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Acetaminophen vs. ibuprofen

asteriskmag.com

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Re: Acetaminophen vs. ibuprofen

#221

Post by trvz »

rustyhancock wrote: post #184
schnitzelstoat wrote: post #116

Earlier quoted context omitted.

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 You used to be able to buy aspirin, phenacetin and caffeine..but phenacetin with withdrawn.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 Then Phenacetin was withdrawn and paracetamol became part of APC (like Alka selzta XS ,…

Reminder: don't take medical advice from someone who can't write correctly.

Re: Acetaminophen vs. ibuprofen

#222

Post by TheOtherHobbes »

mzl wrote: post #149
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.

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.

I managed to overdose by accident with severe dental pain. Wasn't thinking straight, took about 8g - which is even more scarily close to the limits.

I'm fairly sure that caused some liver damage. I wasn't aware of anything apart from feeling a bit weird.

At the time, I had no idea it was potentially deadly.

Re: Acetaminophen vs. ibuprofen

#225

Post by rXwubXUGAm »

In my personal experience, paracetamol hardly does anything when it comes to alleviating fever symptoms. Like I'm not sure whether I'd be able to distinguish it from placebo. I always default to ibuprofen and the difference it makes is like night and day. I only take it like a handful of times a year and usually no more than 1000mg a day so I'm hoping I'll be fine.

Re: Acetaminophen vs. ibuprofen

#226

Post by ac2u »

sfn42 wrote: post #203
apatheticonion wrote: post #153

Earlier quoted context omitted.

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

I take both. 500-1000mg acetaminophen, 200-400mg ibuprofen. Usually helps for headaches which I get frequently. I only take them for the worst headaches though, so probably once every couple of weeks on average.

Yeah if I need to I take both also. In addition I be sure to have a caffeinated drink also as caffeine has been shown to both speed the absorption and boost the efficacy (5-10%) of paracetemol over a multi hour period. https://pubmed.ncbi.nlm.nih.gov/17442681/

Re: Acetaminophen vs. ibuprofen

#227

Post by antirez »

In the article it is mentioned but it is worth stressing that N-acetylcysteine is a trivially available antidote for paracetamol overdose (and you may have it at home without knowing, Fluimucil, Mucomyst, NAC or alike).

Also: in Europe everybody normally takes paracetamol and not FANS as a first reach to minimize adverse effects. So this article looks like very US centric. AFAIK liver failure because of paracetamol in Europe is very rare. So here there could be cultural issues at play (medical culture of what is prescribed, and the fact that Europeans in general take lower dosages of everything).

EDIT: trick, if you very rarely take paracetamol and other pain medications, the next time try to take just 250mg. It works for most people, no need to take 750 or even 1 gram of paracetamol. 500 works for almost everybody, 250 for many folks.

Re: Acetaminophen vs. ibuprofen

#228

Post by rustyhancock »

sixeyes wrote: post #208
rustyhancock wrote: post #184

Earlier quoted context omitted.

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 ,…

Wiki for phenacetin says it's mechanism of action is being metabolized into paracetamol. IDK about your "nowhere as effective". It was withdrawn for sometimes being metabolized into another, toxic and carcenogenic, molecule.

Here is a summary of COCHRANE evidence on Paracetamol "widely used and ineffective"[0].

It's a paradox no?

Paracetamol is only the presumed only active metabolite, and that is why paracetamol rapidly replaced phenacetin.

There is a quirk though, phenacetin actually delivers paracetamol to your brain and spine (where it primarily reduces pain) faster than an oral dose of paracetamol.

Similarly IV paracetamol is far more effective that oral paracetamol.

Phenacetin was also considered mildly addictive, and induced a gentle euphoria and then sedation.(We still see sedation after paracetamol in children and the elderly). But general use we don't see these effects in paracetamol, why did phenacetin do this more effectively? Probably the higher peak levels around nerve endings.

These effects are both wanting of an explanation of phenacetin is just paracetamol and directly analegisic.

[0] https://web.archive.org/web/20240721144157/http://www.eviden...

Re: Acetaminophen vs. ibuprofen

#229

Post by e40 »

wouldbecouldbe wrote: post #182
e40 wrote: post #162

Earlier quoted context omitted.

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.

Really nice you found a workaround. I am constantly trying different ways to alleviate my pain without drugs.
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