As someone taking a lot of Tylenol after a car accident a week ago, thanks for the advice!
I'll switch to Ibuprofen now. They didn't give me any prescription meds because there were no broken bones, but my chest and left shoulder are in so much pain, specially when I wakeup. Airbags were deployed, and I went from 84 mph to zero when the crash happened (dashcam had the speed on it).
Just make sure you have food in your stomach when you take ibuprofen. I used to take 12 a day in high school to play (badly) at sports and it can do a number on your stomach lining. Iirc the mechanism that causes it to dull the pain also creates stomach acid.
When I was younger (and stupider) I was prescribed giant 800mg ibuprofen pills for an injury. I wasn't in the habit of eating with them, and ended up burning the end of my esophagus with stomach acid. I could only eat popsicles and slurpees for a couple weeks because it was too painful to swallow anything else.
> Iirc the mechanism that causes it to dull the pain also creates stomach acid.
Maybe it also increase stomach acid production, but my understanding is that the primary problem is that it thins the protective stomach lining.
Ibuprofen is a non-selective inhibitor of the COX enzymes. Inhibiting COX-2 reduces pain and inflammation. Inhibiting COX-1 inhibits stomach lining growth and the clotting process. Pharma has created selective COX-2 inhibitors, but some of those have run into their own problems (blood clots leading to myocardial infarctions in the case of Vioxx patients who weren't also on aspirin, IIRC... though, an increase in MIs would seem to be the natural and obvious side effect of intentionally reducing COX-1 inhibition. IIRC, the increase in MIs was in contrast to the traditional Ibuprofen treatment, not compared to an unmedicated baseline.)
I also took it daily and heavily in high school during basketball season for shin splints. Probably a couple of years of pulling that mess. I often think back now to how I had a complete system that timed for efficacy, taking a few 30 min before practice then more while suiting up, then even more if I could during and then after practice. I'd alter this timing on game days since practices were walk-thrus, etc.
In some ways it's a relief to hear from someone else with that experience (this was 20 years ago for me).
Large doses of vitamin C taken with aspirin or ibuprofen also seem to help with the stomach acid problem. Inspired by a paper on PubMed (so this isn't entirely anecdotal) I tried it and it works for me.
Food also helps but not 100%. IME it does not seem to "soak up" all of the excess acid. Vitamin C is also not 100% but IME more effective than food.
I'm not a frequent or high dose user of NSAIDs, I just seem to have an easily irritated stomach.
Talk to you doctor before trying this, but it is usually OK to take both acetaminophen (Tylenol) and ibuprofen (Advil) at the same time.
They work in different ways, so using them together can let you stay well away from a harmful dose of either and still get better pain relief that taking a maximum dose of just one.
I somehow injured my rotator cuff, an injury normally associated with athletes but that I somehow got while sleeping?! With my doctor's permission, I did 1000 mg of acetaminophen every 8 hours and 400 mg of ibuprofen every 4 hours. The later was originally going to be 800 mg every 8 hours, but I asked if I could do it 400 mg every 4.
You still have to be careful with NSAIDs. I have kidney failure but when being diagnosed they presumed it was likely due to NSAIDs but the real reason was finally autoimmune disease. I think they say long term use of NSAIDs is not good for kidneys. For me NSAIDs are entirely excluded. But my nephrologist say Tylenol is fine for long term if I stay within limits. Fortunately I've not had to use it often. And I don't take OTC medicines now without doctor review.
Since I'm on an anticoagulant, I can tell you that the deal with NSAIDs is bleeding: they have anti-platelet properties which can make you more susceptible to bleeding.
My second hand knowledge from a talk with a pharmacist: both paracetamol (tylenol) and ibuprofen are much more dangerous, than I previously believed.
Both have very tight margins between normal dose and overdose. If I remember correctly overdosing is 50% over the normal dose. So take couple more pills a day than it says on the label - and you can land in the hospital.
I was super glad for that info, because I treated instructions more as a suggestion. Now I am much more cautious. _Never_ go above what's instructed, use them as instructed (before/after a meal, etc.), do not mix drugs unless explicitly allowed by your doctor and for the love of god do not mix medicine and alcohol. It's too easy to overdose these common drugs.
The maximum safe dosage of Tylenol is 4000mg; an extra-strength pill is 500mg, and a normal dose is 2 pills, meaning the dose you'd have to take to push the danger zone is 400% over the normal dose.
But Tylenol’s label says a maximum of 4g per day or 8 extra strength tablets (500 mg each).
From what I’ve gathered, you can detect some liver damage as you get close to 10g per day, but we’re talking mildly elevated ALT/AST enzymes. But if you’re sick, or drink a lot or not eating, you could see serious toxicity at 200% of the maximum daily dose.
Yes, but Tylenol’s toxicity is due to glutathione depletion. Your body can handle the toxic metabolites with no issue, as long as there isn’t a lot of them.
Once you’ve depleted your liver’s glutathione stores (too much tylenol, too much alcohol, not enough food to replenish glutathione) then the Tylenol becomes very toxic to liver tissue.
Take both to help not overdo the dosing on either. While tylenol can be bad for the liver, like someone else said ibuprofen can wreak havok on your GI system. That's not all -- it can stain or injure your renal system if you overdose it. Tylenol overdoses, if caught in time, can be mitigated by acetylcysteine (as an antidote). I am unaware of any such equivalent for ibuprofen besides dialysis (usually if it gets concentrated enough to cross the blood-brain barrier).
That's crummy you didn't get at least a small rx for narcotics for the first few days - there is a time and place for them. Don't forget to make sure the chest pain is not preventing adequate respirations.
not a doctor, but careful with Ibuprofen also, it has its own risks. Paracetamol / Acetaminophen is one of the safest taken at the right levels. You can actually have both at the same time as well.
My cousin burned a hole in his stomach with Ibuprofen trying to quash some pain that turned out to be metastatic esophageal cancer. (Somehow, he's still alive.) Mind your NSAIDs!
what ever the medication you use, just read carefully the instructions, there's all the info in there that you need to safely use it. Paracetamol (Tylenol) is perfectly safe as long as you don't cross the recommended dosages.
If you might be taking Ibuprofen for a while, I encourage you to also look at its long-term-usage side-effects. Probably NBD, but worth keeping in the back of your mind.
It isn't NBD, ibuprofen will absolutely destroy your esophagus. The difference is that ibuprofen is safe once and will kill you over time, but Tylenol is safe over time and will kill you once.
There's a protocol where you switch between them which is okay, but you should get the good stuff if you need it.
You can also take NAC, which is what they give you for the antidote. As a bonus it's also effective against acne, addictive behavior, and stimulant tolerance.
I'll switch to Ibuprofen now. They didn't give me any prescription meds because there were no broken bones, but my chest and left shoulder are in so much pain, specially when I wakeup. Airbags were deployed, and I went from 84 mph to zero when the crash happened (dashcam had the speed on it).