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Should DayQuil Be Legal?

theargumentmag.com

251–260 of 322 posts

Re: Should DayQuil Be Legal?

#251
post #39

I just can't get super upset about this. Sure, OTC companies are duping customers with marketing, but what's new about that? As the person holding the money, it's my job to look at what is effective and what the active ingredients are in any given product. Or ask my doctor/nurse/pharmacist what to do, if I can't be bothered to make the effort myself. When I want to get irrationally angry about something in a departme…

While I can appreciate the principle of not blindly trusting OTC medicine marketing, it is not realistic to expect every person to be highly competent in fully understanding their medical choices. It is far more reasonable to expect the companies marketing healthcare products to be honest to their customers.

If anything, you need honesty from healthcare companies in the first place if you're even going to begin making an informed decision. You're putting the cart before the horse here: people absolutely should be doing their own research before medicating themselves, but it is the OTC companies that obstruct that.

And, secondary to all of this, your analogy about shampoo is misinformed. Still, it is fitting for this scenario, but not in the way you intended. There are lots of different hair types, including ethnic hairstyles that require specific treatments. There are also a number of lifestyle choices that can change your hair treatment needs. As a result, the shampoo aisle actually is stocked with a wildly varying assortment of haircare choices, but actually figuring out what product works best for your needs can be challenging because it is walled behind layers of marketing nonsense that don't inform the consumer adequately on what makes each product different. This isn't much different than the problems in the medicine aisle.

It took a lot of secondhand research to find the ideal hair care product for my thick, curly hair that would mitigate the damage of thrice-weekly swimming in a chlorinated pool. I can assure you, not everything in the shampoo aisle is exactly the same. It was especially hard figuring this out as a man, when so many products are arbitrarily marketed to specific genders.

Re: Should DayQuil Be Legal?

#252
post #150

Earlier quoted context omitted.

I didn’t know this until recently either. I grew up on a family where if there was pain, you just take tylenol to deal with it. We always followed the dosage timing and never had issues. So recently when my wife had some chronic pain I suggested taking tylenol but even after two days the pain would not go away and she went to ER. They did a blood check to see if they could find anything. They didn’t find the cause, j…

Not to chastise you or your wife, there is an actual "Liver Warning" on Tylenol Product labels. They warn against 4000mg/day or with alcohol consumption. It's not an on/off switch, the damage occurs on a ramp that achieves a critical point after so much consumption. Saying this to encourage label reading and to refute those who might try to characterize your wife's experience as anecdotal. And for those who stop read…

Alcohol can actually be protective in a paracetamol overdose. Paracetamol itself isn't relatively dangerous, the metabolic product created by the liver is.

Alcohol use acutely reduces the levels of these enzymes which convert paracetamol into it's toxic byproduct as ethanol preferentially binds to the same enzyme for it's own metabolism. Therefore, acute alcohol consumption can reduce the harmful effects of paracetamol.

The reverse is true for overdose in the context of chronic alcohol use, when the liver adapts to long-term alcohol exposure by increasing the levels of enzymes, therefore rapidly metabolising paracetamol into it's toxic byproduct and worsening harm.

Source: doctor

As a side comment, the lack of medical knowledge displayed in HN threads paired with the absolute confidence some verdicts are delivered with is worrying, and something I thought this forum would be better at than other sites (looking at you, reddit). Paracetamol and NSAIDs (including ibuprofens) are safe drugs if taken to the package directions. Some of the ideas shared in this thread about taking one over the other, or not taking one ever etc, are not rational. Please consult your doctor if you are worried about your particular situation, but generally OTC medicines are not dangerous if taken to the package instructions.

Accidental overdoses of paracetamol are exceeding rare, but intentional ones are common.

Re: Should DayQuil Be Legal?

#253
post #74

This article uses the trick where you pick studies that support your argument and ignore all of the studies that disagree with it. There are other studies where Dextromethorphan improves both objective and subjective measures of coughing: https://pubmed.ncbi.nlm.nih.gov/37232330/ They also picked a study that shows honey outperforming Dextromethorphan but ignored all the studies that show honey performing similarly o…

Are you sure you posted the right paper? That paper appears to present a clinically insignificant outcome for DXM in children. I think it's perfectly reasonable to contest the research summary this article is providing. All science-based articles on interesting topics are going to be like that. But you're writing your comment as if they took a flyer on DXM, and the research consensus is in fact that DXM is not effect…

I don't know if OP changed their link but the one currently in their post (https://pubmed.ncbi.nlm.nih.gov/37232330/) did find DXM to be effective:

"Using objective and subject assessment tools validated in pediatric populations, this study provided evidence of the antitussive efficacy of DXM in children, aged 6–11 years, at the current OTC monograph dose and labeled indication. Compared with placebo, DXM treatment reduced cough rates 21.0% over 24 h (primary endpoint) and 25.5% during daytime/awake hours. In addition, children treated with DXM reported greater reductions in cough severity and frequency in the mornings and afternoons over 3 days than children treated with placebo. These treatment effects were statistically significant despite the study not reaching its planned sample size and are medically relevant."

Also as I mentioned in another comment, the author of original article misrepresents the findings of their own citation. DXM was found to be effective in adults, just not children.

Re: Should DayQuil Be Legal?

#254

This article uses the trick where you pick studies that support your argument and ignore all of the studies that disagree with it. There are other studies where Dextromethorphan improves both objective and subjective measures of coughing: https://pubmed.ncbi.nlm.nih.gov/37232330/ They also picked a study that shows honey outperforming Dextromethorphan but ignored all the studies that show honey performing similarly o…

> This article uses the trick where you pick studies that support your argument and ignore all of the studies that disagree with it.

