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Acetaminophen vs. ibuprofen

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Re: Acetaminophen vs. ibuprofen

#281

Post by vanderZwan »

spzb wrote: post #263
vanderZwan wrote: post #245

Earlier quoted context omitted.

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it onl…

AIUI one of the many quirks of the US health insurance system is that a lot of people have only minimal cover which doesn't include things like physiotherapy and rehabilitation treatment. That means that they often can't treat a painful condition at source so their only option is to mask the pain with painkillers.

This is so absurd to me. The expression "prevention is better than cure" isn't just folk wisdom, in just about any country with nationalized healthcare the studies also confirm that this costs less money. The only exception I ever heard was a Dutch study in the 2000s suggesting that people growing older due to smoking less was going to increase healthcare costs, because people were getting older putting pressure on the pension system, but let's not peer further into that can of worms.

So by all accounts it should be cheaper for for-profit insurance companies too, unless they have ways to externalize the costs onto the rest of society. Which I guess is more circumstantial evidence for how messed up the system must be.

Re: Acetaminophen vs. ibuprofen

#282

Post by lapcat »

vanderZwan wrote: post #245
magicalhippo wrote: post #110

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say acetaminophen (paracetamol here) should be the default for treating fever and pain in kids, adults, pregnant women and elderly, and have for some time. Ibuprofen they say should be used with caution. [1]: https://www.dmp.no/nyheter/behov-for-smertestillende-slik-ve.…

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it onl…

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule.

This is vastly overstating the rationality of the human body. It's no more rational than the human mind, which is often quite irrational. Your body isn't the product of medical school, nor intelligent design, but rather random natural selection, which is decent but demonstrably far from perfect.

Re: Acetaminophen vs. ibuprofen

#283

Post by dncornholio »

apatheticonion wrote: post #153
magicalhippo wrote: post #110

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say acetaminophen (paracetamol here) should be the default for treating fever and pain in kids, adults, pregnant women and elderly, and have for some time. Ibuprofen they say should be used with caution. [1]: https://www.dmp.no/nyheter/behov-for-smertestillende-slik-ve.…

Really? I get headaches semi-frequently and my first line of defense is ibuprofen, I use acetaminophen sporadically as a last resort

Why? Does ibuprofen work better? It's bad for your stomach walls.

Re: Acetaminophen vs. ibuprofen

#284

Post by dncornholio »

makeitdouble wrote: post #155
jasperry wrote: post #5

This is some of the most useful information I've received in a while. Like the author, the low overdose threshold of acetaminophen made me avoid it, even though I always take low doses anyway and ibuprofen gives me acid reflux almost every time.

Still take it with a huge grain of salt. Even official advice usually has severe limitations due to its broadness or straight politics, so medical analysis from random blogs truely isn't the best. Acetoaminophen also has issues for people with weaker stomachs (I can attest), and will come with additional medication to cover these effects as needed. The whole "Is it safe yes/no" table has many asterixes and might be o…

Never take anything that written on the medications with a grain of salt. Disregard everything that you have read online. The medicine instructions are your single source of truth

Re: Acetaminophen vs. ibuprofen

#285

Post by cue_the_strings »

It is a damn shame bordering conspiracy that metamizole (https://en.wikipedia.org/wiki/Metamizole, known as Analgin in eastern Europe and the Balkans, apparently also India) is not more widely available in the west. It's literally a wonder drug, the only non-narcotic (hence non-addictive) that actually relieves serious pain (including post-op) pain in my experience.

Since I've had a fair share of it in my life so far (more than 1kg of it so far, in total), and I investigated the disparaging studies and they are definitely not convincing at all; more recent ones somewhat absolve it (check the Wikipedia page).

I've never had any side effects from it, and I don't know anyone who did, unlike for any other painkiller (diclofenac, ketoprofen, ibuprofen, acetaminophen / paracetamol).

It is a medicine where I'm almost 100% sure the studies against it are intentional sabotage by pharma companies, and the vigor and persistence this is done with is really telling (lots of doctors and pharmacists in my extended family, including in regulatory bodies). The campaign against it never ends.

