5 ms·

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibup

by mrb 7y ago

French sources specifically mention severe cases of covid-19 in "young and healthy" patients (eg. see https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibuprofene-et-autres-anti-inflammatoires-20200314 https://lefigaro.fr/sciences/coronavirus-alerte-sur-l-ibupro... ) but this important piece of information has NOT been relayed by international medias. Jean Paul Hamon, medical doctor and president of the Federation of French Doctors said on TV to NOT take NSAIDs (anti-inflammatory drugs) if #covid19 is suspected. The ONLY common point among young covid-19 patients they have witnessed in critical care centers in France was that they all took NSAIDs.

dukha 7y ago
Translation from French: paracetamol is preferred over nonsteroidal anti-inflammatory drugs (NSAID). Dose of paracetamol should not exceed 3g/day and doses should be spaced throughout the day.
- slowmovintarget 7y ago
  "Paracetamol" a.k.a. "acetaminophen", common brand: Tylenol.
  - deleted 7y ago
    [deleted]
  - arcticbull 7y ago
    Which is itself the leading cause of acute liver failure in the US. The active dose is very close to the lethal dose, much more so than naproxen or ibuprofen.
    - calebsurfs 7y ago
      The active dose is nowhere near the lethal dose. It is however close to the dose where you could see some minor damage to the liver. It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, not because they are loading up on acetaminophen itself.
      - DanBC 7y ago
        Paracetamol is dangerous in overdose, and the therapeutic dose is pretty close to the overdose amount. The therapeutic index is approx 10. Compare that to morphine, which has a therapeutic index of about 70. (although the therapeutic index is tricky to use because of dose response curves) We know that paracetamol is commonly used in both accidental and deliberate overdose. And this is true in countries that don't have the opioid crisis, and it was true in the US before the opioid crisis. > It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, This is part of the problem, yes. But it's incomplete. We know that paracetamol alone causes problems for the liver even with small overdosing. https://britishlivertrust.org.uk/researchers-shed-new-light-paracetamol-causes-liver-damage/ https://britishlivertrust.org.uk/researchers-shed-new-light-...
        deleted 7y ago
        [deleted]
      - arcticbull 7y ago
        This isn't really a debate: - "Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported" [1] in 2005. It was also true before the opioid epidemic really began. - "The recommended dose of acetaminophen in adults is 650 to 1,000 mg every 4 to 6 hours, not to exceed 4,000 mg in a 24-hour period." [2] - "Single doses of more than 150 mg/kg or 7.5 g in adults have been considered potentially toxic." [2] - "The minimal dose associated with liver injury can range anywhere from 4 to 10 g" [2] The active dose is very close to the dose at which liver damage occurs (4X single dose or 1X daily dose) and also a fatal dose (10X single dose or 2.5X daily dose). Further, it's exacerbated by alcohol use, which is why you should never drink and then take Tylenol. Wheres, ibuprofen the safety margin is 120X a single dose and 40X a daily dose. For naproxen, it's 63X a single dose or 21X a daily dose [3]. [1] https://www.medpagetoday.org/psychiatry/depression/2233?vpass=1 https://www.medpagetoday.org/psychiatry/depression/2233?vpas... [2] https://www.uspharmacist.com/article/acetaminophen-toxicity-what-pharmacists-need-to-know https://www.uspharmacist.com/article/acetaminophen-toxicity-... [3] https://www.advilaide.com/safety/overdose https://www.advilaide.com/safety/overdose
    - jakub_g 7y ago
      Ibuprofen is OTOH much riskier and disadvised for many groups of patients, like those with gastric problems (Ulcertativ Colitis, Crohn's etc.) The problem is often due to people overdosing, often due to mixing different pills that each contain paracetamol. Each cure becomes poison after a threshold.
      - arcticbull 7y ago
