Choosing a painkiller can be a headache

You've got a headache. What do you do? Among your choices are Tylenol, Advil, Aleve and Bayer. Plus the generic acetaminophen, ibuprofen, naproxen and aspirin. Which one should you take? It's enough to make that minor pain in the neck a full-blown migraine.

The over-the-counter painkillers all fight low fevers and reduce muscle pain, headaches and menstrual symptoms. Choosing between the different types can simply be a matter of personal preference. Each person will likely have one that works slightly better because, contrary to what the Declaration of Independence tells us, all people are not created equal, says Simeon Orekoya, a pharmacist at Morton's Care Pharmacy in D.C. "All body systems are not the same. I can take something and feel nothing. You can take something and feel nauseous."

For most customers, the choice between generics and name brands usually comes down to a question of price or perception. "Generics are oftentimes less expensive, so many patients choose them for cost reasons," D.C. internist Elliot Aleskow says. Others prefer the security of a big-name company manufacturing their medicine. Generic brands can differ by about one-tenth of a milligram in their makeup from name brands, Aleskow says, a difference that is minuscule.

To determine the best painkiller for you, Ariel Green, an internal medicine resident at Johns Hopkins Bayview Medical Center, says to look at the potential side effects. Though side effects are rare, each medicine can cause different reactions according to a person's medical history or lifestyle choices. For example, acetaminophen can damage the liver, so it's best avoided if you're consuming alcohol, Green says. If you're prone to ulcers, take acetaminophen, because aspirin, naproxen and ibuprofen can cause stomach bleeding.

Aleskow says that people often forget that over-the-counter medicine can have side effects, especially if taken while they're on other medication. "Being a good consumer means talking with your doctor frankly about the side effects," he says.