Re: Acetaminophen vs. ibuprofen

#286

Post by bluGill »

socalgal2 wrote: post #214
magicalhippo wrote: post #110

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say acetaminophen (paracetamol here) should be the default for treating fever and pain in kids, adults, pregnant women and elderly, and have for some time. Ibuprofen they say should be used with caution. [1]: https://www.dmp.no/nyheter/behov-for-smertestillende-slik-ve.…

Here in my body, it tells me acetaminophen does absolutely nothing for pain where as ibuprofen does. I wouldn't take ibuprofen for fever

I once got it to make a small difference for pain - but I was in the hospital (surgery recovery) where the doctors were giving me more than the daily maximum.

Re: Acetaminophen vs. ibuprofen

#287

Post by fc417fc802 »

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

As an American this is such a weird question to me. I purchase my ibuprofen and benadryl in bottles of anywhere from 400 to 1000 pills every few years.

Re: Acetaminophen vs. ibuprofen

#288

Post by brazzy »

vanderZwan wrote: post #245
magicalhippo wrote: post #110

> But if acetaminophen is safer, then why don’t official sources tell you that? Guess it depends on country. Here in Norway official sources[1][2] do say acetaminophen (paracetamol here) should be the default for treating fever and pain in kids, adults, pregnant women and elderly, and have for some time. Ibuprofen they say should be used with caution. [1]: https://www.dmp.no/nyheter/behov-for-smertestillende-slik-ve.…

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it onl…

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it only hurts when I lean on it. Because it's healing. So I don't. Why would headaches or other "inconvenient" pains be different?

Pain is also suffering, and there is no virtue in suffering needlessly.

Even more importantly, there's also chronic pain, which can severely affect quality of file permanently and is essentially an illness all of its own. Research supports the concept of "pain memory", where chronic pain develops as the result of leaving the pain from a temporary condition untreated.

Re: Acetaminophen vs. ibuprofen

#289

Post by Flashtoo »

robocat wrote: post #219
epcoa wrote: post #45

Earlier quoted context omitted.

No. Ethanol and tylenol compete for CYP2E1 that produces toxic NAPQI, so no, acute alcohol intoxication has a protective effect at least where it comes to tylenol toxicity.

No. Alcohol and Acetominophen/paracetamol should not be mixed. When alcohol enters the picture, it increases the activity of CYP2E1, so the body produces more of the NAPQI toxin. Alcohol also decreases glutathione production, the body’s natural defense mechanism, meaning NAPQI is more likely to build up in the liver in dangerous concentrations. https://www.medicalnewstoday.com/articles/322813 Sorry, crappy link. If y…

There is a danger in chronic abuse resulting in upregulation. Mixing the two at once is no problem for the liver, which is also why patient information leaflets for paracetamol do not contain a warning to avoid alcohol, only about chronic alcohol abuse.

Your crappy source is vague in what consumption pattern constitutes a risk and actually cites a better source that supports the idea that acute alcohol consumption reduces paracetamol toxicity. https://www.biorxiv.org/content/10.1101/2020.07.07.191916v1....

That's a mathematical model, but this relationship between the two is what I was taught in medical school and it is still supported by the science. There's plenty of other sources, I just picked that one because your article cites it. Just search for "paracetamol ethanol" on Google Scholar.

Re: Acetaminophen vs. ibuprofen

#290

Post by justinc8687 »

vidarh wrote: post #82
justinc8687 wrote: post #70

Earlier quoted context omitted.

P.S. like someone mentioned in a comment below happened to them, be careful with NSAIDs over the long term. Until recently I took them daily for better part of 3 years. I was recently diagnosed with chronic kidney disease. Can't definitively say causation, but they definitely contributed. They're fine for short term use but can really f$%# you up with long term, daily use.

It is absolutely valid to warn about long term use, and NSAIDs in particular (I was lucky and had a gastroscopy before they'd done any serious damage, but they found significant erosion of my stomach lining due to NSAIDs), but acetaminophen/paracetamol isn't an NSAID (ibuprofen and aspirin, for example, are)

To be clear, it was nabumetone, celecoxib or meloxicam (at various times, not overlapping) for me.
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