3 ms·

I do not understand the whole "paracetamol/acetaminophen is useless and dangerous". It is dangerous if you overdose, but in normal doses it is as harmless as it

I do not understand the whole "paracetamol/acetaminophen is useless and dangerous". It is dangerous if you overdose, but in normal doses it is as harmless as it can go, and while it may be indeed in issue when people are not as well educated in how to use it, judging a drug by the effects of what happens if you overdose would rule out a lot of other drugs and substances. About its effectiveness, it is more useful in some cases and less in others, in principle if inflammation is part of the problem NSAIDs will work much better, but in many cases they are both effective in comparable degrees. It all depends on the source of pain. Personally I take NSAIDs only if it is really needed, because in the past they have really messed up my stomach. And the cases that NSAIDs were effective and paracetamol was not was in some injury cases. And yeah, there are studies that show paracetamol is effective and others that show it is ineffective, it all has to do with the exact cause of the symptoms because "pain" and "fever" are too general as symptoms. The fact that it does not work in some case does not mean it does not work in another and it is useless.

drewg123 4y ago
I think paracetamol/acetaminophen is fine, as long as you realize the dose you are taking. However, this is harder than it sounds, as (at least in the USA), it is included in all manner of "night-time cold medicine" and "cough syrup", as well as in prescription narcotic pain killers. So if you take it by itself, and then take one of the all-in-one medications that includes it, you can exceed the maximum dose. I think a first step should be banning mixing paracetamol/acetaminophen with other medications, so the people have a better chance of monitoring their dosage.
- spiderxxxx 4y ago
  I don't think paracetamol is safe to take, it has a cumulative effect on your kidneys, even if you take a "safe dose". https://www.krcp-ksn.org/m/journal/view.php?number=224 https://www.krcp-ksn.org/m/journal/view.php?number=224
- throwawaymobule 4y ago
  It's only hearsay, bit I have read that for many opioid painkillers like percocet adding in the paracetamol is to stop people from abusing them by consuming a large number of pills. I doubt it makes a difference for most abusers, and is more about fear of legislation than concern about health.
sandyarmstrong 4y ago
Agreed. NSAIDs are contraindicated for me based on chronic health issues and related medications I have to take, so acetaminophen is the only OTC option I have. It very obviously _does_ work on multiple pain sources. It would be nice if it had anti-inflammatory properties, but it's not useless without it.
giraffe_lady 4y ago
The distance between its effective dose and fatal dose is much smaller than most if not all other otc drugs and certainly much smaller than you want in a ubiquitous medicine.
- ubermonkey 4y ago
  That is a completely bananas thing to say not even remotely supported by the data. The LD50 for acetaminophen is something like 380 mg per kilogram. Extra-strength Tylenol is a 500mg pill; dosage guidelines are no more than 6 pills in 24 hours, which is 3,000 mg. For a 150 pound person, the LD50 would be 57,000 mg.
  - giraffe_lady 4y ago
    Yeah I shouldn't have said fatal dose I meant "acute liver damage" dose.
  - Avshalom 4y ago
    25.5g. although another way of think of it is 13 tylenol arthritis pills is the ld50 for a kindergartner and in the US they come in a bottle not a blisterpack.
  - ac29 4y ago
    > Extra-strength Tylenol is a 500mg pill; dosage guidelines are no more than 6 pills in 24 hours, which is 3,000 mg. Its a 500mg pill, but 2 pills (1000mg) is the recommend dose. So, only 3 doses per 24 hours.
ubermonkey 4y ago
EXACTLY this. I rarely take Tylenol, since my aches are usually inflammation-related and thus better addressed with an NSAID, but after my hip replacement it was a GREAT aid to me. The experience was kind of revelatory about the effectiveness of the drug. The notion that it's useless is patently absurd.
Volundr 4y ago
Anecdotally, I rarely get migraines, but when I do NSAIDS don't touch it. Acetaminophen helps though. Definitely not useless to me.
- sacnoradhq 4y ago
  - Mild attack: Caffeine, i.e., dark chocolate, coffee, or caffeine pills - Moderate: Aspirin (250 mg) + Acetaminophen (250 mg) + Caffeine (65 mg) - "Break glass" emergency: Imitrex (sumatriptan) https://www.ncbi.nlm.nih.gov/books/NBK553159/ https://www.ncbi.nlm.nih.gov/books/NBK553159/ https://www.ncbi.nlm.nih.gov/books/NBK513274/ https://www.ncbi.nlm.nih.gov/books/NBK513274/
  - Volundr 4y ago
    Interesting, maybe I'll try some caffeine next time. I'm a little hesitant because my usual strategy is two Tylenol and a nap. 9 times out of 10 I manage to fall asleep and by the time I wake up it's either gone, or at least manageable.
    - sacnoradhq 4y ago
      3-ingredient Excedrin has existed for 25 years. I think it was Aspirin and Tylenol before that. " Acetaminophen 250 mg Aspirin 250 mg –Non-Steroidal Anti-Inflammatory Drug (NSAID) Caffeine 65 mg " https://www.excedrin.com/products/migraine/ https://www.excedrin.com/products/migraine/ https://www.excedrin.com/products/extra-strength/ https://www.excedrin.com/products/extra-strength/ ^ both contain exactly the same amounts of exactly the same ingredients. https://www.reddit.com/r/mildlyinteresting/comments/397g2d/excedrin_migraine_and_extra_strength_have_the/ https://www.reddit.com/r/mildlyinteresting/comments/397g2d/e... Commercial from 1999 https://youtu.be/RxXVm6Rc-D0 https://youtu.be/RxXVm6Rc-D0 Corny 80's commercials: https://youtu.be/YQdN1wwGvpI https://youtu.be/YQdN1wwGvpI https://youtu.be/ID-OrIyXBMw https://youtu.be/ID-OrIyXBMw
  - jwestbury 4y ago
    Though, if you're getting migraines regularly, it's a good idea to talk to a doctor about prophylactic treatment, rather than treating acute symptoms.
sacnoradhq 4y ago
If you have aspirin in the house, also keep the OD antidote NAC. (PDF) https://www.tylenolprofessional.com/sites/tylenol_hcp_us/files/acetaminphen_overdose_treatment_info.pdf https://www.tylenolprofessional.com/sites/tylenol_hcp_us/fil... Notes: 0. It smells bad due to sulfur breakdown. 1. It got a bad rep from shady online vendors. 2. It's a mostly benign supplement recommended by some MDs offlabel for ADHD. Its primary action is aiding glutathione synthesis.
- KiwiJohnno 4y ago
  Possible typo there - Asprin is a completely different painkiller (from the NSAID family)
- spiderxxxx 4y ago
  Better to have their stomach pumped at a hospital and get IV NAC - it's too dangerous to treat at home, this is a serious condition and you can not treat it yourself.

