To provide guidance to health care providers and their patients in their clinical decision-making, researchers from Florida Atlantic University's Schmidt College of Medicine have published a review in the Journal of Cardiovascular Pharmacology and Therapeutics addressing cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers. They examined the benefits and risks of over-the-counter and prescription drugs for pain relief such as aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and prescription drugs such as diclofenac (Voltaren), a non-aspirin NSAID [Non-Steroidal Anti-Inflammatory Drugs], and selective cyclooxygenase-2 inhibitors such as celecoxib (Celebrex) as well as acetaminophen (Tylenol).
NSAIDs include aspirin, traditional non-aspirin NSAIDs such as ibuprofen, (Motrin or Advil), naproxen, (Aleve) and diclofenac, (Voltaren) as well as selective cyclooxygenase 2 inhibitors (COXIBs), such as celecoxib (Celebrex), and acetaminophen (Tylenol).
All of these drugs have benefits and risks. Aspirin decreases inflammation as well as coronary events and stroke, but increases gastrointestinal symptoms and bleeding, however, without adverse hepatic or renal consequences. Non-aspirin NSAIDs decrease inflammation, but have been associated with adverse major coronary events and stroke with long-term use as well as major upper gastrointestinal and kidney side effects, as well as electrolyte imbalances such as high sodium or potassium and even heart failure.
Cyclooxygenase 2 (COX2) inhibitors were developed primarily because of their more favorable gastrointestinal side effect profile relative to aspirin and traditional non-aspirin NSAIDs, but confer adverse cardiovascular as well as hepatic and renal effects. Acetaminophen has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.
[...] "The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes," said Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine.
Journal Reference:
Manas A. Rane, Alexander Gitin, Benjamin Fiedler, Lawrence Fiedler, Charles H. Hennekens. Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs$. Journal of Cardiovascular Pharmacology and Therapeutics, 2019; 25 (1): 3 DOI: 10.1177/1074248419871902
(Score: -1, Offtopic) by Anonymous Coward on Tuesday February 11 2020, @08:23PM (13 children)
no thanks..
(Score: 3, Insightful) by Freeman on Tuesday February 11 2020, @08:30PM (7 children)
. . . ignorance is bliss?
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 5, Insightful) by ikanreed on Tuesday February 11 2020, @08:45PM (6 children)
I mean technically, I wouldn't think a lay person should derive medical advice from reading medical journals, especially single articles, as that can lack the holistic understanding that overall best practices are derived from, and the general expertise of an actual doctor. AC is right, don't get medical advice from the internet. Trying to do that makes you go crazy, and conjoined with how the internet unevenly spreads information(much less disinformation), you're gonna end up in a quack's scam following whatever you read online.
On the other hand, learning never hurt anyone, and as long as you don't get ultracrepidarian about it, learn as much as you can, the information could prove useful to you someday.
(Score: 2) by barbara hudson on Wednesday February 12 2020, @02:35AM (5 children)
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @02:19PM (4 children)
I would seriously argue that even if you kept up with an entire field of literature, and were generally a well educated person, there's still important things a bottom-of-class in medical school doctor might still be able to do better than you. Like diagnosis, which doesn't just entail knowledge of symptoms, but also the intuition derived from seeing hundreds of cases, and recognizing when something is "off" from the normal progression of a disease.
(Score: 2) by barbara hudson on Wednesday February 12 2020, @02:54PM (3 children)
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @02:57PM (2 children)
And you think that compares favorably to professional diagnosis?
(Score: 2) by barbara hudson on Wednesday February 12 2020, @04:30PM (1 child)
I've had 25 or 26 bone fractures - I'll trust my diagnosis over an xray because they miss half of them until years later when you can see the bone callus that forms around the break. Especially if you have preternaturally not-dense-enough bones to begin with (osteopenia, not osteoporosis - I've been breaking bones since my late 20s that shouldn't have broken).
In the end, any health care decisions are up to the patients, so might as well use the resources out there, such as the online libraries at the national institutes of health, to better inform your decisions, and know what questions to ask.
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @04:35PM
I don't think people are stupid, save for a few specific counter examples that have removed all doubt as to that truth. I think medicine is a field where actual expertise matters.
