Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Acetaminophen vs. ibuprofen

asteriskmag.com

Post reply on HN
Print view View original

241–250 of 504 posts

Re: Acetaminophen vs. ibuprofen

#241

Post by rustyhancock »

Nursie wrote: post #210
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 You used to be able to buy aspirin, phenacetin and caffeine..but phenacetin with withdrawn.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 Then Phenacetin was withdrawn and paracetamol became part of APC (like Alka selzta XS ,…

Interesting. I guess it tracks with personal experience. I find Paracetamol is OK for fevers/generic cold symptoms but absolutely useless for a headache, Ibuprofen is the only thing that shifts them. Well it's the only thing that shifts them now I'm in a country where I can't buy soluble aspirin and codeine OTC.

I end up using paracetamol often for pain because it's what's to hand.

What annoys me is that so many people have your experience and are effectively gaslit about the fact it seems to often perform so poorly.

Re: Acetaminophen vs. ibuprofen

#242

Post by freedomben »

AnthonyMouse wrote: post #220
4gotunameagain wrote: post #86

Earlier quoted context omitted.

It is mind boggling how statements like that are possible in the US. I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction.

> I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction. Having a condition that actually warrants strong opioids and not being able to get them at any price is definitely not an improvement. The problem is fundamentally that we want to pretend doctors can always distinguish two people describing the same symptoms when one person actually has them a…

> And between these the second one is unambiguously better, because the first one is the government screwing innocent people and the second one is guilty people screwing themselves.

Could not agree more. Depriving people with legitimate pain of opioids is IMHO legitimate torture. It's a bit of a variance on the trolley problem in that the doctor/government isn't causing the pain, but their inaction is prolonging it.

Re: Acetaminophen vs. ibuprofen

#243

Post by mrcrm9494 »

lloydatkinson wrote: post #234
gregoryyy wrote: post #131

Earlier quoted context omitted.

Yup - in the UK, paracetamol is usually recommended for general pain relief before Ibuprofen. Additionally, Ibuprofen and NSAIDs have a lot of interactions which can make them unsafe - SSRIs or blood thinners for example.

Where does Aspirin fit into this? I only use paracetemol and ibuprofen. The one time I tried asprin I got a stomach pain.

aspirin is an NSAID, taking it modifies the prostaglandine levels (through its COX inhibition) and this influences the mucosa of your stomach. ibuprofen can still have the same side effects, because its belonging to the same class of drugs.

Re: Acetaminophen vs. ibuprofen

#244

Post by harmonics »

triage8004 wrote: post #60
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…

NAC is so amazing for us in terribly polluted areas. Also great before drinking

I am blessed with living in one of the most polluted areas in the world (PM2.5 going into thousands of µg/m³ in winter; summers are not much better due to dense chemical smog). Can you say more about how you're using it to combat that? Thanks!

Re: Acetaminophen vs. ibuprofen

#245

Post by vanderZwan »

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 only hurts when I lean on it. Because it's healing. So I don't. Why would headaches or other "inconvenient" pains be different?

In my case headaches are usually caused by sleep deprivation causing high sensitivity to external stimuli, muscle tension, dehydration, or some combination of that. So I'll first try to take a nap and/or stick to low-stimuli environments, have a good stretch and/or heated up massage pillow for the neck, and make a quick home-made oral rehydration solution with some salt and sugar. That usually alleviates most if not all of the pain.

And I'm not saying painkillers should always be avoided. If I have insomnia-induced headaches in the morning and a long day ahead with many social interactions, then I know that headaches will make me a grumpy asshole, so I'll obviously will take a painkiller for everyone's sake. And sometimes I can only fall asleep if I take a painkiller to get rid of the headache first, so I need it to break the vicious cycle. I'm not saying people should "walk it off" here, just to focus on trying to figure out the actual cause first before medicating the symptom way. That's also healthier in the long run, no?

Re: Acetaminophen vs. ibuprofen

#246

Post by throwawayffffas »

To the author, my guy, you are clearly not an endocrinologist stop pretending you are, and trust the people that study these things for a living.

