Tylenol

[DrHenley]

The more I read about Tylenol/acetaminophen/paracetamol, the more I wonder why it is still on the market.
None of the following are "conspiracy theories." You won't get banned from YouTube or Facebook for spreading misinformation if you post it.

• At a standard dose, paracetamol only slightly decreases body temperature, it is inferior to ibuprofen in that respect, and the benefits of its use for fever are unclear.
• It appears that 0.2 °C decrease of the body temperature in children after a standard dose of paracetamol is of questionable value, particularly in emergency situations.
• Meta-analyses showed that paracetamol is less effective than ibuprofen in children, including children younger than 2 years old, with equivalent safety.
• Paracetamol may relieve pain in acute mild migraine but only slightly in episodic tension headache. However, the aspirin/paracetamol/caffeine combination helps with both conditions where the pain is mild and is recommended as a first-line treatment for them.
• Paracetamol is effective for post-surgical pain, but it is inferior to ibuprofen.
• The pain relief paracetamol provides in osteoarthritis is small and clinically insignificant.
• Pain after a dental surgery provides a reliable model for the action of analgesics on other kinds of acute pain. For the relief of such pain, paracetamol is inferior to ibuprofen.
• Paracetamol fails to relieve procedural pain in newborn babies. For perineal pain postpartum paracetamol appears to be less effective than non-steroidal anti-inflammatory drugs (NSAIDs).
• American College of Rheumatology and Arthritis Foundation guideline for the management of osteoarthritis notes that the effect size in clinical trials of paracetamol has been very small, which suggests that for most individuals it is ineffective.
• The evidence in its favor for the use in low back pain, cancer pain, and neuropathic pain is insufficient.
• Chronic consumption of paracetamol may result in a drop in hemoglobin level, indicating possible gastrointestinal bleeding, and abnormal liver function tests.
• There is a consistent association of increased mortality as well as cardiovascular (stroke, myocardial infarction), gastrointestinal (ulcers, bleeding) and renal adverse effects with taking higher dose of paracetamol.
• The drug may also increase the risk of developing hypertension.
• Elevated frequency of asthma and developmental and reproductive disorders is observed in the offspring of women with prolonged use of paracetamol during pregnancy.
• Some studies suggest that there is evidence for the association between paracetamol during pregnancy and autism spectrum disorder and attention deficit hyperactivity disorder.
• Meta-analyses suggest that paracetamol may increase the risk of kidney impairment by 23% and kidney cancer by 28%. Paracetamol is particularly dangerous to the liver in overdose, but even without overdose those who take this drug may develop acute liver failure requiring liver transplantation more frequently than the users of nonsteroidal anti-inflammatory drugs.
• Paracetamol poisoning is the foremost cause of acute liver failure in the Western world, and accounts for most drug overdoses in the United States, the United Kingdom, Australia, and New Zealand.
• According to the US Food and Drug Administration, the drug may cause rare and possibly fatal skin reactions such as Stevens–Johnson syndrome and toxic epidermal necrolysis.

 

[DrHenley]

P.S. My mother was a big believer in Tylenol. I wasn't. I noticed from an early age that it did absolutely nothing to relieve pain or fever, and I insisted on children's aspirin instead.
My mother religiously dieted and exercised and ate only organic healthy foods. She was on the "Atkins Diet" years before Atkins even invented it. She died of kidney and liver cancer.

 

[M0del_31]

I’ve witnessed first hand children’s Tylenol reduces 102F to 98.8F in a toddler in about 40 minutes. I does similarly for me. It may not work on some people as well; I suppose it effects their body chemistry differently. I don’t use it until fevers get above 102 because it is a foreign substance. Besides a little fever does more good than harm.

 

[EastenerWesterner]

I used to make a run to Canada to get Tylenol 3 which were OTC.
ibuprofen has many of the same side effects.

 

[DrHenley]

I’ve witnessed first hand children’s Tylenol reduces 102F to 98.8F in a toddler in about 40 minutes. I does similarly for me. It may not work on some people as well; I suppose it effects their body chemistry differently. I don’t use it until fevers get above 102 because it is a foreign substance. Besides a little fever does more good than harm.

Of course the quotes above were talking about on average...mileage may vary... But now they do not recommend Tylenol for just reducing fever.
Another issue is the dosage required to reduce fever. It appears that at the recommended dose, on average it lowers fever by 0.2° C (0.4° F) and at higher doses lowers fever by 0.7° C (1.3° F). Higher doses is where you quickly start running into liver toxicity.
Ibuprofen is more effective with about the same risk of short term side effects (mainly gastrointestinal). Those studies were not looking at long term side effects.
Which begs the question, why use Tylenol?

