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Acetaminophen vs. ibuprofen

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Re: Acetaminophen vs. ibuprofen

#331

Post by lapcat »

Supermancho wrote: post #326
lapcat wrote: post #282

Earlier quoted context omitted.

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. This is vastly overstating the rationality of the human body. It's no more rational than the human mind, which is often quite irrational. Your body isn't the product of medical school, nor intelligent design, but rather random natural selection, which is decent but demonstrably far from perfect.

> It's no more rational than the human mind Neither is a car, but I still take it to get checked out when a warning light is on.

> Neither is a car, but I still take it to get checked out when a warning light is on.

I can't believe I need to say this, but cars did not evolve by natural selection. Cars are intelligently designed (by humans, not by God) to show a warning light when there is a problem you should get checked out. So cars are actually rational in that respect.

Hacker News comments never fail to depress me.

Re: Acetaminophen vs. ibuprofen

#332

Post by mghackerlady »

gregoryyy wrote: post #131
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.…

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.

Ibuprofen interacts with SSRIs? Anecdotally I've never had any problems with my Escitalopram and the Wikipedia page doesn't mention any interactions

Re: Acetaminophen vs. ibuprofen

#333

Post by diogenes_atx »

Scattered throughout this discussion are a number of comments concerning the potential damage to the stomach lining from ibuprofen, naproxen and aspirin. This is an important consideration when choosing a painkiller. According to a recent Washington Post article by Trisha Pasricha, MD, "You should avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs — such as ibuprofen, naproxen and aspirin — whenever possible. If you do need to take them, use the smallest dose for the shortest time feasible."

Dr. Pasricha adds: "I don’t get too concerned if my patients take one or two doses every now and then. But through regular use, such as several times a month or more, NSAIDs are well-known to increase intestinal permeability. In other words, NSAIDs can damage the lining of our guts. That’s because NSAIDs reduce the blood flow in the tiny vessels feeding our guts and disrupt the intestinal cells forming a barrier between the outside world and your insides. This has been proven over and over again through decades of research."

Conclusion: Acetaminophen is generally safer than ibuprofen, naproxen and aspirin.

https://www.washingtonpost.com/wellness/2024/12/09/ibuprofen...

https://archive.is/XRZEU

Re: Acetaminophen vs. ibuprofen

#335

Post by Eisenstein »

robocat wrote: post #213
Eisenstein wrote: post #102

Earlier quoted context omitted.

"Acetaminophen toxicity is the second most common reason for liver transplantation worldwide and the most common cause of acute liver failure in the United States. Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States." 56,000 emergency room visits is the key here, because "the mortality associated with acetaminophen overd…

About 50% of overdoses are intentional (especially suicidal teenagers), with the other 50% accidental. So when pondering the issue of numbers, it matters what path people took to overdose.

For all accidental acute poisonings leading to hospitalizations from OTC drugs amongst adults and adolescents, the top culprits are:

1. Acetaminophen: Dangers noted in article, and stats given in my parent comment

2. NSAIDs: "NSAIDs are ingested commonly in overdose, however severe toxicity is rare"

3. Salicylates "Severe salicylate poisoning follows ingestion of greater than 500 mg/kg". For an adult weighing 150lbs that is 68kg, which means severe poisoning requires 34g of aspirin, which at 325mg per pill is 104 pills total. Hardly easy to do this accidentally.

[1] "Acute poisoning: understanding 90% of cases in a nutshell", S L Greene, P I Dargan, A L Jones, Postgrad Med J 2005;81:204–216

Re: Acetaminophen vs. ibuprofen

#336

Post by pikminguy »

Something I'm surprised this article didn't mention is that sometimes the anti-inflammatory is the point. If you have swelling along with the pain then ibuprofen or any other NSAID is going to be much more effective. That would be the main reason to go with ibuprofen in my opinion. But again if you take medical advice from an internet comment you're already doing it wrong.

Re: Acetaminophen vs. ibuprofen

#338

Post by user_7832 »

fc417fc802 wrote: post #295
user_7832 wrote: post #67

Earlier quoted context omitted.

Totally get it, I too only understood it "theoretically" till I had a (fairly minor!) dental operation. ... Suddenly I'm maintaining a continuous note of when I'm taking which medicine to avoid crossing safe limits (which I anyway was crossing most days). I was only told to take 2 paracetamols a day (bullshit dose, I'd be waking up from the pain even with more pain meds). "Diclofenac for rare use" - well, if nothing…

Pain management can be crazy but in your case it sounds like they simply didn't prescribe the appropriate medication presumably due to the anti opiate hysteria that has taken hold.

While that's quite possibly true, I forgot to mention that I'm not in the US but India. I was conscious the whole time, with only local anesthesia. Also the dentist in question is actually our "family" dentist, and he's a pretty knowledgeable/skillful guy (easily more knowledgeable than many GPs on health matters of the body).

Fun fact, you can totally get them to pause the procedure without saying a word. All you have to do is end up in a lot of pain, have your heart rate skyrocket like anything, and get everyone in the OT very concerned ;)

Re: Acetaminophen vs. ibuprofen

#339

Post by sidewndr46 »

vanderZwan wrote: post #250
vanderZwan wrote: post #245

Earlier quoted context omitted.

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 […

Maybe you took carprofen?

Re: Acetaminophen vs. ibuprofen

#340

Post by sidewndr46 »

huhkerrf wrote: post #267
vanderZwan wrote: post #245

Earlier quoted context omitted.

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.

Does acetaminophen require a prescription in France?
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