My ex-husband’s work used to have a pain killer called PainAid for anyone who
needed it. It was half tylenol and half advil. I think they had to stop making it because it was very hard on the kidneys.
I have had 2 surgeries and a broken arm and they told me to take 2 extra-strength tylenols and 2 advils rotated every 2 hours.
They said a test was done (maybe England) and the people who used this for pain relief actually felt better than the people who took a narcotic for pain.
OK, everybody who posted advice here, raise your hand if you are an M.D. or a pharmacist…
I’d worry about the effects on my liver. Are they metabolized the same way, or can the liver handle both?
For what it’s worth, my nursing textbook uses the Tylenol/Ibuprofen combo as the example under the term “potentiate”. But I also agree with you - they may or may not literally potentiate one another, since they work (we think) on different parts of the body.
They are both primarily metabolised by the liver, but while Tylenol is implicated in liver damage, ibuprofen is not. Even when used by alcoholics and those with liver disease, we don’t see further liver damage or a change in the effectiveness with ibuprofen (we do with Tylenol.)
Ibuprofen pain relief works primarily by inhibiting the production of prostaglandins. Prostaglandins are released at the site of the problem and make us feel pain there. Tylenol’s mechanism of action is less understood, but it’s believed to work on the central nervous system, inhibiting the nitric acid pathways that nerves use to sense pain, including inhibiting the production of the famous Substance P.
So it’s entirely fair to say that they work differently, and combining the two will relieve often pain better. Ibuprofen works at the site of the pain, and Tylenol works on the nerves that sense pain.
(Not an MD, but a nursing student studying pharmacodynamics during my summer off.)
Help me wrap this up: separate by two hours or simultaneous?
And: when pain is coming on, right, After its settled in you’re screwed right?. (I get migraines.)
When it comes to migraines, you want to take meds the very second you feel it, if you get auras (I don’t) take the meds then.
As for at the same time or separate, I take them both at the same time for things like headaches where one dose should get rid of the problem, but for things that will come back when the meds wear off (back pain, muscles aches, sore throat) I space them apart. Since you should only take each one of them every four hours, if you alternate your getting something every two hours.
Also, when it comes to migraines, for me, the only things that work are Maxalt (I like the minty dissolvable ones) or injectable Imitrex.
Pain is always easier to treat when it’s mild or absent (that is, keep on top of it, don’t space out your doses so far that you have break through pain, as long as you follow directions and don’t overdose.) I can bore you with the details if you’d like, but let’s just say that the “light” pain fibers respond better to pain relief than the “deep” pain fibers. Once you feel a lot of pain, it takes much longer and much higher doses of meds to make it go away again.
It’s kind of a pain (ha!) that the dosing schedules don’t match up.** Tylenol should not be taken more frequently than every 6 hours.** Ibuprofen is every 4-6 hours. I set the alarm in my cell phone so I don’t get confused.
If you need the ibuprofen only every 6 hours, then take both at once, every 6 hours.
If you need ibuprofen more frequently, a sample schedule might look like:
8 AM - Tylenol and Ibuprofen
Noon - Ibuprofen
2 PM - Tylenol
4 PM - Ibuprofen
8 PM - Tylenol and Ibuprofen
Midnight - Ibuprofen
2 AM - Tylenol
4 AM - Ibuprofen
Of course, always check with your doctor or pharmacist for the pain regimen best suited to you, your body and your type of pain.
Thanks. I get headaches where I throw up, but no auras, etc., so I never investigated “migraines” per se. New guidelines, new diseases…
I used to get those too, about once a week. Pain that was so bad all I could do was lay in my bed. Even changing positions made my head POUND, throwing up was awful. Every single week. My doctor gave me imitrex pills, but because of the nausea, I couldn’t swallow them. The injections where a godsend. A shot in the arm and I could feel the effects within seconds. The excruciating part of the pain would be gone in minutes, the majority of it was gone in 10 to 15 minutes and the rest lingers for another hour, but I could be up and moving within 5 minutes. Gotta love it. Using pills instead of the injectables (imitrex, maxalt) works, but instead of the pain being gone in minutes, IME it takes about two hours. Still worth it though since Tylenol and Advil don’t even put a dent in a migraine.
ETA, luckily I only the the OH MY GOD I’M GOING TO DIE, KILL ME NOW migraines about once a year. I still get migraines several times a month, I still give myself a shot of imitrex to get rid of them, but they aren’t debilitating anymore.