        > Each cure becomes poison after a threshold. Right, and I'm saying that threshold is much lower for Tylenol than other NSAIDs, separate of whether it's disadvised for certain demographics. That's fact.
- Flow 7y ago
  Maybe there are different recommendations where you live, but here in Sweden and most of the hits on a web search suggest max dosage of paracetamol is 4g/day spread out.
  - forkexec 7y ago
    Upper tolerable dosage isn't as simple as one number for everyone. How much someone can take depends on how long someone takes it, their relative health and their mass dosage (mg/kg). I could take 2g c.i. (6g/day) for weeks (114 kg, large healthy liver, younger) but a little grandmother (40 kg) couldn't.
- forkexec 7y ago
  Ibuprofen already is known to lead to GI perforation and mental decline in the elderly, so there's rarely a compelling reason to administer it. Paracetamol is much safer over short durations for analgesic and antipyretic properties generally unless acute or chronic liver injury is suspected.
Alex3917 7y ago
Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. Normally when you see young people taking large doses of NSAIDs, it's because they're either elite athletes or have an autoimmune disease or something.
- gopalv 7y ago
  > Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. There are enough people who have no idea that hang-over + pop-2-advil is a deadly combination in this situation. Also a lot of the "new year, new body" resolution folks start too hard at the gym & then push through with NSAIDs. Young people, particularly the fit, do go through a lot of NSAIDs out of OTC convenience.
  - alkonaut 7y ago
    "Massive amounts" to me sounds like at least the max dose for at least a week. Taking 2 ibuprofen in a day against a flu like headache is what your doctor recommends, probably. Not exactly a massive amount even if repeated for a week.
    - Rebelgecko 7y ago
      I don't know about for the flu, but for other types of injuries doctors will often recommend taking double or triple the recommended dose on the bottle.
    - AstralStorm 7y ago
      There is 2 standard EU OTC Ibuprofen which is 400 mg and 2 South Korean Ibuprofen which is 2000 mg. Indian formulations also come extra strong.
- Donzo 7y ago
  Lots of people take Ibuprofen when they have a fever.
sirtoffski 7y ago
Interesting for sure. When I've first heard reports of ibuprofen + CoV-19, I went to check out what Harvard Health was recommending [0]. Under "What treatments are available to treat coronavirus?": Currently there is no specific antiviral treatment for COVID-19. However, similar to treatment of any viral infection, these measures can help... ... Take acetaminophen, ibuprofen, or naproxen to reduce fever and ease aches and pains. Be sure to follow directions. If you are taking any combination cold or flu medicine, keep track of all the ingredients and the doses. For acetaminophen, the total daily dose from all products should not exceed 3,000 milligrams. So it seems there is no widespread consensus on the matter for now. North American professionals, from what I've seen on social media, tend to disagree with their European colleagues on the matter. Personally, I remain somewhat skeptical until there's more data available. [0] https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center https://www.health.harvard.edu/diseases-and-conditions/coron...
- deleted 7y ago
  [deleted]
SpicyLemonZest 7y ago
Although it's important to note here that French people take just a completely silly amount of painkillers, so there may be overuse problems being conflated into the recommendations. If your local health authorities say using painkillers is appropriate, I wouldn't rule that out. https://link.springer.com/article/10.1007/s10194-008-0046-6 https://link.springer.com/article/10.1007/s10194-008-0046-6
he0001 7y ago
It seems like Switzerland is also recommending this and referring to a study done on mice. I don’t have links since they most likely in French/German. Edit: link to recommendation https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/news/news-06-03-20201.html https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/news/ne...

