Use caution with all pain medications, reports the Harvard Heart Letter
The AHA suggests starting with aspirin or acetaminophen (Tylenol) to quell muscle or joint pain. Aspirin is good for the heart, and acetaminophen doesn’t affect blood clotting. If they don't work, the next step for most people would be a nonsteroidal anti-inflammatory drug (NSAID). Try naproxen (Aleve) first, then ibuprofen (Advil). Next is diclofenac, but more caution is needed with this drug (which is available only by prescription). Celebrex, the only drug in the class known as COX-2 inhibitors that remains on the market, should be the last resort for managing pain. In addition to the side effect of increasing the risk of clots in the bloodstream, COX-2 inhibitors can also reduce blood flow through the kidneys and raise blood pressure. For short-term pain in some people, a narcotic pain reliever such as tramadol (Ultram), codeine, or fentanyl (Actiq, Duragesic) may be an option.
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