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Acetaminophen vs. ibuprofen

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Re: Acetaminophen vs. ibuprofen

#181

Post by kazinator »

KaiserPro wrote: post #151
kazinator wrote: post #129

Earlier quoted context omitted.

The higher risk of GI bleeds is could be somewhat balanced by not having to take as many. There are also slow release forms of naproxen. (Which make sense given its long action: lets people fade in the next one while the previous dose slowly fades out). That could also help make it easier on the GI tract.

> The higher risk of GI bleeds is somewhat balanced by not having to take as many! Unless I am missing something, the data really doesn't back that up. naproxen is much more longer lasting and has a higher chance of causing ulcers. Hence why its not over the counter in the UK and is prescribed with omeprazole to reduce the risk of issues.

I'm reading about this in more detail. Indeed, it's not the contact between the medication and the digestive tract that is the problem, but simply its presence in the blood stream. By inhibiting those certain enzymes, it reduces the production of prostaglandings, causes problems for the lining.

Naproxen will be around longer due to its long half-life, so it creates more opportunity for this problem.

Re: Acetaminophen vs. ibuprofen

#182

Post by wouldbecouldbe »

e40 wrote: post #162
wouldbecouldbe wrote: post #123

Earlier quoted context omitted.

Try dealing with a herniated disc, more ibu is definitely better. Too little wont do anything, proper dose and you feel healed

Spine issues are the single thing that pish me to ibuprofen or naproxen over acetaminophen. The latter does nothing for my issues.

yeah, its the inflammation going down that reliefs the nerve.

Took me 3 months, out of 2 i wasn't able to sit. Luckily I could walk and that give me great relief. So walked for hours.

Keeping the habit, will mostly being coding from my phone & walking from now on.

Re: Acetaminophen vs. ibuprofen

#183

Post by hannob »

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.

Buy a pack of 20x500mg (just checked, common size in Germany), take 2-3 every half hour for a while.

Sure, that's extreme. But if you're unaware of the risks, you feel sick, and you believe it's helping you.

I mean, people aren't killing themselves in masses with it, but it happens every now and then. Easily imaginable that one in a few million people will have enough tendency to take more pills and is unaware of the overdose danger.

Re: Acetaminophen vs. ibuprofen

#184

Post by rustyhancock »

schnitzelstoat wrote: post #116
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.

Ibuprofen is better are reducing fever and managing headaches.

Paracetamol is the safer version Phenacetin. You used to be able to buy aspirin, phenacetin and caffeine..but phenacetin with withdrawn. APC when it was marketed was very popular but soon you were told to never give children aspirin for a fever so we used Paracetamol. Then Phenacetin was withdrawn and paracetamol became part of APC (like Alka selzta XS , or just the popular caffeine paracetamol combos)

Paracetamol came in as safer but similar, yet no where near effective. It captured bith the market feeling of its pros and cons. So we interpreted it as safer than alternatives (especially aspirin for children due to Reye syndrome). But also dangerous which might be why OPs view was that ibuprofen is safer.

The NNT (number of people you'd need to take it) to be headache free after 2 hours is about 12-20 for paracetamol. But only 7-10 for ibuprofen.

It's quite surprising that paracetamol became the defacto analgesic given it performs so poorly but it was historical inertia. And plenty of people argue that if we were to start over we would not make paracetamol OTC.

Re: Acetaminophen vs. ibuprofen

#185

Post by imtringued »

bonsai_spool wrote: post #101
ButlerianJihad wrote: post #87

Earlier quoted context omitted.

"Good for fever"? Only ignorant consumers would attempt to counteract the body's very own defenses against infection and disease. A fever is not dangerous within normal parameters, except for being dangerous to the virus and bacteria that threaten the body. Your body runs a fever because it engages in a battle to the death with these microbes. If you defeat the body's own defenses by lowering the fever, for example i…

> "Good for fever"? Only ignorant consumers would attempt to counteract the body's very own defenses against infection and disease. Yes, ignorant consumers and physicians across the world. You can't just 'vibe medicine' or 'vibe biology' - please don't comment if you don't know what you're talking about.

Someone with a basic understanding of evolution and biology understands that evolution will take any free lunch it can get.

The vast majority of the time medicine can only ever help with (acute) symptoms and rarely the underlying cause unless it is something like vaccines or antibiotics.

Medicine has side effects because if there was a free lunch to be obtained from medicine, the human body would have synthesized the medicine directly. Hence medicine is always about making tradeoffs.

When it comes to general health, there is always a causal chain of cause -> primary symptom -> secondary symptom -> tertiary symptom -> ... and a lot of medicine tends to work on the secondary or tertiary symptom.

Pain evolved to be an accurate indicator of damage to encourage you to stop ruining your body and not a punishment.

Re: Acetaminophen vs. ibuprofen

#186

Post by elric »

dgan wrote: post #135
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…

I randomly bought NAC just to try it. I dont know about the chemical interactions, but going out with collegues at that time taught me that it's basically impossible to get drunk. Usually a pint of beer is enough to make le feel at least a little dizzy, but when taking NAC, it was all like drinking water

When I go out drinking with my pharmacist buddy, we take NAC before going out. He swears it makes hangovers less likely. I can't say I've noticed that particular effect, but I do seem to sleep a bit better on those nights.

Re: Acetaminophen vs. ibuprofen

#187

Post by throw1234567891 »

watwut wrote: post #166
iamniels wrote: post #130

Earlier quoted context omitted.

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

It is not false. It does nothing. Head hurts, you take paracetamol ... head still hurts. The belly hurts, you take paracetamol ... nothing change. When I took ibuprofen it did actually made an actual real change.

Maybe you had an inflammation-induced pain. That would explain why ibuprofen helped, and paracetamol did not.

Re: Acetaminophen vs. ibuprofen

#188

Post by marcogarces »

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…

In mozambique i was committed to the hospital with my liver failing after spending two weeks taking acetaminophen daily because everyone at work got sick and someone had to keep the business up (it was a bank, our IT department was very specific and only 6 people knew that job and everyone got extremely hill). After two weeks, i finally went to the hospital and I couldn't leave; spent the next two weeks fighting for my life and at some point I was told I was not going to make it. All due a simple over the counter medicine... crazy. This was 2016. To this day I still get extremely tired if I take it, so I have to choose it carefully when to take it.

Re: Acetaminophen vs. ibuprofen

#189

Post by elric »

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.

Dissolvable tablets & powders are still useful for getting rid of mucus. Maybe inhaling is better, but anecdotally the tablets seem to work.

Re: Acetaminophen vs. ibuprofen

#190

Post by jeroenhd »

krupan wrote: post #76

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.

I kind of doubt that, to be honest, given how much more effective and less directly damaging it is during normal use compared to NSAIDs.

I find it interesting that people take these as fever reduction mechanisms. Fevers are a defence mechanism, not just an inconvenience. Maybe it makes more sense in places without decent workers' rights (like having a limited amount of sick days you need to manage), but it feels weird for me to actively harm your body's defence mechanisms unless you're in "you should see a doctor" territory already.

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