(Score: 4, Interesting) by Anonymous Coward on Tuesday February 11 2020, @09:58PM (3 children)
No thanks, you say...
'Acetaminophen has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.'
This side of the pond, we know Acetaminophen more by the name Paracetamol, which my sister takes a rather large amount of on a daily basis as part of her Rheumatoid Arthritis drug regime. She was told it was an anti-inflammatory, and she has said from the start that 'it doesn't fucking work', not even as an analgesic either alone or combined with codeine. So, this little snippet was news to me, and one quick trawl through some medical papers and it's apparently true about the lack of efficacy. I can see there's a bit of further trawling involved before the next meeting with her quacks.
So, let's not call it dishing out medical advice, let's call it dishing out pointers..
As to the subject of TFA, speaking from personal experience, as painkillers, Acetaminophen/Paracetamol has never worked for me, ditto re Ibuprofen. The old standby Aspirin works, to a point, opiates obviously work...but they're just that wee bit too 'moreish', however I've found that whisky¹ works a lot better (which is why I keep a bottle of the cheap stuff handy - currently a bottle of Dimple Golden Selection, no point wasting single malts...) , and absinthe, ouzo (not the cheap watered down tourist shit) or B.P. grade Ethanol work best..
--
¹ Whisky, in my case, seems to work better as an analgesic than, for example, Rum, however YMMV... I'm quite willing to volunteer for a proper medical study into the relative analgesic effects of a range of spirits on my wrecked and tortured body, science needs to know things like which malt whisky blend is best for toothache!..
However, having shared a flat with medical students (who are all now Doctors) and having been to many parties with their good selves and Nurses, I fear that any supplies bought in for such a study would be joyously quaffed by those of the medical professions involved in said study long before I'd get to see them..tosspots(trad) the lot of them...
(Score: 2) by Azuma Hazuki on Wednesday February 12 2020, @03:14AM
APAP doesn't have somatic anti-inflammatory effects, this is true. It acts centrally, and apparently one of its metabolites looks a lot like anandamide, an endogenous *cannabinoid.* From personal experience, I can tell you 500-1,000mg of APAP does seem to take the edge off, but it's something I try to take no more than a few times a month.
I am "that girl" your mother warned you about...
(Score: 2) by RS3 on Wednesday February 12 2020, @03:07PM
Acetaminophen compliments aspirin, ibuprofen, naproxen sodium, and others. "Excedrin" is aspirin, acetaminophen, and caffeine. When combined, most people get twice the pain relief of the same amount of either.
Mixing NSAIDs is strongly discouraged, but any can be taken with acetaminophen (unless the person has some rare reaction to the mixture).
Has your sister tried meloxicam?
(Score: 1, Informative) by Anonymous Coward on Wednesday February 12 2020, @04:07PM
You are correct that acetaminophen is not anti-inflammatory. It it thought to work by addressing nociceptive pain receptors directly and may dull the pain response to them. It can work and does better for aches and pains caused by physics causes (i.e. cuts, bruises, bumps).
Ibuprofen *is* an NSAID and can work with certain types of inflammation.
Opiates generally work by influencing mu nerve receptors in the nerve-to-nerve transmission of pain (it dulls the signal in tranmission, not at the received site source).
Alcohol works by keeping your brain from noticing the pain and has nothing to do with the extra-cerebral nervous system at all. It's not a pain killer, it's a CNS depressant. Ativan and other benzos do something similar with neurotransmitters - doesn't kill pain but rather makes you not care about it or keeps you from noticing it. Caffeine works by keeping your body from falling into stimulant withdrawl, and as a stimulant seems to work well for some migraine sufferers where the migraine may be rolling in due to a chemical domino effect.
What the article is saying is what professionals have known for a long time: Different types of pain relievers and adjuvant medications for different kinds of pain.
(Score: 3, Insightful) by All Your Lawn Are Belong To Us on Wednesday February 12 2020, @03:58PM
You have a very strange sense of who is speaking. SN wasn't saying anything. Florida Atlantic University's School of Medicine was.
So by all means feel free to ignore the Journal of Cardiovascular Pharmacology and Therapeutics. Your funeral.
This sig for rent.