drewg123 4y ago

I think paracetamol/acetaminophen is fine, as long as you realize the dose you are taking. However, this is harder than it sounds, as (at least in the USA), it is included in all manner of "night-time cold medicine" and "cough syrup", as well as in prescription narcotic pain killers. So if you take it by itself, and then take one of the all-in-one medications that includes it, you can exceed the maximum dose. I think a first step should be banning mixing paracetamol/acetaminophen with other medications, so the people have a better chance of monitoring their dosage.

spiderxxxx 4y ago
I don't think paracetamol is safe to take, it has a cumulative effect on your kidneys, even if you take a "safe dose". https://www.krcp-ksn.org/m/journal/view.php?number=224 https://www.krcp-ksn.org/m/journal/view.php?number=224
throwawaymobule 4y ago
It's only hearsay, bit I have read that for many opioid painkillers like percocet adding in the paracetamol is to stop people from abusing them by consuming a large number of pills. I doubt it makes a difference for most abusers, and is more about fear of legislation than concern about health.

sandyarmstrong 4y ago

Agreed. NSAIDs are contraindicated for me based on chronic health issues and related medications I have to take, so acetaminophen is the only OTC option I have. It very obviously _does_ work on multiple pain sources. It would be nice if it had anti-inflammatory properties, but it's not useless without it.

giraffe_lady 4y ago

The distance between its effective dose and fatal dose is much smaller than most if not all other otc drugs and certainly much smaller than you want in a ubiquitous medicine.