by mrb 7y ago

dukha 7y ago

Translation from French: paracetamol is preferred over nonsteroidal anti-inflammatory drugs (NSAID). Dose of paracetamol should not exceed 3g/day and doses should be spaced throughout the day.

slowmovintarget 7y ago
"Paracetamol" a.k.a. "acetaminophen", common brand: Tylenol.
- deleted 7y ago
  [deleted]
- arcticbull 7y ago
  Which is itself the leading cause of acute liver failure in the US. The active dose is very close to the lethal dose, much more so than naproxen or ibuprofen.
  - calebsurfs 7y ago
    The active dose is nowhere near the lethal dose. It is however close to the dose where you could see some minor damage to the liver. It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, not because they are loading up on acetaminophen itself.
    - DanBC 7y ago
      Paracetamol is dangerous in overdose, and the therapeutic dose is pretty close to the overdose amount. The therapeutic index is approx 10. Compare that to morphine, which has a therapeutic index of about 70. (although the therapeutic index is tricky to use because of dose response curves) We know that paracetamol is commonly used in both accidental and deliberate overdose. And this is true in countries that don't have the opioid crisis, and it was true in the US before the opioid crisis. > It causes problems because people are addicted to opioid drugs that are typically combined with acetaminophen, This is part of the problem, yes. But it's incomplete. We know that paracetamol alone causes problems for the liver even with small overdosing. https://britishlivertrust.org.uk/researchers-shed-new-light-paracetamol-causes-liver-damage/ https://britishlivertrust.org.uk/researchers-shed-new-light-...
      - deleted 7y ago
        [deleted]
    - arcticbull 7y ago
      This isn't really a debate: - "Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported" [1] in 2005. It was also true before the opioid epidemic really began. - "The recommended dose of acetaminophen in adults is 650 to 1,000 mg every 4 to 6 hours, not to exceed 4,000 mg in a 24-hour period." [2] - "Single doses of more than 150 mg/kg or 7.5 g in adults have been considered potentially toxic." [2] - "The minimal dose associated with liver injury can range anywhere from 4 to 10 g" [2] The active dose is very close to the dose at which liver damage occurs (4X single dose or 1X daily dose) and also a fatal dose (10X single dose or 2.5X daily dose). Further, it's exacerbated by alcohol use, which is why you should never drink and then take Tylenol. Wheres, ibuprofen the safety margin is 120X a single dose and 40X a daily dose. For naproxen, it's 63X a single dose or 21X a daily dose [3]. [1] https://www.medpagetoday.org/psychiatry/depression/2233?vpass=1 https://www.medpagetoday.org/psychiatry/depression/2233?vpas... [2] https://www.uspharmacist.com/article/acetaminophen-toxicity-what-pharmacists-need-to-know https://www.uspharmacist.com/article/acetaminophen-toxicity-... [3] https://www.advilaide.com/safety/overdose https://www.advilaide.com/safety/overdose
  - jakub_g 7y ago
    Ibuprofen is OTOH much riskier and disadvised for many groups of patients, like those with gastric problems (Ulcertativ Colitis, Crohn's etc.) The problem is often due to people overdosing, often due to mixing different pills that each contain paracetamol. Each cure becomes poison after a threshold.
    - arcticbull 7y ago
      > Each cure becomes poison after a threshold. Right, and I'm saying that threshold is much lower for Tylenol than other NSAIDs, separate of whether it's disadvised for certain demographics. That's fact.
Flow 7y ago
Maybe there are different recommendations where you live, but here in Sweden and most of the hits on a web search suggest max dosage of paracetamol is 4g/day spread out.
- forkexec 7y ago
  Upper tolerable dosage isn't as simple as one number for everyone. How much someone can take depends on how long someone takes it, their relative health and their mass dosage (mg/kg). I could take 2g c.i. (6g/day) for weeks (114 kg, large healthy liver, younger) but a little grandmother (40 kg) couldn't.
forkexec 7y ago
Ibuprofen already is known to lead to GI perforation and mental decline in the elderly, so there's rarely a compelling reason to administer it. Paracetamol is much safer over short durations for analgesic and antipyretic properties generally unless acute or chronic liver injury is suspected.

Alex3917 7y ago

Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. Normally when you see young people taking large doses of NSAIDs, it's because they're either elite athletes or have an autoimmune disease or something.

gopalv 7y ago
> Why would young and healthy patients be taking "massive amounts of NSAIDs" if they didn't have co-morbidities? This doesn't really make any sense. There are enough people who have no idea that hang-over + pop-2-advil is a deadly combination in this situation. Also a lot of the "new year, new body" resolution folks start too hard at the gym & then push through with NSAIDs. Young people, particularly the fit, do go through a lot of NSAIDs out of OTC convenience.
- alkonaut 7y ago
  "Massive amounts" to me sounds like at least the max dose for at least a week. Taking 2 ibuprofen in a day against a flu like headache is what your doctor recommends, probably. Not exactly a massive amount even if repeated for a week.
  - Rebelgecko 7y ago
    I don't know about for the flu, but for other types of injuries doctors will often recommend taking double or triple the recommended dose on the bottle.
  - AstralStorm 7y ago
    There is 2 standard EU OTC Ibuprofen which is 400 mg and 2 South Korean Ibuprofen which is 2000 mg. Indian formulations also come extra strong.
Donzo 7y ago
Lots of people take Ibuprofen when they have a fever.

sirtoffski 7y ago

Interesting for sure. When I've first heard reports of ibuprofen + CoV-19, I went to check out what Harvard Health was recommending [0]. Under "What treatments are available to treat coronavirus?": Currently there is no specific antiviral treatment for COVID-19. However, similar to treatment of any viral infection, these measures can help... ... Take acetaminophen, ibuprofen, or naproxen to reduce fever and ease aches and pains. Be sure to follow directions. If you are taking any combination cold or flu medicine, keep track of all the ingredients and the doses. For acetaminophen, the total daily dose from all products should not exceed 3,000 milligrams. So it seems there is no widespread consensus on the matter for now. North American professionals, from what I've seen on social media, tend to disagree with their European colleagues on the matter. Personally, I remain somewhat skeptical until there's more data available. [0] https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center https://www.health.harvard.edu/diseases-and-conditions/coron...

deleted 7y ago
[deleted]

SpicyLemonZest 7y ago

Although it's important to note here that French people take just a completely silly amount of painkillers, so there may be overuse problems being conflated into the recommendations. If your local health authorities say using painkillers is appropriate, I wouldn't rule that out. https://link.springer.com/article/10.1007/s10194-008-0046-6 https://link.springer.com/article/10.1007/s10194-008-0046-6

he0001 7y ago

It seems like Switzerland is also recommending this and referring to a study done on mice. I don’t have links since they most likely in French/German. Edit: link to recommendation https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/news/news-06-03-20201.html https://www.bag.admin.ch/bag/de/home/das-bag/aktuell/news/ne...