BTW, I don't use anything unless fever gets over 103°F. Enteric aspirin is my first choice. Alleve (naproxen) is my second choice based on my doctor's recommendation. Advil (ibuprofen) is my third choice. Tylenol is my never ever choice.

 

[JackDW]

Interesting. I recently (6 months ago) went to see a kidney doctor (just needed to add a magnesium supplement) and the doctor advised me to NOT take aspirin or ibuprofen. He advised that if I needed something for minor pain (sore muscles or joints) to ONLY take Tylenol as it was easier on the kidneys. I do have small no intrusive kidney stones.

 

[M0del_31]

Unfortunately I’m going through some fever hell and here’s my experience today.
Tylenol 325mg x 2 - Takes about 40min to start lowering temp from 102.5F to 98.8F - efficacy lasts about 4 hours
Bayer aspirin 325mg x 2 - First time to try it for fever and took about 2 hours to lower 102F to 98.1F - efficacy lasts about 6 hours.
For fever, Tylenol has always worked for me in about 45 minutes like clockwork.

 

[KateMTx]

NSAIDs such as ibuprofen can also cause rare cases of SJS (just like acetaminophen) and also have many other well-documented side effects, such as increasing blood pressure, contributing to stomach bleeding, and causing kidney damage with sustained use (according to recent studies, this is especially a concern in combination with certain blood pressure medications . . . which may be needed because of the increased blood pressure due to taking the NSAID medications. . .). For me I can't take ibuprofen at all anymore and try to avoid NSAIDs in general because they do affect my blood pressure. Acetaminophen is fairly effective for my migraines, though when I get a bad one I will also take naproxen (Aleve). All drugs have side effects and risks and the important thing is to be aware and understand them and use as little as possible and only when truly needed.

 

[Kevin L]

As a paramedic, I've always disliked Tylenol and have never trusted it.

The famous scientist Carl Sagan ran the numbers and stats on Tylenol, and decided that about 3,000 people a year end up on dialysis because of chronic use.

If it's of interest, a drug called Mucomyst (which is a med used to help with the lung congestion of pneumonia, emphysema, and bronchitis) can actually be used as a partial antidote for a Tylenol overdose. The generic name for Mucomyst is acetylcysteine.

We carried it on the ambulance for this purpose, as attempted suicide with Tylenol by adolescent girls is not uncommon.

 

[bigpaul]

I try to live my life taking the least possible medicine, I limit what goes into my body hence my stance on the clot shots.

 

[Survivor_316]

Read these statistics for statin drugs, too. It is really astounding that most of them got approved.

Amazing about the acetylcysteine, Kevin. Would NAC work the same or would it cause too much vomiting? Would glutathione infusions work, too?

I told a friend about NAC when he went through covid liver damage. He was told he had to go to a specialist and then when he started NAC, he had a second liver function test done and it was then fine. There's no way of knowing if it was repairing itself without the NAC support, but it was interesting.

 

[Cindyd]

Larry's PCP tells him not to take ibuprofen due to risk of kindey issues. He has 1 kidney due to donating other to his son, and he has multiple health issues. PCP tells him to take only Tylenol if he needs it for breakthrough pain (he also has prescribed narcotic pain med). Sounds like he might want to rethink the PCP recommendations or have a discussion with him.

Years ago I ended up in hospital for 5 days with acute renal failure. My BP was very, very low, and turns out I also had pneumonia. Prior to going to ER, I had been taking ibuprofen max dose every X hours, per bottle instruction, but I had done that daily for a week, hoping whatever I had would run it's course soon.

I was much younger then, plus sick as a dog at the time. Never dawned on me that a week's worth would cause a problem, I thought onlly much longer term use could cause issues. The doctor told me the ibuprofren was culprit for the kidney issue.

Luckily, I haven't been that sick since, and I rarely take either but if I am in pain with my neck or back, and stretching, heat or ice doesn't work, I reach for the Ibuprofren. I never take Tylenol simply becuase I don't find it as effective for me. I wasn't aware of all the research though about it.

 

[Survivor_316]

Larry's PCP tells him not to take ibuprofen due to risk of kindey issues. He has 1 kidney due to donating other to his son, and he has multiple health issues. PCP tells him to take only Tylenol if he needs it for breakthrough pain (he also has prescribed narcotic pain med). Sounds like he might want to rethink the PCP recommendations or have a discussion with him.