Not only you can't take more than 4 grams of paracetamol per day, you must not take it for more than 3 days straight, it says so on the leaflet.

Biochemistry and medicine are hard and complex, all the quacks out there that preach snake oil treatments went down the path of thinking their domain specific knowledge in random domains somehow transfers to medicine it does not.

Re: Acetaminophen vs. ibuprofen

#247

Post by nerptastic »

7bit wrote: post #104
seemaze wrote: post #3

I grew up with the understanding that acetaminophen was the safe choice for fever or aches, and ibuprofen what the more potent compound for inflammation and severe pain. I recall casual anecdotes that "my doctor said 1.5x or 2x ibuprofen dose is ok when warranted" to address major incursions. I've never once thought about taking more than the recommended dosage of acetaminophen, largely because I had no expectation t…

If your doctor recommends to take a specific dose, take the specific dose. Don't half it. Taking half of stuff can also cause further damage. Like with antibiotics, where it can lead to bacteria becoming resistant. So don't be the "smarter" person. Do as your doctor says and if you have doubts, consult another doctor before just doing what you think is safe, but actually isn't.

Is this not the case for OTC drugs? Specifically, the two mentioned in the article. I rarely take either of them, but if my doctor tells me to take 1 ibuprofen every 6 hours or so, if I halve that am I actually doing more damage?

Re: Acetaminophen vs. ibuprofen

#248

Post by ncruces »

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.

Same in Portugal.

Re: Acetaminophen vs. ibuprofen

#249

Post by lazzurs »

jcul wrote: post #212
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 Ireland you can buy acetaminophen in stores, gas stations etc. For ibuprofen you need to go to a pharmacy.

I couldn't get over this after moving here from the UK where you can pick up a pack for 10p in a supermarket.

Re: Acetaminophen vs. ibuprofen

#250

Post by vanderZwan »

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…

> That's also healthier in the long run, no?

Long-winding tangential anecdote (which is why I'm replying to myself in a separate comment), but I have pretty extreme example of this: I managed to avoid nearly all suffering after getting a tonsillectomy in my mid-thirties, while using almost no painkillers.

My ENT surgeons warned that me "I'd hate him for about a month, then I'd love him for never having to deal with [serious medical condition that justified the removal of tonsils] again". He prescribed all kinds of stuff to alleviate the expected suffering, and advised me to try to take the weakest options I was comfortable with, because the heavier ones might have some unpleasant side effects. It's the only time in my life I've been prescribed painkillers at all, actually (this was in Sweden, btw).

I got codeine/paracetamol as a coughing suppressor and mild painkiller, a couple of heavier painkillers for if it got worse (I forgot the name but some kind of heavy-duty variation of diclophenac that you can only get with a prescription), and some kind of nasty solution to gargle with that supposedly would numb my throat if it got really bad. I've been told this is nothing compared to what you can expect in the US.

Then in the evening after the surgery, when I was trying to eat a soup with my mom, I realized soup didn't hurt as much as drinking plain tap water. And then I thought: isn't it odd that drinking plain water feels like a thousand paper-cuts in the open wound in my throat, but whenever the coughing made the wounds open and bleed, the blood doesn't hurt at all? Blood is mostly water, so what is the difference? Could it be the salt? Is this similar to why drinking demineralized water is bad for you? What's the opposite of demineralized water? Oral rehydration solution. Ok, trivial to make, let's try that. I'll drink it luke-warm to be close to body temperature too.

Turns out that that works. Oral rehydration solution is almost painless to drink after a tonsillectomy. I know this is anecdata, but sample size three: I've since shared this information with two friends who got a tonsillectomy, and they've been extremely grateful for this tip.

It even seemed to speed up my recovery, probably due to a lack of irritation triggering inflammation. I was eating solid food within days. DAYS. My mom, a retired family physician herself, couldn't believe her eyes.

I ended up only needing the codeine/paracemtal in the evening to suppress coughing in my sleep, and brought back all the other pain-killers without opening them.

Post reply on HN