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I've never understood why people even bother with paracetamol/acetaminophen. Ibuprofen and other NSAIDs like naproxen are (in my experience) much better painkil

I've never understood why people even bother with paracetamol/acetaminophen. Ibuprofen and other NSAIDs like naproxen are (in my experience) much better painkillers and are much less likely to kill you. Edit: NSAIDs are bad if you are bleeding (or are about to be bleeding like before surgery), and they can cause stomach ulcers.

IvyMike 4y ago
If you've got stomach issues, NSAIDs can exacerbate those. And NSAIDs are definitely a no-no if you're bleeding, or have any other condition which could be worsened by blood thinners.
PuppyTailWags 4y ago
NSAIDs are rough on your stomach/digestive system. A doc told me to stay off them after a bout of gastritis.
rubatuga 4y ago
If you don't know then don't say that Advil is better. You can die of ulcers on Advil or get kidney damage.
DebtDeflation 4y ago
I just take good old fashioned aspirin. I figure may as well get the cardio-protective benefit along with my analgesic and anti-inflammatory effects. As long as I take it with some food and a full glass of water, no gastric issues.
bryanlarsen 4y ago
In my experience, caffeine is the most effective OTC headache relief drug, with the combo of acetaminophen and ibuprofen and caffeine working even better. Of course 99.9% of American adults are desensitized to caffeine, so are unable to utilize its medicinal effects.
- sonofhans 4y ago
  More to the point, we are utilizing its medicinal effects all the time :)
- gumby 4y ago
  This is likely not due to any analgesic property of caffeine (not sure there is any) but rather due to many headaches being caffeine withdrawal.
  - eigenvalue 4y ago
    I always thought it was more about the constricting of blood vessels that caffeine causes, which reduces the blood supply that is a main cause of headaches. So it alleviates the underlying cause rather than reduces the pain.
    - tomjakubowski 4y ago
      Caffeine dilates blood vessels - withdrawal will make them constricted
      - tedunangst 4y ago
        Backwards. It's a vasoconstrictor.
        felixg3 4y ago
        Exactly, and some types of headaches come from vasodilation (like migraine pain).
        tomjakubowski 4y ago
        it's complicated... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003984/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003984/ "A mild and transitory vasoconstrictor effect exists, which depends mainly on the caffeine concentration in the VSMC. However, the main and predominant effect of caffeine on the vascular wall is vasodilating, acting equally on the VSMC directly or indirectly and also on the endothelial structure." The paper also says that withdrawal headaches are caused by vasodilation so I was wrong about that. "When you abruptly stop the consumption of caffeine in a habitual consumer, there is a greater number of available adenosine receptors, which potentiates the vasodilation produced by adenosine, causing the symptoms"
freehorse 4y ago
It may kill you only if you overdose, otherwise it is perfectly safe and harmless. In contrast, NSAIDs are not as well tolerated, for example by people with stomach issues. Moreover, NSAIDs are contraindicated in certain situations that reducing inflammation is not wanted (eg it has been shown to delay recovery in case it is used the first days after bone fractures and other injuries). In cases where reducing inflammation is desired, NSAIDs will work better.
madars 4y ago
NSAIDs can cause stomach bleeding in some. Also, Tylenol and Ibuprofen target different metabolic pathways so you can combine or alternate them and, in some cases, get better pain relief than with opioids which come with different risks, including dependence. https://www.latimes.com/science/sciencenow/la-sci-sn-pain-opioids-ibuprofen-20171107-story.html https://www.latimes.com/science/sciencenow/la-sci-sn-pain-op... https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain/ https://thedaily.case.edu/study-ibuprofen-acetaminophen-effe...
- nwienert 4y ago
  If you've ever taken both, you know for 100% sure that something is fishy with this paper. Opioids : Nuke :: NSAID : Knife Looking at it, it seems the dose made the difference entirely. That said for minor pain it's often enough.
pkaye 4y ago
As a person in kidney failure, I can't take Ibuprofen and other NSAIDs. Acetaminophen is the only OTC painkiller I can take. Prolonged use of NDAIDs can cause kidney injury btw.
sidewndr46 4y ago
ibuprofen is literally a muscle growth inhibitor
elihu 4y ago
Acetaminophen works really well for me (I usually only take half of an extra-strength Tylenol at a time), whereas ibuprofen doesn't seem to do much. I think it's good there are multiple options and people can just take what works for them.
lostlogin 4y ago
I’d you aren’t eating much, ibuprofen is just terrible. Anyone who has had that happen to their stomach wouldn’t recommend it without food.
refurb 4y ago
More people die from NSAIDs than acetaminophen each year. An estimated 100,000 hospitalizations and somewhere between 1,000-15,000 deaths due to GI complications (bleeding). https://www.sciencedaily.com/releases/2005/01/050111123706.htm https://www.sciencedaily.com/releases/2005/01/050111123706.h... So each drug has its place. There is no "one size fits all"

IvyMike 4y ago

If you've got stomach issues, NSAIDs can exacerbate those. And NSAIDs are definitely a no-no if you're bleeding, or have any other condition which could be worsened by blood thinners.

