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Acetaminophen vs. ibuprofen

asteriskmag.com

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Re: Acetaminophen vs. ibuprofen

#31

Post by petesergeant »

throwaway27448 wrote: post #27
pugio wrote: post #17

Really lovely article. In paramedicine we usually treat 10g of acetaminophen in a 24-hour window as a potentially fatal overdose. That's also why the law in Australia was changed to require acetaminophen to come in blister packs (harder to get each pill out) of no more than 16. At 500 mg, that only gets you up to 8 g if you eat the whole thing, which is still hopefully non-fatal. I always thought a simple over-the-co…

What does ingesting 10g of acetaminophen even look like? I've got to imagine the fatal dose is far, far, far lower with chronic usage. Finding out that people are ingesting grams is profoundly disturbing.

> What does ingesting 10g of acetaminophen even look like?

20 not-especially-large tablets

Re: Acetaminophen vs. ibuprofen

#32

Post by pugio »

Nursie wrote: post #26
pugio wrote: post #17

Really lovely article. In paramedicine we usually treat 10g of acetaminophen in a 24-hour window as a potentially fatal overdose. That's also why the law in Australia was changed to require acetaminophen to come in blister packs (harder to get each pill out) of no more than 16. At 500 mg, that only gets you up to 8 g if you eat the whole thing, which is still hopefully non-fatal. I always thought a simple over-the-co…

When was this changed? I arrived in Aus in 2021 and was amazed to be able to buy a pack of 40+, coming from the UK where the limit had been in place for some years.

Jan 2025: https://www.psa.org.au/changes-to-paracetamol-scheduling-wil...

It's the usual public health balancing act of help vs harm.

Re: Acetaminophen vs. ibuprofen

#33

Post by petesergeant »

seemaze wrote: post #3

I grew up with the understanding that acetaminophen was the safe choice for fever or aches, and ibuprofen what the more potent compound for inflammation and severe pain. I recall casual anecdotes that "my doctor said 1.5x or 2x ibuprofen dose is ok when warranted" to address major incursions. I've never once thought about taking more than the recommended dosage of acetaminophen, largely because I had no expectation t…

I think most overdoses happen as a result of someone trying to hurt themselves, but I’ve also previously been in sufficient pain (always dental) that I’m counting the minutes down to when I can take more painkillers, so it’s easy to see how you could take double the expected dosage.

Re: Acetaminophen vs. ibuprofen

#34

Post by adithyareddy »

tokyobreakfast wrote: post #25
pugio wrote: post #17

Really lovely article. In paramedicine we usually treat 10g of acetaminophen in a 24-hour window as a potentially fatal overdose. That's also why the law in Australia was changed to require acetaminophen to come in blister packs (harder to get each pill out) of no more than 16. At 500 mg, that only gets you up to 8 g if you eat the whole thing, which is still hopefully non-fatal. I always thought a simple over-the-co…

You can still die if you take your idiot-proof Aussie blister packs with alcohol. So it's more an inefficient use of cabinet space. You can overdose on water too, they haven't banned 5-gallon jugs (yet).

Yes, and you can still die in a car crash if you're wearing your seatbelt, and wearing a helmet on your motorcycle won't save you from a head-on with a truck, and you can still drown in a pool with a lifeguard, and you can still die in a burning building with smoke detectors.

Harm reduction is about shifting probability distributions, not guaranteeing outcomes. Kids can still get into pill bottles with childproof medication caps, but accidental ingestion of aspirin by children reduced by 40-55% after they were mandated. [0]

[0]: https://pubmed.ncbi.nlm.nih.gov/440889/

Re: Acetaminophen vs. ibuprofen

#35

Post by vasco »

petesergeant wrote: post #31
throwaway27448 wrote: post #27

Earlier quoted context omitted.

What does ingesting 10g of acetaminophen even look like? I've got to imagine the fatal dose is far, far, far lower with chronic usage. Finding out that people are ingesting grams is profoundly disturbing.

> What does ingesting 10g of acetaminophen even look like? 20 not-especially-large tablets

Or 10 slightly larger ones

edit: https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten

Re: Acetaminophen vs. ibuprofen

#36

Post by rao-v »

pugio wrote: post #17

Really lovely article. In paramedicine we usually treat 10g of acetaminophen in a 24-hour window as a potentially fatal overdose. That's also why the law in Australia was changed to require acetaminophen to come in blister packs (harder to get each pill out) of no more than 16. At 500 mg, that only gets you up to 8 g if you eat the whole thing, which is still hopefully non-fatal. I always thought a simple over-the-co…

Could somebody package Tylenol with a sufficient amount of NAC to de-risk it? I suspect such a formulation would not require trials?

Re: Acetaminophen vs. ibuprofen

#37

Post by burnt-resistor »

IANADATINMA.

Max dose combination (IBU/APAP FDC) can be useful as a substitute in emergency therapeutic situations compared to opiates. Not recommended ordinarily because of liver, kidney, and stomach impairment.[0]

Taking ibuprofen with questionable stomach condition may want to consider taking a famotidine adjuvant or duexis [1] or acetaminophen instead.

Overdose treatment of acetaminophen poisoning is the stinky N-acetylcysteine (NAC), so that maybe worth stocking whenever Tylenol is kept in a house with kids. Overdose of ibuprofen is palliative, requiring IV fluids and dialysis.

0. https://www.researchgate.net/publication/382639515_Ibuprofen...

1. https://pubmed.ncbi.nlm.nih.gov/25516006/

Re: Acetaminophen vs. ibuprofen

#38

Post by petesergeant »

pupppet wrote: post #24

If you don't make a habit of taking either, what actually performs better?

Depends what you’re taking it for. Generally people take NSAIDs for muscle and dental pain, or anything that’s obviously inflammation, and paracetamol for anything else, particularly headaches, and is a common adjunct treatment if you have a cold or flu.

Re: Acetaminophen vs. ibuprofen

#39

Post by throwaway27448 »

petesergeant wrote: post #31
throwaway27448 wrote: post #27

Earlier quoted context omitted.

What does ingesting 10g of acetaminophen even look like? I've got to imagine the fatal dose is far, far, far lower with chronic usage. Finding out that people are ingesting grams is profoundly disturbing.

> What does ingesting 10g of acetaminophen even look like? 20 not-especially-large tablets

Is this not suicidal behavior?

Re: Acetaminophen vs. ibuprofen

#40

Post by petesergeant »

vasco wrote: post #35
petesergeant wrote: post #31

Earlier quoted context omitted.

> What does ingesting 10g of acetaminophen even look like? 20 not-especially-large tablets

Or 10 slightly larger ones edit: https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten

I’ve pretty much only ever seen them sold at 500mg; are you regularly seeing them where you are sold in 1g form?
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