ubermonkey 4y ago
That is a completely bananas thing to say not even remotely supported by the data. The LD50 for acetaminophen is something like 380 mg per kilogram. Extra-strength Tylenol is a 500mg pill; dosage guidelines are no more than 6 pills in 24 hours, which is 3,000 mg. For a 150 pound person, the LD50 would be 57,000 mg.
- giraffe_lady 4y ago
  Yeah I shouldn't have said fatal dose I meant "acute liver damage" dose.
- Avshalom 4y ago
  25.5g. although another way of think of it is 13 tylenol arthritis pills is the ld50 for a kindergartner and in the US they come in a bottle not a blisterpack.
- ac29 4y ago
  > Extra-strength Tylenol is a 500mg pill; dosage guidelines are no more than 6 pills in 24 hours, which is 3,000 mg. Its a 500mg pill, but 2 pills (1000mg) is the recommend dose. So, only 3 doses per 24 hours.

ubermonkey 4y ago

EXACTLY this. I rarely take Tylenol, since my aches are usually inflammation-related and thus better addressed with an NSAID, but after my hip replacement it was a GREAT aid to me. The experience was kind of revelatory about the effectiveness of the drug. The notion that it's useless is patently absurd.

Volundr 4y ago

Anecdotally, I rarely get migraines, but when I do NSAIDS don't touch it. Acetaminophen helps though. Definitely not useless to me.

sacnoradhq 4y ago
- Mild attack: Caffeine, i.e., dark chocolate, coffee, or caffeine pills - Moderate: Aspirin (250 mg) + Acetaminophen (250 mg) + Caffeine (65 mg) - "Break glass" emergency: Imitrex (sumatriptan) https://www.ncbi.nlm.nih.gov/books/NBK553159/ https://www.ncbi.nlm.nih.gov/books/NBK553159/ https://www.ncbi.nlm.nih.gov/books/NBK513274/ https://www.ncbi.nlm.nih.gov/books/NBK513274/
- Volundr 4y ago
  Interesting, maybe I'll try some caffeine next time. I'm a little hesitant because my usual strategy is two Tylenol and a nap. 9 times out of 10 I manage to fall asleep and by the time I wake up it's either gone, or at least manageable.
  - sacnoradhq 4y ago
    3-ingredient Excedrin has existed for 25 years. I think it was Aspirin and Tylenol before that. " Acetaminophen 250 mg Aspirin 250 mg –Non-Steroidal Anti-Inflammatory Drug (NSAID) Caffeine 65 mg " https://www.excedrin.com/products/migraine/ https://www.excedrin.com/products/migraine/ https://www.excedrin.com/products/extra-strength/ https://www.excedrin.com/products/extra-strength/ ^ both contain exactly the same amounts of exactly the same ingredients. https://www.reddit.com/r/mildlyinteresting/comments/397g2d/excedrin_migraine_and_extra_strength_have_the/ https://www.reddit.com/r/mildlyinteresting/comments/397g2d/e... Commercial from 1999 https://youtu.be/RxXVm6Rc-D0 https://youtu.be/RxXVm6Rc-D0 Corny 80's commercials: https://youtu.be/YQdN1wwGvpI https://youtu.be/YQdN1wwGvpI https://youtu.be/ID-OrIyXBMw https://youtu.be/ID-OrIyXBMw
- jwestbury 4y ago
  Though, if you're getting migraines regularly, it's a good idea to talk to a doctor about prophylactic treatment, rather than treating acute symptoms.

sacnoradhq 4y ago

If you have aspirin in the house, also keep the OD antidote NAC. (PDF) https://www.tylenolprofessional.com/sites/tylenol_hcp_us/files/acetaminphen_overdose_treatment_info.pdf https://www.tylenolprofessional.com/sites/tylenol_hcp_us/fil... Notes: 0. It smells bad due to sulfur breakdown. 1. It got a bad rep from shady online vendors. 2. It's a mostly benign supplement recommended by some MDs offlabel for ADHD. Its primary action is aiding glutathione synthesis.

KiwiJohnno 4y ago
Possible typo there - Asprin is a completely different painkiller (from the NSAID family)
spiderxxxx 4y ago
Better to have their stomach pumped at a hospital and get IV NAC - it's too dangerous to treat at home, this is a serious condition and you can not treat it yourself.