PuppyTailWags 4y ago

NSAIDs are rough on your stomach/digestive system. A doc told me to stay off them after a bout of gastritis.

rubatuga 4y ago

If you don't know then don't say that Advil is better. You can die of ulcers on Advil or get kidney damage.

DebtDeflation 4y ago

I just take good old fashioned aspirin. I figure may as well get the cardio-protective benefit along with my analgesic and anti-inflammatory effects. As long as I take it with some food and a full glass of water, no gastric issues.

bryanlarsen 4y ago

In my experience, caffeine is the most effective OTC headache relief drug, with the combo of acetaminophen and ibuprofen and caffeine working even better. Of course 99.9% of American adults are desensitized to caffeine, so are unable to utilize its medicinal effects.

sonofhans 4y ago
More to the point, we are utilizing its medicinal effects all the time :)
gumby 4y ago
This is likely not due to any analgesic property of caffeine (not sure there is any) but rather due to many headaches being caffeine withdrawal.
- eigenvalue 4y ago
  I always thought it was more about the constricting of blood vessels that caffeine causes, which reduces the blood supply that is a main cause of headaches. So it alleviates the underlying cause rather than reduces the pain.
  - tomjakubowski 4y ago
    Caffeine dilates blood vessels - withdrawal will make them constricted
    - tedunangst 4y ago
      Backwards. It's a vasoconstrictor.
      - felixg3 4y ago
        Exactly, and some types of headaches come from vasodilation (like migraine pain).
      - tomjakubowski 4y ago
        it's complicated... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003984/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003984/ "A mild and transitory vasoconstrictor effect exists, which depends mainly on the caffeine concentration in the VSMC. However, the main and predominant effect of caffeine on the vascular wall is vasodilating, acting equally on the VSMC directly or indirectly and also on the endothelial structure." The paper also says that withdrawal headaches are caused by vasodilation so I was wrong about that. "When you abruptly stop the consumption of caffeine in a habitual consumer, there is a greater number of available adenosine receptors, which potentiates the vasodilation produced by adenosine, causing the symptoms"

freehorse 4y ago

It may kill you only if you overdose, otherwise it is perfectly safe and harmless. In contrast, NSAIDs are not as well tolerated, for example by people with stomach issues. Moreover, NSAIDs are contraindicated in certain situations that reducing inflammation is not wanted (eg it has been shown to delay recovery in case it is used the first days after bone fractures and other injuries). In cases where reducing inflammation is desired, NSAIDs will work better.

madars 4y ago

NSAIDs can cause stomach bleeding in some. Also, Tylenol and Ibuprofen target different metabolic pathways so you can combine or alternate them and, in some cases, get better pain relief than with opioids which come with different risks, including dependence. https://www.latimes.com/science/sciencenow/la-sci-sn-pain-opioids-ibuprofen-20171107-story.html https://www.latimes.com/science/sciencenow/la-sci-sn-pain-op... https://thedaily.case.edu/study-ibuprofen-acetaminophen-effective-opioids-treating-dental-pain/ https://thedaily.case.edu/study-ibuprofen-acetaminophen-effe...

nwienert 4y ago
If you've ever taken both, you know for 100% sure that something is fishy with this paper. Opioids : Nuke :: NSAID : Knife Looking at it, it seems the dose made the difference entirely. That said for minor pain it's often enough.

pkaye 4y ago

As a person in kidney failure, I can't take Ibuprofen and other NSAIDs. Acetaminophen is the only OTC painkiller I can take. Prolonged use of NDAIDs can cause kidney injury btw.

sidewndr46 4y ago

ibuprofen is literally a muscle growth inhibitor

elihu 4y ago

Acetaminophen works really well for me (I usually only take half of an extra-strength Tylenol at a time), whereas ibuprofen doesn't seem to do much. I think it's good there are multiple options and people can just take what works for them.

lostlogin 4y ago

I’d you aren’t eating much, ibuprofen is just terrible. Anyone who has had that happen to their stomach wouldn’t recommend it without food.

refurb 4y ago

More people die from NSAIDs than acetaminophen each year. An estimated 100,000 hospitalizations and somewhere between 1,000-15,000 deaths due to GI complications (bleeding). https://www.sciencedaily.com/releases/2005/01/050111123706.htm https://www.sciencedaily.com/releases/2005/01/050111123706.h... So each drug has its place. There is no "one size fits all"