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Acetaminophen vs. ibuprofen
261–270 of 504 posts
Re: Acetaminophen vs. ibuprofen
#262Earlier quoted context omitted.
You can still buy 100 packs, they are just behind the counter at chemists. TBH it's a rather stupid restriction - do they think people only ever own 1 packet of paracetamol at a time? In my household we have at least half a dozen, including a 100-pack from Oz and a 500-pack from America.
Oh right - that's probably what we did, buy a big pack from behind the counter. I don't think you can even do that in the UK. Yeah we usually have a few packs hanging around, and I get the 'it seems stupid' thing, but sometimes just adding a tiny bit of friction when someone's trying to kill themselves might save a life. I dunno, I hope that's shown in the evidence anyway. Otherwise it's just pointless like the whole…
> Oh right - that's probably what we did, buy a big pack from behind the counter.
No, when you visited they were still on the shelf. They only put them behind the counter in 2025.
> sometimes just adding a tiny bit of friction when someone's trying to kill themselves might save a life
I'm philosophically not for making suicide harder. If someone wants to die, that's their right. And practically, while you might be able to show a stat-sig decrease in paracetamol poisoning, I'd expect the suicides to largely just move to other methods.
Re: Acetaminophen vs. ibuprofen
#263> 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…
AIUI one of the many quirks of the US health insurance system is that a lot of people have only minimal cover which doesn't include things like physiotherapy and rehabilitation treatment. That means that they often can't treat a painful condition at source so their only option is to mask the pain with painkillers.
Re: Acetaminophen vs. ibuprofen
#264Only twice have I ever used Acetaminophen close to the max daily limit, and those were both when I was experiencing a raging tooth infection. I'd pop 2x500 mg paracetamol 4 times a day, which helped just enough to get through the day. The tooth infections were so severe that the dentist had to put anesthesia directly into the root / nerve, multiple times - felt like a lightning strike each time. One of these times I'd put the pain level at a 9 out of 10. I'm just going to assume that 10 out of 10 pain is when you basically consider ending it all, purely in the heat of the moment.
Having gout, I've also had some pretty severe bouts where the pain level has been in the 8/10 range. Unfortunately nether paracet or ibuprofen worked.
In any case, when I see regular people eating these painkillers as candy, I'm starting to wonder what pain levels they are experiencing. I'm generally very cautious of using this stuff.
Re: Acetaminophen vs. ibuprofen
#265Earlier quoted context omitted.
You will indeed find various figures for various pain types all are far worse than ibuprofen. Here is an example from the Cochrane library > For the IHS preferred outcome of being pain free at two hours the NNT for paracetamol 1000 mg compared with placebo was 22 (95% confidence interval (CI) 15 to 40) in eight studies (5890 participants; high quality evidence), with no significant difference from placebo at one hour…
"pain free" is a long way from the pain is manageable. Pain is an understudied subject, where we have too little knowledge. Just using the word manageable is an indication of this.
That's very true, but the metric is applied to all medications you compare against that's what's important. You also just get a baseline idea of what's good by guessing what you'd accept.
Episodic tension type headache tested with ibuprofen Vs placebo NNT is 14. (Btw that's not great itself) But it's better than paracetamols often quoted figure 20.
Here's why I say it's not great. Why don't you guess some reasonable NNTs for say moderate depression treated with SSRIs, or no relapse in schizophrenia treated with an antipsychotic. Now guess the NNT for a statin to prevent a first heart attack.
SSRI for moderate depression about 10, antipsychotics to prevent schizophrenia relapse over 2 years NNT= 3 (excellent )Statin to prevent a first heart attack 200! (This one always shocks me). Statins have a clear role of course.
[0] https://thennt.com/nnt/ibuprofen-treatment-episodic-tension-...
Re: Acetaminophen vs. ibuprofen
#266> 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…
> the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US.
Americans' relationship with painkillers is absolutely unhinged.
Re: Acetaminophen vs. ibuprofen
#267> 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…
Since we're talking about acetaminophen and ibuprofen, in France you're liable to end up with a medicine cabinet full of acetaminophen, because almost anytime you go to the doctor with any type of pain, they add it to the prescription.
Re: Acetaminophen vs. ibuprofen
#268Really 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…
You can still die if you take your idiot-proof Aussie blister packs with alcohol. So it's more an inefficient use of cabinet space. You can overdose on water too, they haven't banned 5-gallon jugs (yet).
s/idiot-proof/idiot-resistant/g
Also applies to most similar phrases ending in -proof. Should be eye-opening.
Re: Acetaminophen vs. ibuprofen
#269Earlier quoted context omitted.
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.
"I took it and it didn't work so it's a fake placebo drug" - wow, your scientific method is flawless, have you considered a career at the US Department of Health?
That might be a good fit considering who's in charge today.
Re: Acetaminophen vs. ibuprofen
#270Only twice have I ever used Acetaminophen close to the max daily limit, and those were both when I was experiencing a raging tooth infection. I'd pop 2x500 mg paracetamol 4 times a day, which helped just enough to get through the day. The tooth infections were so severe that the dentist had to put anesthesia directly into the root / nerve, multiple times - felt like a lightning strike each time. One of these times I'…
Pain is weird. It's extremely subjective, not only between people but also within your own body. Paraphrasing something Paul Rozin mentioned in a paper on so-called benign masochism: people can learn to enjoy eating the most extremely spicy food, but even those people will still scream out in pain you rub the ghost pepper they're eating in their eyes. Pain sensation is therefore localized and contextual.
So we should not be too quick to dismiss the pain of others.
As far as 10/10 pain goes, I've heard cluster headaches can get so bad it has driven people to suicide during an episode.