You have no doubt heard or seen the Capital One commercial that asks: “What’s in Your Wallet?” It’s been running for at least two decades. We ask a different question: What’s in Your Medicine? Most people have no idea what OTC ingredients are in their pain reliever, heartburn medicine or laxative. They just trust the brand name. What about Aleve? Do you know the difference between AleveX Pain Relieving Lotion, Aleve Back & Muscle Pain, AleveX Pain Relieving Spray, Aleve Liquid Gels and Aleve Arthritis Pain Gel?
Brand Name “Extension”
Successful brands often expand like mushrooms after rain. Companies love to build upon success. That’s why you often see a wide range of products under an umbrella brand.
Take Clorox, for example. It was introduced as an industrial disinfectant in 1913. In 1916, the company started selling a less concentrated version for home makers. Today, there are dozens of products under the Clorox brand, from laundry bleach and fabric sanitizer to disinfecting wipes and toilet bowl cleaners.
The Tylenol Brand:
The pharmaceutical industry loves brand extension. There are few better examples than Tylenol. This pain reliever contained a single pain reliever: acetaminophen. McNeil Laboratories introduced it in 1955 as TYLENOL Elixir for Children. It initially required a doctor’s prescription. Now, however, there are more than two dozen Tylenol products on pharmacy shelves.
For example, Tylenol Cold + Flu Severe contains acetaminophen, dextromethorphan, guaifenesin and phenylephrine. Most people don’t know that dextromethorphan is a cough suppressant, guaifenesin is an expectorant and phenylephrine is a decongestant. (By the way, oral phenylephrine is probably ineffective as a decongestant.) There is also Tylenol Cold + Flu + Cough. It contains acetaminophen, dextromethorphan, doxylamine (an antihistamine) and phenylephrine. We could go on, but you get the point.
People often get confused by OTC ingredients that they cannot pronounce. Once they trust a particular brand, they don’t usually check on new products under that name.
Aleve Is a Nonsteroidal Anti-Inflammatory Drug (NSAID):
The nonsteroidal anti-inflammatory medicine naproxen was a popular prescription pain reliever in the 1980s. It was originally sold under the brand name Naprosyn.
The FDA approved naproxen for over-the-counter sale in 1994. The Bayer company sells it under the brand name Aleve. Naproxen is the active ingredient in the oral pain reliever, Aleve Liquid Gels.
What OTC Ingredients Are in New Topical Aleve Products?
Now, the company has introduced some other products. In addition to five forms of pills, a nighttime pain reliever and a formulation for colds and sinus problems, the Aleve name is also found on several topical medications.
OTC ingredient lists are almost assuredly boring for lots of people. They do not have much of a story line and we suspect that many people barely glance at them. Drug names are also hard to pronounce or spell, much less remember.
Aleve Arthritis Pain Gel:
This is going to get incredibly complicated very quickly. That means you will need to try and make sense out of what will seem totally confusing.
As mentioned, the Aleve brand name has been linked to the nonsteroidal anti-inflammatory (NSAID) oral medicine naproxen for decades. But Aleve Arthritis Pain Gel does not contain naproxen. Instead it contains a different NSAID called diclofenac. This anti-inflammatory topical gel has been sold under the brand name Voltaren Arthritis Pain Gel for many years. By the way, the Aspercreme Arthritis Pain Relief Gel formula also contains diclofenac. That is quite different from Aspercreme Pain Relief Cream which contains trolamine salicylate. If salicylate looks a little like acetylsalicylic acid (aspirin), that’s because they both belong to a class of medicines called salicylates. I warned you it would get complicated!
The OTC Ingredients in AleveX:
But wait, it gets even more confusing. There are now three new topical AleveX pain relieving products. There is AleveX Pain Relieving Lotion with Rollerball Applicator, AleveX Pain Relieving Lotion and AleveX Pain Relieving Spray. The active ingredients in all three products are menthol and camphor.
These are not exactly breakthrough compounds from modern pharmaceutical laboratories. Menthol is a component of many plants, but particularly mint. It has been used medicinally for more than a century.
When pharmacist Lunsford Richardson formulated Vicks VapoRub in the 1890s, menthol was considered an exotic ingredient. He also included camphor, an aromatic compound originally distilled from the bark of the camphor tree.
Television commercials featuring AleveX Pain Relieving Lotion with Rollerball Applicator make it seem as if this is an innovative new product:
“Introducing AleveX. It’s fast, powerful, long-lasting relief with a revolutionary rollerball design, because with the right pain reliever, life opens up.”
There is nothing wrong with utilizing old, herbal formulas like camphor or menthol. They are quite different from the NSAID diclofenac, though. Someone who thinks Aleve Arthritis Pain Gel is likely to have the same OTC ingredients as AleveX Pain Relieving Lotion or Aleve Liquid Gels will be disappointed. In some cases, making a mistake about OTC ingredients could be dangerous.
So Many OTC Ingredients = So Much Confusion:
We recently received this question from a reader:
Q. I broke my wrist, and my surgeon recommended Aleve cream for the first week. It works great for the inflammation. Also, I suffer from neuropathy and find it helps ease that pain. Is there any reason I should stop using it after a week?
A. You’ll need to pay attention to which Aleve product you are buying. Aleve Arthritis Pain Gel contains the NSAID diclofenac, just as Voltaren Gel does.
A product with a somewhat similar-sounding name, AleveX Pain Relieving Lotion, contains the natural compounds camphor and menthol, somewhat similar to Vicks VapoRub. So-called inactive ingredients include boswellia, clove oil, eucalyptus oil, linseed oil, peppermint oil, rosemary oil among other natural compounds. There is also AleveX Pain Relieving Spray and AleveX Pain Relieving Lotion with Rollerball Applicator.
The manufacturer warns that if symptoms persist for more than a week you should “stop use and ask a doctor.”
Topical diclofenac is less likely to cause stomach ulcers than if you were taking it as a pill. Nonetheless, symptoms such as stomach pain or acid reflux have been reported. Some readers of this website have experienced elevated blood pressure as a reaction to using topical diclofenac.
So far as we are aware, daily use of menthol and camphor should cause few, if any, serious adverse effects. Redness, rashes and other allergic reactions have been reported, however. Report any adverse reactions to your pharmacist and physician promptly!
Making Sense of Brand Extension:
Here are some examples of brand extension that require vigilance:
- Voltaren Arthritis Pain Gel contains diclofenac
- Voltaren prescription oral medicine contains diclofenac
- Aleve Arthritis Pain Gel contains diclofenac
- Aleve pills contain naproxen
- Aleve Back & Muscle Pain pills contain naproxen
- Aleve PM caplets contain the antihistamine diphenhydramine plus naproxen
- AleveX Pain Relieving Lotion contains camphor and menthol plus lots of inactives
- Advil pills contain ibuprofen
- Advil Targeted Relief cream contains capsaicin, camphor, menthol, methylsalicylate
We’re not opposed to brand expansion. But consumers need to learn to read labels carefully. They should also ask their pharmacists about the OTC ingredients and proper use of new products under old brand names.
You can read about the pros and cons of topical diclofenac gel at this link.
Will You Risk a Heart Attack with Diclofenac Gel?
If you use diclofenac gel to ease arthritis pain, will it increase your chance of a cardiovascular complication?
Please share your own experience with oral and topical pain meds. Have you used topical diclofenac gel? If so, please describe your experience in the comment section below. If you think this article is worth sharing, scroll to the top of the page and use the icons for email, Twitter and/or Facebook to pass it along to family or friends. Thank you for supporting our work.
