,分为片剂(tablet)和液体胶囊(liquid-gel),胶囊在胃部分解速度比片剂快一点,理论上胶囊装的布洛芬起效快一点,但其实时间相差不是很大,有些人喜欢胶囊是因为较容易吞咽。成人和12岁以上儿童每次服用1-2片,隔4-6小时服用一次,最大剂量一天不可超过1200mg,若使用5天后仍无法止痛,请看医生。婴幼儿服用剂量请遵守产品说明书。

阿司匹林 Aspirin

阿司匹林也叫乙酰水杨酸(acetylsalicylic acid),和布洛芬类似,是一种非甾体抗炎药,可消炎退热止痛,还有抗血小板凝集效果。阿司匹林起效比布洛芬慢,不能急速缓解疼痛,但止痛效果较强。

阿司匹林最常见的副作用是胃部不适,最好餐后服用。孕妇、哺乳期妇女、年长者、患有慢性病者、酗酒者和有在服用其他非甾体抗炎药者一定要先征询医生意见。孕期最后3个月,除非医生许可,不可服用阿司匹林。儿童不可服用阿司匹林,有导致雷伊氏综合征(Reye’s Syndrome)风险,对大脑和肝脏造成严重损伤。

非处方药的阿司匹林有 325mg/片和 500mg/片两种剂量,还有低剂量的 81mg/片。但 81mg 的阿司匹林一次吃4片,所以等同325mg。

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有些复方止疼药(如 Goody’s)包含阿司匹林 + 对乙酰氨基酚 + 咖啡因,止痛效果更好。

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对于 325mg/片和 500mg/片的阿司匹林,成人和12岁以上儿童,每次可服用1-2片;81mg/片的阿司匹林,每次服用4-8片,间隔4小时一次,最大剂量一天不可超过 4000mg(自己计算好多少片哦)。阿司匹林不可以与布洛芬和萘普生钠同时使用!

萘普生钠 Naproxen sodium

这种成分的止痛药比较新,不为人熟知,它在美国常见的商品名是 Aleve。它也是一种非甾体抗炎药,可缓解偏头痛、牙痛、经痛、肌肉和关节痛等,也有退热作用。使用禁忌同阿司匹林一样;孕妇不可服用萘普生钠,有增加胎儿先天缺陷的风险;12岁以下儿童不可以服用萘普生钠。

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萘普生钠的剂量是 220mg/片,它药效时间长,成人和12岁以上儿童每次服用1片,隔8-12小时服用一次,最大剂量一天不可超过3片。不可以与布洛芬和阿司匹林同时使用!

孕妇及胃痛建议使用 Tylenol

孕妇和哺乳期妇女止痛退热建议选择对乙酰氨基酚/Tylenol。除非经医生指导许可,孕妇不建议使用非甾体类抗炎药(NSAID,即布洛芬、阿司匹林、萘普生钠)。哺乳期妇女可使用布洛芬(Motrin/Advil)。

胃痛可用对乙酰氨基酚/Tylenol,不建议使用非甾体类抗炎药(阿司匹林、布洛芬、萘普生),因为它们会刺激胃。

美国常见的非处方胃药

这些药物的专利权已经过期,所以大家也可以购买仿制药(generic brand),价格会比较便宜。药房都有驻店药剂师,购买前可根据自己身体状况先咨询医生或药房药剂师。

美国缓解痛经的非处方药及保健品

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