Tylenol is a good choice for those needing relief from the physical pain caused by osteoarthritis in the joints or from headache pain and who also have heart troubles such as high blood pressure, heart failure, heart attacks, chest pain due to narrowed coronary arteries (angina), or stroke. Using acetaminophen is a much safer bet than most over-the-counter pain relievers like ibuprofen (Advil and generic) and naproxen (Aleve and generic), according to a recent report by Consumer Reports Best Buy Drugs. That’s because acetaminophen is unlike other common, over-the-counter pain medications, like ibuprofen and naproxen, which can aggravate high blood pressure, and in turn raise a person's risk of having a heart attack. Those drugs can also cause fluid retention. In people who have a “weak heart” (due to congestive heart failure or left ventricular dysfunction), that could make symptoms worse. Acetaminophen has not been shown to have those effects.

More than 600 products, including prescription and over-the-counter pain relievers and drugs to reduce fevers, have acetaminophen as an ingredient. It’s the most commonly prescribed drug for pain and the most common drug ingredient in the U.S., used every week by approximately 23 percent of U.S. adults—that's 52 million people. Because the drug has a good record for safety and effectiveness, when used according to labeling instructions, it’s been a long-standing recommendation of Consumer Reports Best Buy Drugs as the best pain reliever option for people who also have a heart condition.

Acetaminophen can help relieve mild to moderate pain, including headaches and joint pain from osteoarthritis, and is gentler on the stomach than drugs like ibuprofen and naproxen, which can cause gastrointestinal irritation, ulcers, and bleeding.

Although it might be a better choice for you, you’ll still need to be careful when taking acetaminophen. High doses can damage the liver, so take the lowest dose you can to get enough pain relief, and don’t take more than 3,250 milligrams or 10 325-mg pills in a day. And because acetaminophen shows up in so many products, check all drug labels for acetaminophen to make sure you stay below the safe upper limit. Avoid acetaminophen altogether if you are at risk for liver disease or drink alcohol heavily, because that multiplies the dangers.

For more about the best pain reliever options for you and much more, see Consumer Reports' new guide to pain relief.

Editor's Note: This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).