Acetaminophen vs. ibuprofen • Hacker News Board

Re: Acetaminophen vs. ibuprofen

#141

Post by unmole » Wed, Apr 22, 2026, 7:20 AM UTC

oliyoung wrote: post #127

It's a very strange cultural thing too, Australians (and I presume other Commonwealth countries) default to paracetamol (acetaminophen) before ibuprofen Paracetemol has always been seen as first thing you'd take for pain relief, and you'd "step up" ibuprofen as an escalation, but that might more to do with marketing of Panadol (paracetemol) vs Nurofen (ibuprofen). We'd look on at the US where you were taking Advil li…

> I presume other Commonwealth countries) default to paracetamol (acetaminophen) before ibuprofen

Can confirm this is true in India.

Paracetamol is widely used. Paracetamol + Ibuprofen is more common than Ibuprofen by itself.

Re: Acetaminophen vs. ibuprofen

#142

Post by KaiserPro » Wed, Apr 22, 2026, 7:20 AM UTC

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.

wait, how are you getting naproxen?

Whenever its prescribed here, its paired with some sort of intestine protection medicine to stop it burning holes in your stomach/intenstines

Ibuprofen is much safer, so long as you eat with it.

Paracetamol is also safer, so long as you don't OD.

BUT! so long as you stay below 4 grams a day, you'll be safe. (yes yes, in some situations you can take double, but unless you are under supervision, thats asking for liver pain.)

Re: Acetaminophen vs. ibuprofen

#143

Post by mirekrusin » Wed, Apr 22, 2026, 7:21 AM UTC

why they don't make pills with ibuprofen + nac?

Re: Acetaminophen vs. ibuprofen

#144

Post by shlant » Wed, Apr 22, 2026, 7:21 AM UTC

iamniels wrote: post #130

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.…

In Western Europe too. > but it does absolutely nothing with actual pain. It is placebo at best. This is simply false.

you responded to the wrong comment. I assume this want mean for https://news.ycombinator.com/item?id=47860061

Re: Acetaminophen vs. ibuprofen

#145

Post by kakacik » Wed, Apr 22, 2026, 7:21 AM UTC

isoprophlex wrote: post #122

skrebbel wrote: post #85

Earlier quoted context omitted.

People who are in a lot of pain and don’t know the risks. Rationalizations like “they probably put the limit way lower than the real limit so idiots don’t OD themselves, so I can safely take a bit more” become very attractive when you’re in a lot of pain.

Okay that's right, if you just keep upping the dose because you're still in pain it might be easy to just slam a few every 4 hours From personal experience if i have a headache I'll take 1000 mg all at once; it either works right away or it doesnt and I stop bothering until I've had a good nights rest...

Imagine if that rest will do nothing for that headache and its there morning day and night. Or some injury-related pain which simply can't be downtuned. Plus when old, half of the body aches, all old injuries and general deterioration.

I had only very brief experiences with longer intense pain but it made my mind into pudding and desperate knot of how-to-stop-this-at-all-costs. Normal life is not possible and sanity is not granted.

Re: Acetaminophen vs. ibuprofen

#146

Post by i_think_so » Wed, Apr 22, 2026, 7:23 AM UTC

Don't forget ye olde aspirin. It has a cheat mechanic: https://en.wikipedia.org/wiki/Salicylate_poisoning

You take too much and it can give you a fever, which might entice you to take more aspirin. Nasty.

Obligatory Reye's mention:

https://www.uspharmacist.com/article/reyes-syndrome-a-rare-b...

and my own editorializing -- this is not just a problem for little kids. As various articles explain, if you've had flu-like symptoms (from whatever cause) you should be wary of aspirin. Will one standard dosage kill you? Unlikely. But if you've got better options, particularly pre-loading NAC before Tylenol, why not consider them first?

Re: Acetaminophen vs. ibuprofen

#147

Post by wolfi1 » Wed, Apr 22, 2026, 7:23 AM UTC

there is an antidote for paracetamol: ACC (Acetylcysteine)

Re: Acetaminophen vs. ibuprofen

#148

Post by oulipo2 » Wed, Apr 22, 2026, 7:25 AM UTC

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.…

Same in France

Re: Acetaminophen vs. ibuprofen

#149

Post by mzl » Wed, Apr 22, 2026, 7:26 AM UTC

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.

I've been prescribed slightly more than 5g per day (2 x 650mg tablets every 6 hours) for pain after an operation jointly with ibuprofen, which is scarily close to the limits.

Re: Acetaminophen vs. ibuprofen

#150

Post by tpm » Wed, Apr 22, 2026, 7:27 AM UTC

sitharus wrote: post #136

watwut wrote: post #126

Earlier quoted context omitted.

The only issue with treating pain with paracetamol is that it does not work at all against the pain. It works against fewer or maybe mild inflammation and what not ... but it does absolutely nothing with actual pain. It is placebo at best.

> but it does absolutely nothing with actual pain Neither paracetamol nor ibuprofen work by blocking pain. Depending on the type of pain and your physiology it can range from really effective to not at all. I only take paracetamol, it works better than both ibuprofen and opioids for me. I know other people who have the exact opposite experience. There’s no absolute here.

Yeah, for me paracetamol is worse in everything - fever, pain, etc.

For mild stuff I use ibuprofen, if it gets worse, diclofenac works every time.