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @08:51PM (38 children)
Reduces pain and has no negative gastrointestinal, hepatic or renal effects.
(Score: 4, Touché) by Anonymous Coward on Tuesday February 11 2020, @08:57PM (23 children)
No, just diarrhea, nausea, constipation, dry mouth, somnolence, confusion, muscle weakness, sweating. abdominal pain, headache, fatigue, anorexia and weight loss, dizziness, nervousness, hallucinations, anxiety, depression, flu-like symptoms, indigestion, shortness of breath, hypoventilation, apnoea, and urinary retention.
(Score: 4, Informative) by Freeman on Tuesday February 11 2020, @09:05PM (9 children)
You forgot death, as Fentanyl is that oh happy of substances that has been reported as contributing to the death rate. Since, it's super potent.
CDC Report Says That Fentanyl is the Deadliest Drug in America [soylentnews.org]
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Informative) by fustakrakich on Tuesday February 11 2020, @09:32PM (5 children)
You forgot death
Well, after that all your problems are solved.
Unfortunately the AC beat me to it, but the safest thing is still aspirin and weed, and at least one shot of Don Julio as often as needed.
La politica e i criminali sono la stessa cosa..
(Score: 2) by Booga1 on Wednesday February 12 2020, @03:44AM (2 children)
I know you referred to aspirin, but don't combine acetaminophen/paracetamol with alcohol. That multiplies the side effects and liver damage from acetaminophen.
References say regular dose acetaminophen(325mg) can be used with up to three drinks per day, but it just doesn't seem worth risking your liver.
(Score: 1) by fustakrakich on Wednesday February 12 2020, @04:00AM
Precisely why I stick with aspirin. A little hole in my stomach will close up with some sodium bicarbonate in my drink
La politica e i criminali sono la stessa cosa..
(Score: 5, Informative) by takyon on Wednesday February 12 2020, @04:05AM
If you're taking a painkiller other than alcohol, lose the alcohol for a while.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @04:21PM (1 child)
Unless you're driving. I'd rather not be killed because you had a headache and were driving buzzed.
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @04:31PM
Welp, just make sure to stay out of the way then, and you're golden.
(Score: 2) by dry on Wednesday February 12 2020, @06:46AM (2 children)
Yes, it is poisonous if not taken as recommended, usually caused by not knowing exactly what you are taking. Aspirin kills quite a few people too, usually by not taking as directed, Acetaminophen is consistently one of the top killers of kids, usually due to thinking the pills are candy.
Drug store drugs can be deadly
(Score: 2) by Freeman on Wednesday February 12 2020, @04:47PM (1 child)
The difference is the amount it takes to kill. As far as Fentanyl is concerned it's such a tiny amount extra to be a fatal overdose. Whereas something like Aspirin / Acetaminophen, it's not likely to be an adult accidentally overdosing and killing themselves that way. It's the parents' job to raise their kids to adulthood. Keeping medicine in places your kid can't get to it and making sure they know never to take medicine without mommy/daddy is a given. Accidents happen and that's a sad thing, but has nothing to do with the extreme danger of something like Fentanyl.
https://www.oxfordtreatment.com/substance-abuse/fentanyl/lethal-dose/ [oxfordtreatment.com]
Contrast that with something like Acetaminophen.
https://www.answers.com/Q/How_much_Tylenol_is_lethal [answers.com]
While that last quote isn't from an authoritative source, it's generally correct.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by dry on Thursday February 13 2020, @02:31AM
My understanding is that the people ODing on fentanyl are actually buying, or rather attempting to buy, heroin and such. It would be much the same if you were buying aspirin etc from some shady guy on the street corner who was cutting the aspirin with fentanyl to make sure it was effective.
Legalization or at least decriminalization, along with regulation is the solution to the people accidentally poisoning themselves with fentanyl or other street drugs. As a bonus, many a junkie will turn into a productive member of society when they don't have to spend all their time struggling for the next fix.
(Score: 2) by RS3 on Tuesday February 11 2020, @09:35PM (11 children)
Awesome list. And in the elderly, especially if they have any other medical problems, fragility, etc., Fentanyl, Tramadol, and all opioids and synthetic opioids cause brain damage, sometimes life and personality-altering permanent brain damage.
