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Acetaminophen vs. ibuprofen

asteriskmag.com

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Re: Acetaminophen vs. ibuprofen

#111

Post by CalRobert »

rdevilla wrote: post #80
CalRobert wrote: post #71

Earlier quoted context omitted.

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.

Same here actually, I find it slightly helpful but the effect’s useful time is limited. I’ve wondered if I could capture the gas released while bubbling and inhale that…

Re: Acetaminophen vs. ibuprofen

#112

Post by binoct »

kazinator wrote: post #20

You don't want either of these; what you want is naproxen. It works similarly, but stays a lot longer (half life is cited as being anywhere from 12 to 17 hours). Acetaminophen and ibuprofen are just for temporary problems, like a headache that would go away on its own in a couple of hours. They are uneconomic and inconvenient if you have something more persistent to keep at bay. Four ibuprofens or one naproxen? No br…

As pointed out in the article, naproxen is an NSAID like Ibuprofen, though slightly more COX1 selective. It likely has a somewhat lower risk of serious renal and cardiovascular events, but higher risk of GI bleeds. There are some studies that show little to no increase cardiovascular risk, but most do show some or even comparable to ibuprofen.

Convenience vs ibuprofen is a thing given the longer half life, but it still generally comes with similar risks. If you are taking anything for more than just an occasional headache, definitely discuss with a doctor, COX2 selectives like celecoxib may be a better risk profile and even more convenient.

(COX1 and COX2 selectivity loosely separate which systems get the brunt of the side effects)

Re: Acetaminophen vs. ibuprofen

#113

Post by crustaceansoup »

CalChris wrote: post #83

For migraines, I take two CVS Migraine about every week to ten days. It's a cocktail of acetaminophen, aspirin and caffeine which tallies to 500 mg of acetaminophen, well under then 4g limit. It's good for four hours but you can only take two per day. I didn't know about this acetaminophen risk. So I'll be looking for alternatives. Ibuprofen is for inflammation and not headaches. Naproxen is a candidate.

> Ibuprofen is for inflammation and not headaches

Ibuprofen is very well supported as a treatment for migraines. Not necessarily headaches generally, but definitely migraines.

But there are multiple classes of abort drugs now that a doctor might be able to prescribe you, like triptans and CGRP inhibitors, that work much better than either NSAIDs or acetaminophen.

Re: Acetaminophen vs. ibuprofen

#114

Post by timvdalen »

blueblisters wrote: post #109

Acetaminophen (paracetamol) is the drug of first choice for addressing pain and fever, in India at least. To the extent that it's regularly abused, and I know people who have been hospitalized because of abuse. Even then, doctors are usually disapproving of ibuprofen (or some combination of it with paracetamol) unless paracetamol is contraindicated for some reason, and I had always wondered why.

I did listen to this 99% Invisible story about the use of NSAIDs in India once[1]

What you describe in an interesting contrast to the situation in The Netherlands. Here, virtually no one is prescribing ibuprofen _without_ also prescribing a baseline of paracetamol.

[1]: https://99percentinvisible.org/episode/579-towers-of-silence...

Re: Acetaminophen vs. ibuprofen

#115

Post by i_think_so »

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…

Doin' the Lord's Work here, sir.

Also, loved your TV show back in the day. :-)

Re: Acetaminophen vs. ibuprofen

#116

Post by schnitzelstoat »

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.…

It’s the same in the UK - paracetamol is the default. Ibuprofen is better for reducing swelling, inflammation etc.

Re: Acetaminophen vs. ibuprofen

#117

Post by i_think_so »

protocolture wrote: post #47
throwaway27448 wrote: post #39

Earlier quoted context omitted.

Is this not suicidal behavior?

I took 2 full packs in a day once while trying to recover from severe pain. Didnt find out until later that it was supposedly a fatal dose.

Did you suffer any liver function damage as a result?

I presume your protein intake was adequate and diverse prior to this misadventure....

Re: Acetaminophen vs. ibuprofen

#118

Post by raverbashing »

Honestly this article is mixing a lot of different factors

> Acetaminophen has a scarily narrow therapeutic window. The instructions on the package say it's okay to take up to four grams per day. If you take eight grams, your liver could fail and you could die.

Gee I don't know, I think this is a wide enough window to not miss it. That difference is 8 500mg pills

> that for most people in most circumstances, acetaminophen is safer than ibuprofen, provided you use it as directed. I think most doctors agree with this.

Could be but I think a lot of doctors underestimate the dangers of paracetamol as well

All of the factors the author mentions about IBP are true. But it's all about the details. Safer? Safer in which condition?

"Dehydrated" ok take a glass of water. Active bleeding? Most NSAIDs interfere with that, and no you won't become a hemophiliac by taking one Ibuprofen

Also, some countries do add a notice for kidney problems for Paracetamol as well (e.g.) https://www.medicines.org.uk/emc/product/5164/pil

An as a conclusion, I find it "funny" that nobody considers how healty/safe it is to take paracetamol and have mild analgesia (translation - you're still in pain) and taking ibp and having better analgesia

Re: Acetaminophen vs. ibuprofen

#119

Post by dilyevsky »

the_sleaze_ wrote: post #7
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.

Same here. Great article. I avoid both and stick with naproxen sodium. Any issues with that one? Lasts the longest too.

Naproxen sodium has much higher risk of GI damage especially with long term use.

Re: Acetaminophen vs. ibuprofen

#120

Post by 01100011 »

The article doesn't touch on it, but from what I've read NSAIDs like ibuprofen also slow healing. I have also read, but am unsure how reliable this is, that they can harm the remodeling process during healing and lead to chronic pain.

That said, I've found great relief at times taking a moderately large dose of ibuprofen for several days to break what seems to be a cycle of persistent inflammation. YMMV I guess.

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