It is amazing how the effects of acetaminophen are consistently downplayed, while the risks with ibuprofen are consistently exaggerated.
That's some good marketing, and it kills a lot of people. Especially kids.
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For the dangers of acetaminophen?
ReplyDeleteHere's the NIH discussing the dangers: nlm.nih.gov/medlineplus/druginfo/meds/a681004.html
ReplyDeleteAnd the FDA: fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm381650.htm
And This American Life: http://www.thisamericanlife.org/radio-archives/episode/505/use-only-as-directed
According to This American Life: "Over 150 Americans die each year on average after accidentally taking too much. "
Compare to ibuprofen, where in 1% of people who take it everyday for a year, there is increased stomach bleeding.
Cameron Mount interesting, where'd you hear that?
ReplyDeleteHere's a list of the major drug interactions, particularly including alcohol, epinephrine, and iocane powder: drugs.com/drug-interactions/acetaminophen,tylenol-index.html?filter=3&generic_only=
ReplyDeleteIts true; and yet, tylenol is responsible for more deaths than all NSAIDs combined.
ReplyDeleteHere's the propublica article on confusing dosages: http://www.propublica.org/article/tylenol-mcneil-fda-kids-dose-of-confusion
ReplyDelete::wiki Mercols:: Hold on, taking that down.
ReplyDeleteThe point is that source after source points to the dangers of acetaminophen, but this is the response.
ReplyDeleteCameron Mount And if you use 50% more, you can easily suffer liver failure. That's a really big deal. That means if I take a second dose of DayQuill in 2 hours, I could die. That means if a mom gives a kiddo the drug, and the dad doesn't know and does it to, the kiddo could die. The difference between "safe" and "deadly" is razor thin. And yet, we sweep it under the rug when, and I state this again: Tylenol kills more people than all NSAIDS combined.
ReplyDeleteThat's not 'label it correctly' level, that's 'use something else' level.
I'm not sure what you are trying to argue here. I have never once stated it should be banned; I've suggested we should use something else. I've suggested no changes to governmental policy; those have come from you.
ReplyDeleteWhy are you looking for a fight on this?
I suggest people use other things, sure. Didn't mean I want the fda involved, for various reasons.
ReplyDeleteAcetaminophen is safer than NSAIDs when properly dosed but is easier to overdose, especially because it's a common ingredient in cough medication and other compound OTC preparations like Excedrin; it's easy for someone to lose track of how much they've had.
ReplyDeleteBut within liver tolerance it does not build tolerance (which most NSAIDs do) and it does not have the same effects as long term use of NSAIDs (stomach damage, edema, kidney failure etc.)
This is per my rheumatologist, who has to monitor people on long term NSAID use for kidney failure, and usually has to add opiates later in, because the NSAIDs grow ineffective (and opiates have their own huge stack of problems), but prefers acetaminophen for chronic pain, thanks to its lack of side effects and good tolerance within dosing range.
Its unarguably dangerous if overdosed, and I'm always cautious with dosing and potential interactions.... I'm on another medication which is cleared by the liver, so I dose it very conservatively. But it's still a very useful drug.
My rheumatologist may decide that cannabinoids are even better once there's a bigger body of research (so far it looks like they offer non-drowsy pain remediation without tolerance, and are far less likely to overdose), but right now he says acetaminophen is the best for chronic pain, as long as you're conscientious about dosing. I just use a timer on my phone to make sure that I don't exceed; I only use it for acute and not chronic pain, but between surgery and some other issues a bout of "acute" can be a few weeks, especially since I'm allergic to some formulations of codeine so often have to do without, even for very severe pain. At those times I'm grateful that acetaminophen can be combined with ibuprofen or naproxen, because they're metabolized differently.
I do think that medications containing it should be better labeled to avoid overdosing.... It should be more prominent than a small warning label on cough syrup, for example.
Fun fact: Ibuprofen isn't psychologically addictive but it is chemically addictive. Withdrawal from it is extremely unpleasant, but not physically dangerous. And, best of all, nobody tells you that it's a possible outcome of taking the stuff regularly, so then you think you're dying or something when it happens. >_<
ReplyDeleteThere's a phenomenon called "rebound headaches" that you can get from long use of acetaminophen as well as NSAIDs, so even though my rheumatologist says Tylenol is "safest" for chronic use, I try to save it for acute pain over and above chronic pain, so as not to get into a rebound cycle, and treat migraine with caffeine alone at first, since that's the effective part of Excedrin for me, though I carry Excedrin because I can't find caffeine pills I'm not allergic to. (Luckily I can usually find coffee.)
ReplyDeleteYea, I have chronic migraines, so that was a lovely first semester of college for me.
ReplyDeleteCameron Mount I have a friend who controls chronic cluster headaches with caffeine, too.
ReplyDeleteMy own chronic pain is best managed by the side effects of NSAIDS, caused as it is by inflamation.
ReplyDeleteThe notion that only doctor should give medical advice is ... naive. We all give medical advice to friends, all the time.
ReplyDeleteWilliam Nichols Yeah, I really like NSAIDs for inflammation, and take them proactively after surgery to reduce swelling. (And I ice as well if that's indicated; icing really helps.) But on long term use they hammer the crap out of my kidneys. They're great for inflammation, though!
ReplyDeleteI'm trialing one right now that does low-grade targeted anti-inflammation among other effects, but is broken down by the liver and not the kidneys, and so far so good.... No bad side effects and a little down tick on daily pain and brain fog, and this one doesn't build tolerance, and can be discontinued without tapering.
From the propublica article about 2010 "321 people died from acetaminophen toxicity, according to CDC data. More than half – 166 – died from accidental overdoses.The rest overdosed deliberately or their intent was unclear. For the decade 2001 through 2010, the data shows, 1,567 people died from inadvertently taking too much of the drug." https://www.propublica.org/article/tylenol-mcneil-fda-use-only-as-directed
ReplyDelete