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Acetaminophen vs. ibuprofen

asteriskmag.com

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Re: Acetaminophen vs. ibuprofen

#71

Post by CalRobert »

eru wrote: post #53
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…

Here in Singapore NAC is sold to make muckus more liquid to alleviate coughs. Apparently for some people it also helps with lessening tolerance for their ADHD meds, but I'm not so sure about that.

How is nac (acetylcysteine) delivered there? I can buy dissolvable tablets here in Europe but from what I see that’s less helpful for mucous, things like mucomyst require inhalation, which isn’t in otc products I know of.

Re: Acetaminophen vs. ibuprofen

#72

Post by isoprophlex »

justinc8687 wrote: post #66

I lived with an ICU nurse for years and one of the things he emphasized was the risk of acetaminophen overdose. He's more than once treated the liver failure (and death) from it and by his words, it's one of the worse ways to go. The positive of it is it got me in the habit of logging whenever I take it, either in a note on my phone or just a sheet of paper I place on my dresser under the bottle. This helps make sure…

I'm not disagreeing with you or trying to be disagreeable, but how do people accidentally exceed 3-4 grams daily? That's 6-8 pills!

Re: Acetaminophen vs. ibuprofen

#73

Post by jack_pp »

CalRobert wrote: post #71
eru wrote: post #53

Earlier quoted context omitted.

Here in Singapore NAC is sold to make muckus more liquid to alleviate coughs. Apparently for some people it also helps with lessening tolerance for their ADHD meds, but I'm not so sure about that.

How is nac (acetylcysteine) delivered there? I can buy dissolvable tablets here in Europe but from what I see that’s less helpful for mucous, things like mucomyst require inhalation, which isn’t in otc products I know of.

Same where I'm from, it's in pill / capsule form

Re: Acetaminophen vs. ibuprofen

#74

Post by alexcpn »

I created this open-source application (https://alexcpn-faers-signal-detection.hf.space/) to analyse the FDA FAERS data set a few weeks back, just to do some good work and use Claude Code completely. I got roasted on Reddit for attempting this. But this is meant for specialists to use, as most platforms that analyse this data charge a lot from what I read.

FDA FAERS is the official dataset for reporting Adverse events from taking a drug. FDA adverse event reports about 2 million cases and 4,067 unique drugs

I agree the results are not easy for non medical professionals to interpret correctly. For example DEATH is very strong with Parecetemol and so is DEPENDECE. The latter because from AI it is a confounding factor. Acetaminophen/parecetemol is frequently co-formulated with opioids (like Hydrocodone or Codeine). The "Dependence" signal is likely attributed to the opioid, not the Acetaminophen itself...

Adverse Event Acetaminophen PRR (95% CI) Acetaminophen n ibuprofen PRR (95% CI) ibuprofen n ACUTE KIDNEY INJURY 0.87 (0.80-0.96) 498 4.27 (3.91-4.67) * 483 ANAPHYLACTIC REACTION 0.61 (0.51-0.72) 122 9.85 (8.90-10.90) * 382 ANGIOEDEMA 1.31 (1.13-1.53) 170 15.26 (13.77-16.92) * 378 DEATH 1.44 (1.40-1.49) 3958 0.07 (0.06-0.10) 42 DEPENDENCE 237.12 (231.51-242.88) * 39679 0.02 (0.01-0.05) 4 DEPRESSION 2.18 (2.05-2.31) * 1157 0.39 (0.29-0.52) 43 DRUG EFFECTIVE FOR UNAPPROVED INDICATION 16.77 (16.11-17.46) * 3180 44.17 (42.18-46.25) * 1921 DRUG HYPERSENSITIVITY 0.57 (0.51-0.64) 327 3.30 (2.98-3.65) * 372

Re: Acetaminophen vs. ibuprofen

#75

Post by psidebot »

adrianmonk wrote: post #68
throwaway27448 wrote: post #39

Earlier quoted context omitted.

Is this not suicidal behavior?

Apparently a common source of problems is taking two different medications without realizing they both contain acetaminophen. Suppose your arthritis is acting up, so you start taking Tylenol 8hr Arthritis Pain[1]. That's 2 tablets every 8 hours. They're extended-release with 650mg per tablet. A total of 3900 mg in 24 hours. A few days later you get the flu, so you decide to add what seems like a completely different…

My personal rule is to only purchase over-the-counter meds with a single active ingredient. I'd rather separately take an antihistamine, expectorant and painkiller than a concoction where I have to read the whole label and do math while sick to separate the doses and timings.

Re: Acetaminophen vs. ibuprofen

#76

Post by krupan »

I once read that if acetaminophen were introduced today it 100% would require a prescription because of how dangerous an overdose is.

Unrelated, but it feels like an oversight that this article said nothing about how both acetaminophen and ibuprofen reduce fevers. They aren't used solely for reducing pain.

Re: Acetaminophen vs. ibuprofen

#77

Post by ghosty141 »

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…

> largely because I had no expectation that it would provide additional benefit..

An interesting thing with ibuprofen is that at the regular dose of 400mg it inhibits pain but if you take 1600mg it doesn't inhibit much more pain than the 400mg dose, but the inflammatory effect does increase significantly. A lot of people don't know that and take too much thinking it scales linearly.

Re: Acetaminophen vs. ibuprofen

#79

Post by bonsai_spool »

pupppet wrote: post #24

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

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

Tylenol/acetaminophen is good for fever which NSAIDs won't help. Otherwise, take both and alternate their dosing times for better pain coverage.

Re: Acetaminophen vs. ibuprofen

#80

Post by rdevilla »

CalRobert wrote: post #71
eru wrote: post #53

Earlier quoted context omitted.

Here in Singapore NAC is sold to make muckus more liquid to alleviate coughs. Apparently for some people it also helps with lessening tolerance for their ADHD meds, but I'm not so sure about that.

How is nac (acetylcysteine) delivered there? I can buy dissolvable tablets here in Europe but from what I see that’s less helpful for mucous, things like mucomyst require inhalation, which isn’t in otc products I know of.

In the Philippines it's available as an effervescent tablet to be dissolved in water. They still tend to work better than the western remedies (guaifenesin etc) even in this form IME.

Usually here in Canada it's available in capsule form which I find less effective.

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