(Score: 4, Interesting) by Freeman on Tuesday February 11 2020, @09:43PM (10 children)
Definitely sounds like something best left untouched. Even with all the stigma around weed, it does seem to be at least within the ballpark of alcohol trouble. Perhaps even less trouble than Alcohol, in which case, it should definitely be legalized. At least, I've not heard of a weed addict becoming horribly violent while under the influence. Then again, perhaps, it's just due to sample size and/or the fact that people don't want to get in trouble for partaking in an illegal substance. Still, would at least be worth it to do major studies to decide whether or not to make it legal.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Funny) by RS3 on Tuesday February 11 2020, @10:07PM (7 children)
Weed addicts can get aggressive when they get the munchies, and only get violent if you take away their pizza.
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @11:27PM
https://soylentnews.org/comments.pl?noupdate=1&sid=36001&page=1&cid=956954#commentwrap [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @08:57AM (1 child)
The problem with Weed, at least, locally, is that there's a sizeable percentage of the population here using the stuff, and a number of them are innately violent shitheads, coming from families who have been innately violent shitheads for generations (verifiable, in some cases, at least back to early Victorian times through court records and newspaper archives).
The local strain of choice is Skunk [wikipedia.org], and that really seems to bring out the 'best' in these stabby little fuckers..the sooner they all graduate to becoming spice [wikipedia.org] zombies, the better for the rest of us..
It's disconcerting, to say the least, to travel on a bus where the driver stinks strongly of skunk, in fact, when you see someone lighting up on the streets it's more common for it to be skunk, any very uncommon now for it to be a plain old tobacco cigarette...
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @09:26AM
Chances are that flat screen TVs, video games, smartphones, weed and other decadence are pacifying the population.
(Score: 2) by Freeman on Wednesday February 12 2020, @04:23PM (3 children)
Same can be said for someone that's hypoglycemic.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by RS3 on Wednesday February 12 2020, @06:01PM (2 children)
Interesting, but that has not been my experience.
I had a brother who was an extremely "brittle" type-1 diabetic. He would often become hypoglycemic. He only got silly, goofy, giddy, etc. Convincing him to eat or drink anything was difficult. Many times he went into shock and became unconscious. Fortunately EMTs got there in time to give him IV dextrose. At least one time I had to give him a glycogen shot that saved his life, although he ended up in coma for 2 weeks. They said his blood sugar was 15, and likely much lower just before I administered glycogen.
(Score: 2) by Freeman on Thursday February 13 2020, @12:38AM (1 child)
I don't doubt your experience and perhaps, the irritability is only in some people or in less severe cases, but it's definitely a possible symptom.
https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685 [mayoclinic.org]
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Interesting) by RS3 on Thursday February 13 2020, @02:27AM
Always remember the 2 words before that symptom list: "may include".
With my brother we didn't know anything about his heart rhythm.
Not sure about fatigue- his episodes came on very suddenly- he would go from normal to unconscious in a few minutes.
Didn't notice pale skin (maybe happened too fast for color flush?)
He would get shaky, but again, with him acting silly it's not easy to see shaky.
Didn't notice anxiety- quite opposite- giddy.
He would get sweaty- even his face would sweat.
No change in hunger- had to convince him to drink something, like OJ, soda, dextrose tablet, etc.
Not really irritable, mostly silly / giddy.
Again, his hypoglycemic attacks were sudden, fast, and hard.
(Score: 3, Interesting) by dry on Wednesday February 12 2020, @06:50AM (1 child)
Weed when mixed with other drugs, especially alcohol, can lead to violence and likely occasionally on its own. Some people who are border line insane really shouldn't take weed. It has been known to kill people too, usually when a ton of it hits you in the head.
(Score: 2) by Freeman on Wednesday February 12 2020, @04:26PM
Well, I'd think it's quite likely for someone to die when a ton of anything hits you in the head.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by DeathMonkey on Wednesday February 12 2020, @09:37PM
So....just another Wednesday, then?
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @08:58PM
It also mindfucks you. Weed is better.
