3 ms·

>It's shocking to me how we still refer to paracetamol and ibuprofen in the same breath when their relative risks are so different. And it's shocking to me how

>It's shocking to me how we still refer to paracetamol and ibuprofen in the same breath when their relative risks are so different. And it's shocking to me how we still refer to paracetamol (Acetominophen for us USAians) and ibuprofen in the same breath, when paracetamol might as well be a sugar pill, for all the good it does and ibuprofen is the liniment of the gods!

drKarl 4y ago
Right, I'm European.
- nobody9999 4y ago
  I figured. I added "acetaminophen" because most USAians wouldn't know what "paracetamol" was if it came up and smacked them upside the head.
simianparrot 4y ago
Ibuprofen being an NSAID is high risk for anyone who’s had stomach ulcers due to its risks involved in causing GI bleeding. For people like me it’s simply not even an option.
- nobody9999 4y ago
  >For people like me it’s simply not even an option. Good. More for me. ;) More seriously, you're absolutely right. Which is why even folks who can take ibuprofen should only do so within appropriate limits (IIUC, 2400mg/day maximum). I have spinal issues (disc degeneration, stenosis) which have, in the past, caused serious amounts of pain. If that pain is acute and not too serious, ibuprofen has been a life saver for me. Naproxen sodium, acetaminophen and other NSAIDs have absolutely no effect on me. Without ibuprofen, my life would be a nightmarishly painful endeavor. And so, while I do understand your circumstance (which sucks because NSAIDs are wonderful as analgesics, it's a shame you can't use them), those who ibuprofen can help is a much larger pool than those it harms. Hopefully, one day we'll discover/invent analgesics which don't cause GI issues. If that pain (usually sciatica) becomes chronic, ibuprofen isn't enough. When that's happened, I've ended up having epidural steroid injections[0] which knocks out that inflammation post-haste. [0] https://paindoctor.com/faq-epidural-steroid-injections/ https://paindoctor.com/faq-epidural-steroid-injections/ Edit: Fixed typo, removed extraneous text.
  - wiz21c 4y ago
    I totally concur. Got a condition comparable to yours and ibuprofen makes a real difference whereas paracetamol just doesn't do anything. Dunno why.
    - masklinn 4y ago
      Does it have an inflammatory component? Paracetamol is an analgesic and antipyretic, but it is not anti-inflammatory. And there are other divergences e.g. ibuprofen has been linked to protecting against Parkinson’s, where neither paracetamol nor aspirin (which is an anti-inflammatory) have shown such property. The TLDR is that they’re different molecules, and while they have overlap in their antipyretic and analgesic properties, that does not make them substitutable in all cases.
      - wiz21c 4y ago
        Dam, forgot that. Ibuprofen definitely is NSAID and I do have inflammatory condition. So yeah, that's why it works. Thanks for reminding me :-)
- jeffparsons 4y ago
  This is the kind of thing I'm thinking of, not people taking higher doses than recommended on the pack. For some people, no amount of ibuprofen is a good risk, and I don't think people in general understand this. Nobody reads the label and wonders "could this apply to me?" I guess what I'm suggesting is it should be available over the counter, but not off the shelf.
- pfdietz 4y ago
  While it's rare, ibuprofen is associated with an alarming (but transient) condition called DIAM, Drug-Induced Aseptic Meningitis, and autoimmune reaction that mimics ordinary meningitis. It resolves after the drug leaves the system, but does require the patient to avoid that drug henceforth. https://en.wikipedia.org/wiki/Drug-induced_aseptic_meningitis https://en.wikipedia.org/wiki/Drug-induced_aseptic_meningiti...
School-Cotton 4y ago
I think this must depend on the person. Acetaminophen helps me a lot more than ibuprofen, consistently.
- nobody9999 4y ago
  >I think this must depend on the person. Acetaminophen helps me a lot more than ibuprofen, consistently. I think you're probably right. Acetaminophen does absolutely nothing for me. Nor does Naproxen Sodium. But ibuprofen does. And consistently over decades. I wonder if there's been any research into what makes different analgesics more or less effective for various cohorts. Unsurprisingly, there has been[0][1]. [0] https://www.npr.org/sections/health-shots/2011/09/26/140705557/when-it-comes-to-pain-relief-one-size-doesnt-fit-all https://www.npr.org/sections/health-shots/2011/09/26/1407055... [1] The meta-study referenced in the link is from 2011.