It's even worse than that, they appear not to have actually read the analysis they cited because two of the three studies on DXM found it was effective in adults. The same efficacy was not found in children but there are other very plausible explanations for this (difference in dosage and measurement techniques).

Re: Should DayQuil Be Legal?

#255

I get that the discussion here focuses on doubtful decongestants, but just the mention of acetaminophen makes me think of pharmaceuticals and people's relationship with them in the US. It's a strange world to me, especially how deeply ingrained the brand names are in people's minds - years of evidently successful marketing. What, to me, should be illegal, is building expensive branding around a group of very basic an…

FWIW my guess is most people are aware, and do know that supermarket/drugstore acetaminophen / paracetamol is the same, in some relevant sense, as Tylenol / Panadol. It's not like the retailers lack marketing resources. But for these off-the-shelf drugs the total $/£ amounts are small for a lot of people.

Then, there _are_ arguments about whether generics face adequate testing to ensure the same quality as the originally-approved name brand drug. A lot of this is FUD - I'll happily buy generic acetaminophen in the US - but it's not a totally irrational concern. I doubt any regulator ensures generic equivalence to the same degree of conformity that a big pharma companies' own quality control does.

For example, I personally find real differences in the jankiness of different asthma inhalers, even amongst generics. Maybe that's because I don't shake/use/clean them exactly per the directions, but then that's real-world use for you. My personal experience says brand-name Ventolin has solved a "robustness against user error" problem in a way some alternatives often have not, suggesting the FDA does not enforce equivalence on this dimension. It's not enough of a difference for me to go name-brand, since out-of-pocket price differences can be egregious, but I do distinguish between otherwise-unknown generics.

Finally, you may trust the UK regulator and so do I, but traveling somewhere without good regulatory oversight, I'd probably reach for Panadol - assuming it seemed authentic - over a generic brand I'd never heard of. Brands have value and brand owners have a lot to lose, which is a kind of insurance (see 1982 Tylenol recall).

Re: Should DayQuil Be Legal?

#256
The FDA did this to us by outlawing effective but problematic products and replacing them with relatively safe but ineffective products. And then letting product makers off the hook on claims and pricing

Re: Should DayQuil Be Legal?

#257
post #94

Earlier quoted context omitted.

An interesting new drug is Auvelity, where Dextromethorphan is proposed to help stimulate neurotropic growth factor to help the brain repair itself, and similar related drugs like dextromethorphan and ketamine and other NMDA receptor antagonists are innovative drugs to help prevent Alzheimer's.

> … similar related drugs like dextromethorphan and ketamine and other NMDA receptor antagonists are innovative drugs to help prevent Alzheimer's. Should read “NMDA receptor antagonists _may_ give rise to treatments that _may help prevent or ameliorate the symptoms_ of Alzheimer’s. Nobody even knows how Alzheimer’s works at all — like most diseases it’s a description of some detectable symptoms, some of which could e…

They're referring to Memantine, an NMDA antagonist that has been approved for treating symptoms of Alzheimer's for over 20 years.

Re: Should DayQuil Be Legal?

#258

This article uses the trick where you pick studies that support your argument and ignore all of the studies that disagree with it. There are other studies where Dextromethorphan improves both objective and subjective measures of coughing: https://pubmed.ncbi.nlm.nih.gov/37232330/ They also picked a study that shows honey outperforming Dextromethorphan but ignored all the studies that show honey performing similarly o…

DXM may or may not suppress coughing relative to placebo - the study cited here appears to be have been written entirely by authors from drug companies, so perhaps there is some bias. Here's a meta analysis that favors honey over DXM https://pubmed.ncbi.nlm.nih.gov/32817011/ , the original study that kicked off this idea that also favors honey https://pubmed.ncbi.nlm.nih.gov/18056558/ , and a different meta analysis…

It's worth nothing that all of the studies you linked were performed only on children. It is entirely plausible that DXM is effective in adults but not children because of the difference in dosage or measurement (studies on children often rely on parental surveys).

Re: Should DayQuil Be Legal?

#259

Earlier quoted context omitted.

For a lot of us, Ibuprofen works just as well or better than Acetaminophen, so banning Acetaminophen is not much of a problem. I am on a medication that's contraindicated with NSAIDs, but I made sure that a low dose of Ibuprofen was acceptable.

Ibuprofen is hard on the kidneys and stomach too. And bleeding/clotting issues. Sooo ya :) Better just stay off the beer hubby. Remember, beer makes you fat also.

You don't know us, nor the scale of anything we do in our lives.

But thanks for the input, sweetlips!

Re: Should DayQuil Be Legal?

#260
post #150

The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be . Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijua…

I didn’t know this until recently either. I grew up on a family where if there was pain, you just take tylenol to deal with it. We always followed the dosage timing and never had issues. So recently when my wife had some chronic pain I suggested taking tylenol but even after two days the pain would not go away and she went to ER. They did a blood check to see if they could find anything. They didn’t find the cause, j…

Yup, did some digging on Tylenol/acetaminophen before I had some surgery, and it's a real danger. Oddly enough, it seems downing a whole bottle won't (usually) end your life as it gets mostly directly eliminated rather than metabolized, but taking just around 2-3X the high-strength dose sustained over 3-4 days can destroy your liver — at that point, you have about six weeks unless they find a new liver for you (obviously, there's wide variance in actual dosages and reactions, but that was the general median). For someone with serious acute pain, who doesn't know this hazard, it'd be pretty easy to self-medicate and load up and lose track...

OTOH Ibuprofein, doesn't have anything like that deadly profile, but enough gut and other issues.

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