(Score: 2) by DannyB on Tuesday February 11 2020, @10:40PM (12 children)
Hydrocodone is a great pain reliever. It's just not the first thing I reach for. If I were to take it all the time, that story does not have a happy ending.
Prescription nsaids are great if your stomach doesn't have trouble with them. Fortunately I've been able to take all kinds of nsaids for decades. Pity the poor soul that can't take them.
Doctor asks: do I get constipated from hydrocodone? I say: no, because I don't take enough of it in a single dosing, and also not frequently enough.
The lower I set my standards the more accomplishments I have.
(Score: 3, Informative) by Azuma Hazuki on Wednesday February 12 2020, @03:19AM (11 children)
I've seen histamine-H2 antagonists (*tidine) and proton-pump inhibitors (*prazole) prescribed along with NSAIDs in the pharmacy I work at. Those come with their own issues, especially the PPIs, but it may be worth it to prevent GI lesions in susceptible patients.
The one that really surprises me is that Cele-frickin'-coxib is still on the market. Remember Vioxx? That was the brand name for Rofecoxib, and the entire drug class name "coxib" means "Cyclooxygenase inhibitor." Apparently "studies show" Celecoxib is no more dangerous than diclofenac etc, but I would not be surprised if said studies were biased or slanted...
I am "that girl" your mother warned you about...
(Score: 2) by DannyB on Wednesday February 12 2020, @04:40PM (10 children)
I do remember the name Vioxx. Never took it. But it was headline news.
I've taken Indomethacin (nsaid) for over 15 years now. My arthritis Dr worked with me to try a number of different nsaids until I found one that (1) I liked and (2) I could take three times a day. Some others, like Celebrex could only be taken 2x a day. By the time for the 2nd dose I would already be in a lot of pain again.
I've taken hydrocodone for over 11 years now and haven't gotten into any trouble with it yet. Both primary care and specialist don't have any concerns about my use of hydrocodone.
At this point, those work, and if it ain't broke, as programmers say: then fix it till it is broke.
Also, programming in Java can help put one into a catatonic state. :-)
Humor is also good medicine.
The lower I set my standards the more accomplishments I have.
(Score: 2) by RS3 on Wednesday February 12 2020, @05:46PM (9 children)
Any knowledge of or experience with meloxicam?
(Score: 2) by DannyB on Wednesday February 12 2020, @06:12PM (8 children)
Not me.
The lower I set my standards the more accomplishments I have.
(Score: 2) by RS3 on Wednesday February 12 2020, @06:19PM (7 children)
Me neither, but I don't have problems that need it. It was prescribed to my father, but I don't know why, and he's not with us anymore to ask him about it... Might be something for you to look into- my dad's doctor was voted best doctor in a major metropolitan area many years.
(Score: 2) by DannyB on Wednesday February 12 2020, @06:25PM (6 children)
A weird drug, IMO, is Tramadol. My arthritis dr had me try it instead of hydrocodone in, about, 2010. Take it every day he said.
I got jittery. Couldn't keep my limbs and extremities still. Had to always be shaking of moving them. Had some trouble sleeping. It was like an electric current almost. Also it was definitely addictive. Withdrawal symptoms were no fun either. I quit it and never looked back. I don't find hydrocodone addictive, but I'm sure it can be from all I hear. I hated Tramadol. Have no problem of any recognizable kind with hydrocodone.
The lower I set my standards the more accomplishments I have.
(Score: 4, Informative) by Azuma Hazuki on Thursday February 13 2020, @01:55AM (5 children)
Tramadol is a well-known serotonergic. That sounds like low-grade serotonin syndrome, and it's a major reason tramadol is not recommended to be mixed with SSRIs, triptans, or other serotonin agonists.
Fun story: about 5 years ago I was prescribed tramadol and cyclobenzaprine (Flexeril), the latter of which is a muscle relaxant that looks almost exactly like a tricyclic antidepressant like amitryptiline. I remember just staring at the bottles and asking if they were trying to kill me. They looked like the carpet had just leapt off the floor and bitten them; they were evidently not expecting a "civilian" to know one end of a vial from another! This is the event that got me really interested specifically in pharmacology, as opposed to my generalized organic-chem nerdistry from elementary school: it was self-defense.