[Half raises hand], I’m not a pharmacist yet… but I am currently in pharmacy school, and am a licensed Pharmacist Intern. I am as of today, 380 days away from graduation.
This has been a great thread for me - I don’t get migraines, but I get bad headaches that are just a touch worse than just a couple of Tylenol can handle. I’ll add in the ibuprofen and see how that goes next time I get one.
It’s been already said- Acetaminophen is the big bad for the Liver (though there are studies out there that say in high doses it can impair your kidneys, but usually your liver’s taking the hit first in those high level doses). NSAIDs on the other hand (COX-1,2 inhibitors- your Aspirins, Ibuprofens, and such) cause more problems for your Stomach and your kidneys. So the NSAIDs aren’t really going around trashing your liver, but they will cause stomach ulcers and can cause renal complications in higher doses. That’s why if you’re taking brand name medications, it’s always good to read your labels and see what’s in each one- especially when combining medications.
The problem with Tylenol overdoses is REALLY not a pretty sight, and it’s quite insidious, as people tend to feel sick and awful, but then they’ll feel better- there’s a slight upswing and then it’s 24 hours or so later that the liver completely crashes, and the jaundice and liver failure really starts to kick in.
Nitpick: We will tell you this if you don’t have any of the contraindications for taking higher, prescription strength NSAIDS. If you do, or if you’re not sure, you should probably be careful about trying this at home.
From what I read, Ibuprofen and Naproxen can be taken at the same time (but remember you have to count the dose for each additively.*) However, Aspirin and Naproxen (Aleve) should never be taken together.
wiki “* Naproxen is also not recommended for use with NSAIDs of the salicylate family (Aspirin) (drugs may reduce each other’s effects) or with anticoagulants (may increase risk of bleeding).”*
- In other words, you can use Acetaminophen with Ibuprofen/Naproxen and count the dose of Acetaminophen seperately from the Ibuprofen/Naproxen but those two must be added together, so if the daily dose is (for example only)
4=Naproxen or
8=Ibuprofen or
8=Acetaminophen
You could then (using our example, I am not suggesting this) take 2 Naproxen and 4 Ibuprofen in a day (spread out) AND 8 Acetaminophen. But NOT 4 Naproxen + 8 Ibuprofen. You should consult your MD before taking any OTC medication for an extended period, he may suggest less or even more (My Doc sez **I **can take up to 8 Naproxen a day for the arthritus, but he knows my system very well and I get regular check ups, etc).
Warning about Acetaminophen/Tylenol. It is in many OTC cold etc remedies. So, it may be very bad to take the normal daily dose of Tylenol, and also the normal daily dose of Nyquil. READ THE LABEL!
Cat Whisperer- the combo of aspirin + Acetaminophen + caffiene (which is what Excedrin is) seems to be very effective on headaches for many. You can find generic combos of the three, or just take a regular dose of the two pills and a cuppa.
As always *consult your MD. *
This is often stated but I doubt you’ll find a cite to back up the claim that acetaminophen is toxic to the kidneys except, perhaps, as a result of chronic, high dose use. In other words, even in massive acetaminophen overdose, there is no ill effect on the kidneys (except, possibly, that which sometimes occurs secondarily as a result of liver damage from the acetaminophen).
I have no idea about a synergistic affect between those two drugs, but since it hasn’t been mentioned here, I would like to point out that caffeine does potentiate analgesics. It’s why some medicines (e.g. Excedrin) are acetaminophen, aspirin, and caffeine.
Yep, I wasn’t even going to mention the Kidney thing until I looked it up and saw it in a few sources, the numbers were something like around 2% of overdoses of Tylenol lead to renal failure and such, so I had to throw that out there, but normally I didn’t tend to associate the two together.
While we’re here, does anyone know if Ibuprofen does anything to GABA receptors and, if so, whether A or B?
Oh, and the doctor told my mother to do the 2 hour switch thing, as long as it’s not long term.
Finally, does anyone know why, when I was younger, it seemed like you were told to take 3 advil, and now are told to take 1, and then another if it doesn’t work? Or was I just misinformed as a kid?
My oral surgeon told me about the ibuprofen/acetaminophen thing after I had a tooth pulled. I discovered at that time that it also helped my severe menstrual cramps. YMMV.
Migraines don’t always produce auras. I had migraines for a couple of decades before I got one spectacular aura, and it never repeated. My mother, on the other hand, got auras very frequently, but never with a headache.