Years ago I ended up in hospital for 5 days with acute renal failure. My BP was very, very low, and turns out I also had pneumonia. Prior to going to ER, I had been taking ibuprofen max dose every X hours, per bottle instruction, but I had done that daily for a week, hoping whatever I had would run it's course soon.

I was much younger then, plus sick as a dog at the time. Never dawned on me that a week's worth would cause a problem, I thought onlly much longer term use could cause issues. The doctor told me the ibuprofren was culprit for the kidney issue.

Luckily, I haven't been that sick since, and I rarely take either but if I am in pain with my neck or back, and stretching, heat or ice doesn't work, I reach for the Ibuprofren. I never take Tylenol simply becuase I don't find it as effective for me. I wasn't aware of all the research though about it.

Wow. I wouldn't have thought one week would do that, either.

 

[Kevin L]

Read these statistics for statin drugs, too. It is really astounding that most of them got approved.

Amazing about the acetylcysteine, Kevin. Would NAC work the same or would it cause too much vomiting? Would glutathione infusions work, too?

I told a friend about NAC when he went through covid liver damage. He was told he had to go to a specialist and then when he started NAC, he had a second liver function test done and it was then fine. There's no way of knowing if it was repairing itself without the NAC support, but it was interesting.

I don't know about NAC, as it wasn't an EMS med . . . at least as far as I know.

I take the position that meds are--of course--life-saving, but moderation and lifestyle changes are the key.

If you take too much tylenol and ibuprophen because you keep getting hangovers . . . then quit drinking. If you take too much Tylenol because your back hurts and you're carrying an extra 50 pounds, then work on losing weight.

And so forth.

My feeling is not that meds are bad, but simply that we use them as a substitute for making the right choices because we want instant gratification.

 

[Arcticdude]

I seldom take any drug, OTC or prescribed. I'm usually in a lot of pain in my knees and hips, which the doctors want to replace, and my lower back. For now the pain is tolerable and I just deal with it. Awhile ago I was getting severe headaches, had a CAT scan. The doctor said I had fluid on the brain. I declined any further testing, can't afford the costs. During these headaches I took some ibuprofen. Seemed to help take the edge off a little. I think most drugs are overused, and become ineffective over time.

 

[Propwash]

Growing up in the 1950's/60's everybody took aspirin as a pain reliever and it worked fine.
Then along came Paracetamol and Ibuprofen and I'm still trying to work out which (if any) are better or worse than dear old aspirin.

 

[Kevin L]

Growing up in the 1950's/60's everybody took aspirin as a pain reliever and it worked fine.
Then along came Paracetamol and Ibuprofen and I'm still trying to work out which (if any) are better or worse than dear old aspirin.

Aspirin is great, but it has its faults.

Aspirin can cause ulcers, it can cause tinnitis in the ears, and--I assume--it probably shouldn't be used by a hemophiliac (note that I assume this last point, and I may be wrong).

Aspirin may also kill children because of Reye's Syndrome.


https://www.google.com/url?sa=t&sou...gQFnoECCEQAQ&usg=AOvVaw2S47yuLTym-wPs33STBJxj

 

[rainingcatzanddogs]

Aspirin is great, but it has its faults.

Aspirin can cause ulcers, it can cause tinnitis in the ears, and--I assume--it probably shouldn't be used by a hemophiliac (note that I assume this last point, and I may be wrong).

Aspirin may also kill children because of Reye's Syndrome.


https://www.google.com/url?sa=t&sou...gQFnoECCEQAQ&usg=AOvVaw2S47yuLTym-wPs33STBJxj

I think I recall that aspirin exacerbates ulcers, while bacteria causes them. My son is not a hemophiliac but is on a blood thinner and you are correct, he cannot take aspirin.

 

[Propwash]

Okay it seems aspirin is outdated so that leaves Paracetamol and Ibuprofen
I found these descriptions on the net-
Ibuprofen- (eg Nurofen) painkiller, anti-inflam.
Paracetamol (eg Panadol)- painkiller, not anti-inflam.
They both kill pain, but why is Ibuprofen 'anti-inflammatory' and Paracetamol is not?
What part of our bodies gets 'inflamed' anyway?

 

[DrHenley]

If aspirin is so outdated, why did my cardiologist prescribe it after my heart attack?