I am "that girl" your mother warned you about...
(Score: 2) by RS3 on Thursday February 13 2020, @02:37AM (2 children)
So, I have to ask, have you looked into going to med school?
(Score: 2) by Azuma Hazuki on Friday February 14 2020, @01:21AM (1 child)
With no money, almost 40K in student debt, and having been lifelong poor? Hah. Not in this country. One of the reasons I'm trying to get into Soviet Canuckistan is the possibility of perhaps going to pharmacy school there. This country? The US wants me and all the other poors dead.
I am "that girl" your mother warned you about...
(Score: 2) by RS3 on Friday February 14 2020, @02:13AM
GoFundMe?
Cuba?
(Score: 2) by DannyB on Thursday February 13 2020, @02:52PM (1 child)
Another thing about Tramadol I forgot to mention: I was in a really good mood all the time.
That's just not natural. I distinctly recognized it, that I was always in a good mood on that drug. I didn't like it. It's not normal to always be in a good mood constantly.
The lower I set my standards the more accomplishments I have.
(Score: 2) by Azuma Hazuki on Friday February 14 2020, @01:22AM
I had Tramadol once. *Once.* It made everything all better. I didn't feel numb or disconnected; for the first time in decades, I felt *safe.* And I knew, right then and there, that I could never ever have it again. That kind of thing hooks people.
I am "that girl" your mother warned you about...
(Score: 4, Informative) by kazzie on Tuesday February 11 2020, @09:01PM (9 children)
Readers east of the Atlantic may find it useful to know that acetaminophen is also known as paracetamol.
(Score: 2) by inertnet on Tuesday February 11 2020, @09:53PM (8 children)
Paracetamol, in Europe you can buy 200 mg or maximum 400 mg pills. I heard that they have 1200 mg versions in America.
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @10:06PM
I haven't seen larger pills, so I'm guessing those would be prescription only.
I did hear that Europe also had quantity limits; when I took my European relatives to a Walgreens, they were like kids in a candy store because they could buy a cheap tub of 200 mg acetamenophens / paracetamols.
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @03:15AM (3 children)
I have some that are labeled "extra strength" that I bought in the states that are 500mg. And, some that I bought in either NZ or AU which are also 500mg.
Funny, after getting allergy medicine (without a prescription) in France that had opiates in it, I had the impression that European medicines were the hardcore ones.
(Score: 2) by dry on Wednesday February 12 2020, @06:53AM (2 children)
Acetaminophen is a lot more dangerous then opiates. Lots of kids OD on them and it is a terrible way to die as it causes liver failure.
(Score: 2) by Azuma Hazuki on Thursday February 13 2020, @02:07AM (1 child)
On a purely drug-for-drug basis, no, APAP is *not* "more dangerous than opiates." Good lord, some opiates are lethal in tiny, tiny sub-milligram doses! Talk about your narrow therapeutic index!
The factors that make it dangerous are social more than anything; it's not gated behind DEA scheduling regulations, people are familiar with it so it's seen as "harmless," and it's used a lot. But it's still wrong and bordering on malicious to say it's more dangerous than opioids, good grief.
I am "that girl" your mother warned you about...
(Score: 2) by dry on Thursday February 13 2020, @02:41AM
I guess I'm thinking of access more then LD50 level. There seems to be more cases of kids accidentally poisoning themselves with acetaminophen then fentanyl and even with adults, most opiate poisoning is caused by the unregulated nature of the drugs leading to people not knowing what they're buying and injecting.
(Score: 2) by Azuma Hazuki on Wednesday February 12 2020, @03:20AM (1 child)
I've personally never seen more than 650mg in a single capsule or tablet here (northeastern USA).
I am "that girl" your mother warned you about...
(Score: 2) by DannyB on Wednesday February 12 2020, @04:43PM
It seems like, over the years, the US gets this idea that 500mg in a capsule should be the max OTC. Then it goes back to 650 again. Then back to 500 again.
The lower I set my standards the more accomplishments I have.
(Score: 2) by RS3 on Wednesday February 12 2020, @03:38PM
Here in US the common OTC acetaminophen dosages are 325, 500, and 650 mg.
4,000 mg / day is the allowed limit, but age, weight, liver / kidney health should all be considered.
