Yeah, I should have specified PPIs are best, followed by H2 blockers, followed by old fashioned calcium or magnesium acid reducers.
I thought there were some serious issues with Prilosec, too. No?
IME, Tylenol and Codeine work very well for pain. When it’s prescribed, I worry about the Tylenol due to my alcohol intake.
It’s a simple bit of chemistry though to remove and discard the acetaminophen, so I’ve done that.
And headaches? I had them often in my youth, but I’ll bet it’s been 25-30 years since my last headache!
Muscle and similar body aches I can deal with, but headaches pretty much leave me incapacitated. I relied on ibuprofen for the those headache until I was diagnosed with DMII. Now I take Tylenol. It takes the edge off but doesn’t eliminate the pain entirely. It also takes much long to kick in than ibuprofen did but it’s better than taking nothing. Thankfully it’s pretty rare (a few times a year) that I get headaches.
A nice look at the efficacy of acetaminophen from Rebecca Watson: Why I Think Tylenol is Both Dangerous & Useless - YouTube
For me, I keep Naproxen, Asprin, Ibuprofen, and Acetaminophen in the house. Due to complication worries with the first and last I use them the least. Probably because of that, when I do use Acetaminophen, it seems to work best for me.
Completely anecdotal, but what have you.
Tylenol works pretty well for me but I avoid it because it’s not great for your liver to take tylenol for chronic pain. Ibuprofen works for me too, so that’s what I use most often. Naproxen doesn’t do anything for me at all.
Not compared to the known problems of chronic NSAID use, no. Some theoretical concerns, which haven’t really manifested in significant problems for the typical chronic user. Current medical consensus on this: “Long-term PPI use has been associated with several safety concerns. However, few of these concerns are supported by consistent data demonstrating a causal relationship.”
Currently we’ve a lot of patients who’ve been taking these meds for 3 decades routinely. That’s not a super long period of time, so maybe we will discover causal relationships. It is known that going off PPIs can be challenging, as it causes a reflex increase in heartburn initially.
Other theoretical concerns include possible Clostridioides difficile and other enteric infections, microscopic colitis, hypergastrinemia, atrophic gastritis, Intestinal colonization of multi-drug resistant organisms, inflammatory bowel disease, malabsorption of minerals and vitamins, kidney disease and lupus.
But again, none of that has been really substantiated, while we know that NSAIDs have caused thousands of deaths from GI bleeds and kidney disease.
Pick your poison.
Acetaminophen is hard on your liver. The difference between a therapeudic dose and a damaging or even fatal dose can be quite small.
Prefer Ibuprofen? Substitute kidney damage for liver damage.
If you are a regular user of either of these for pain, you need to work on what is causing the pain and get off these drugs. They are in common, frequent use, but that in no way means that they are safe for you to use.
It all depends on the dose, and the underlying conditions. Most folks can easily tolerate 3 grams a day chronically, even with some mild liver dysfunction from infection. The biggest risk comes for those looking to overdose, and those who drink chronically or binge intermittently. THEN it gets messy.
Acetaminophen might as well be vitamin C for all the good it does for my pain–there’s something about my body chemistry that renders the stuff basically useless, and my daughter is the same way. I took shit tons of ibuprofen in the 800mg football size back in the day so that’s now a guaranteed writhing on the floor pain fest if I try it. My go to NSAID is naproxen, which works well for me on just about everything but since I’m a warfarin patient I’m extremely sparing of taking them at all. For my chronic aches and pains I have gabapentin and that seems to be doing the trick. If that’s not enough I vape CBD oil and that’s actually the most effective painkiller I use.
Acetaminophen does absolutely nothing to me that I can tell. (It made my mother feel significantly worse.)
Ibuprofen works best for me for headache and, when I was still menstruating, for menstrual cramps. Aspirin works best for body aches (sore muscles.). My system seems to tolerate both just fine, at least in the quantities and at the frequences I take them (two standard tabs of either, repeated about every four hours if needed; but only on occasional days, usually for a day or less, and very rarely for more than a day or two at a time.)
Tylrnol neither reduces my pain or fever.
Tylenol is straight “well, if there’s nothing else around” to me.
Ibuprofen works exceedingly well on me; after my surgery in October (yeeted everything reproductive), I switched from hydrocodone to ibuprofen after 2 pills. Felt so much better and pain went down.
Acetaminophen does little or nothing for me, with most types of pain. Usually nothing, in fact
The one situation in which it really kicks ass is when I am aching all over from a fever. For me APAP is a great antipyretic, and when it has brought down my temperature, then the back pain and all-over aches go away.
We’ve been using IV Tylenol a lot in the ER lately, I haven’t seen actual science on how well it’s working.
NSAIDs have been avoided peri-operatively because of increased bleeding risk, although that’s been undergoing re-evaluation lately, you may want to see if you doctor is certain that it’s no good for your procedure.
I stay away from OTC painkillers unless I’m really in pain, for the simple reason that I drink 1-3 glasses of wine almost every day and that’s more than enough stress for my liver. (If I really need a pain killer, I don’t drink - I never take alcohol and painkillers at the same time, though I suspect that long term trends are probably more important than a single day’s consumption of both.)
Having said that - when I was younger, and drank less, I used to get pretty bad migraines once or twice a week. I took Cafergot and Inderal at different periods of my life with good result - Inderal in particular helped a lot. But my ordinary go-to for headache pain was an ibuprofen-acetominophen mix, along with a cup of coffee.
Lucky for me, at almost 65 I have very few aches and pains. But my go-to drug when I do is an OTC acetominophen-ibuprofen mix. Better than either one individually in my experience.
I rarely take painkillers for anything, but I agree with you and with those favouring ibuprofen over acetaminophen, although many disagree so this may be a matter of individual physiology. I know someone who found Tylenol 1 (acetaminophen with 8 mg codeine, at that time available OTC in Canada) effective for occasional migraines. But I found even Tylenol 3 (with 30 mg codeine per tab) ineffective for a bad toothache. I read somewhere on this board that ibuprofen is more effective for toothaches than aspirin or acetaminophen, and in my experience it’s true. To be fair, I haven’t had a really bad toothache in many decades so it’s hard to do a fair comparison. But I’ve occasionally had mild toothaches, and ibuprofen really does seem to work.
A friend’s dog was on NSAIDs that were causing gastrointestinal issues. She was given a prescription for misoprostol.
The pharmacist questioned the reason for the drug, because in humans it can be used to induce abortion. She was told to wear gloves when handling the pills.
Tylenol doesn’t do squat for me. I might as well take nothing. Ibuprofen works, but plain old aspirin works much better for me.
If I have a migraine or a sinus headache, Excedrin (effectively aspirin, Tylenol, and caffeine all together) is the only thing that works. Well technically I always take the generic version of Excedrin, but it’s effectively the same thing.