drKarl 4y ago

Right, I'm European.

nobody9999 4y ago
I figured. I added "acetaminophen" because most USAians wouldn't know what "paracetamol" was if it came up and smacked them upside the head.

simianparrot 4y ago

Ibuprofen being an NSAID is high risk for anyone who’s had stomach ulcers due to its risks involved in causing GI bleeding. For people like me it’s simply not even an option.

nobody9999 4y ago
>For people like me it’s simply not even an option. Good. More for me. ;) More seriously, you're absolutely right. Which is why even folks who can take ibuprofen should only do so within appropriate limits (IIUC, 2400mg/day maximum). I have spinal issues (disc degeneration, stenosis) which have, in the past, caused serious amounts of pain. If that pain is acute and not too serious, ibuprofen has been a life saver for me. Naproxen sodium, acetaminophen and other NSAIDs have absolutely no effect on me. Without ibuprofen, my life would be a nightmarishly painful endeavor. And so, while I do understand your circumstance (which sucks because NSAIDs are wonderful as analgesics, it's a shame you can't use them), those who ibuprofen can help is a much larger pool than those it harms. Hopefully, one day we'll discover/invent analgesics which don't cause GI issues. If that pain (usually sciatica) becomes chronic, ibuprofen isn't enough. When that's happened, I've ended up having epidural steroid injections[0] which knocks out that inflammation post-haste. [0] https://paindoctor.com/faq-epidural-steroid-injections/ https://paindoctor.com/faq-epidural-steroid-injections/ Edit: Fixed typo, removed extraneous text.
- wiz21c 4y ago
  I totally concur. Got a condition comparable to yours and ibuprofen makes a real difference whereas paracetamol just doesn't do anything. Dunno why.
  - masklinn 4y ago
    Does it have an inflammatory component? Paracetamol is an analgesic and antipyretic, but it is not anti-inflammatory. And there are other divergences e.g. ibuprofen has been linked to protecting against Parkinson’s, where neither paracetamol nor aspirin (which is an anti-inflammatory) have shown such property. The TLDR is that they’re different molecules, and while they have overlap in their antipyretic and analgesic properties, that does not make them substitutable in all cases.
    - wiz21c 4y ago
      Dam, forgot that. Ibuprofen definitely is NSAID and I do have inflammatory condition. So yeah, that's why it works. Thanks for reminding me :-)
jeffparsons 4y ago
This is the kind of thing I'm thinking of, not people taking higher doses than recommended on the pack. For some people, no amount of ibuprofen is a good risk, and I don't think people in general understand this. Nobody reads the label and wonders "could this apply to me?" I guess what I'm suggesting is it should be available over the counter, but not off the shelf.
pfdietz 4y ago
While it's rare, ibuprofen is associated with an alarming (but transient) condition called DIAM, Drug-Induced Aseptic Meningitis, and autoimmune reaction that mimics ordinary meningitis. It resolves after the drug leaves the system, but does require the patient to avoid that drug henceforth. https://en.wikipedia.org/wiki/Drug-induced_aseptic_meningitis https://en.wikipedia.org/wiki/Drug-induced_aseptic_meningiti...

School-Cotton 4y ago

I think this must depend on the person. Acetaminophen helps me a lot more than ibuprofen, consistently.

nobody9999 4y ago
>I think this must depend on the person. Acetaminophen helps me a lot more than ibuprofen, consistently. I think you're probably right. Acetaminophen does absolutely nothing for me. Nor does Naproxen Sodium. But ibuprofen does. And consistently over decades. I wonder if there's been any research into what makes different analgesics more or less effective for various cohorts. Unsurprisingly, there has been[0][1]. [0] https://www.npr.org/sections/health-shots/2011/09/26/140705557/when-it-comes-to-pain-relief-one-size-doesnt-fit-all https://www.npr.org/sections/health-shots/2011/09/26/1407055... [1] The meta-study referenced in the link is from 2011.