(Score: 2) by stretch611 on Tuesday February 11 2020, @09:01PM (1 child)
I had Voltaren prescribed to me roughly 20 years ago.
The whole time I was on it, I was also on the toilet because of it. (I actually changed Drs due to it, because my Dr thought i should just get Milk of magnesia instead of switching me to something my stomach would tolerate.)
Voltaren is the only drug that made me react that way in such a constant fashion. I have been on all the others without problems, both prescription and non-prescription of various strengths, (including COX-2 inhibitors which I did not think were still available due to the heart issues,) and never had the issues with any of the others.
Now with 5 covid vaccine shots/boosters altering my DNA :P
(Score: 2) by c0lo on Tuesday February 11 2020, @11:18PM
Don't feed it to buzzards [wikipedia.org], or else S/N may suffer...
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 4, Interesting) by NotSanguine on Tuesday February 11 2020, @09:29PM (4 children)
Personally, I take ibuprofen when I'm in need of an analgesic/NSAID. It works really well -- for me. That said, I have the metaphorical cast iron stomach.
Then again, I don't (at least not in a long time -- my herniated lumbar discs have been asymptomatic for many years) take ibuprofen unless there's pain/inflammation, but when I was having issues with sciatica, I took 2400mg daily for several years without any GI issues.
What's more, Naproxen and Acetominophen have zero effect on me and, as such, are worse than useless -- for me.
Some folks do have serious gastrointestinal issues with ibuprofen and/or other NSAIDS.
I don't have experience with Voltaren or any COXIBs, so I can't comment on those.
As I understand it, some people find that NSAIDs other than ibuprofen, COXIBs and/or acetominophen to be very effective.
I don't think it's complicated to choose an analgesic at all. Just try them all, see what works best and has the fewest/no side effects, and stick with that.
No, no, you're not thinking; you're just being logical. --Niels Bohr
(Score: 2) by Hartree on Wednesday February 12 2020, @01:02AM (3 children)
Yep. Different ones work differently in different people.
Aspirin works best for me in terms of both agreeing with my stomach, killing pain and damping down inflammation.
Ibuprofen tears up my stomach. Acetaminophen doesn't work nearly as well as aspirin.
(Score: 2) by takyon on Wednesday February 12 2020, @01:40AM (2 children)
Ibuprofen is putting in the work. Aspirin is also good but 1,300 mg makes me feel weird.
Acetaminophen? Get it outta here.
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(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @03:39AM (1 child)
I've ended up feeling weird from aspirin (dizzy, ringing in the ears, a sense of being spacey) but only during a rare severe eye splitting migraine and only after taking about 3000 mg -- but in the middle of a migraine, it's easy to do stupid stuff. I checked wikipedia though, and I'd have to take about 12,300 mg to hit a mildly toxic level, and 25,000 or so for life threatening toxicity, so I'll probably do the same thing again next time I get migraine. https://en.wikipedia.org/wiki/Salicylate_poisoning [wikipedia.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @11:11PM
First, DON'T TRUST WIKIPEDIA as your source for something like this. (oopsie! someone misplaced a decmial point! oh well!)
Second, tinnitus (ringing in ears) is a symptom and your 'spaceyness' may be coming from hyperventilating which is also an early sign of aspirin poisoning, and confusion is a later sign. Don't pay attention to the numbers, pay attention to your symptoms. You likely did indeed poison yourself.
Third, what you interpreted as a migraine.... Could it have been a headache from increased intracranial pressure (a throbbing that won't go away)? If you had increased ICP it could be that your aspirin levels up in your head were higher than the rest of your body from localized vasoconstriction. I'm not saying it was, just thinking that's anatomically plausible. And again, you could have gotten salicylate poisoning from a lower dosage, especially if you had anything going on with your kidneys at the time. The maximum safe dosage level for a *healthy* adult is 4,000 mg/day, and normal max dosing is 1,200 mg per every six hours.
But I'm not your Doctor. The point here is before you exceed any dosage recommendations on an OTC package you should get the advice of a medical professional.
It's your life.
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @07:43PM
"The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes," said Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine.
IOW, "we are drug dealing whores".