I’m dealing with a very painful issue right now and I’m getting some relief from various NSAID medications. But each has a different dosage limit - every 8 hours for the ibuprofen, no more than 4000mg for Tylenol per day, etc. But the pain relieving effect is diminished on these before those time limits are up.
So I was wondering, can I take several of them at different intervals as long as none exceed their dosage? Take an ibuprofen, then a Tylenol 4 hours later, an alleve every 12 hours, etc? Or does this still overload your liver or have some other effect that makes it dangerous to do?
Pretend I never said “I” in the first post. And I was just generally asking if NSAIDs stack with each other in terms of the body’s ability to process them out of curiosity.
This isn’t a question that needs a specific consultation with a doctor - it doesn’t relate to a specific problem I have, or anything specific to my biology. It’s just a general question about the nature of NSAIDs.
IANAD but I’m pretty sure your pharmacist will answer these questions for free and very knowledgeably.
That being said, actual NSAIDS do build, and they are all blood thinners, so that would probably get you before the liver would.
I’ve also heard it said that even just the max dose of acetaminophen over long periods can affect the liver, so be super careful about that one. I’m pretty sure it’s not an NSAID though, so won’t thin blood or “stack” in the same way that multiple NSAIDS will.
Again, call your pharmacy, and ask - they know this stuff much better than I do.
In general I don’t think it’s a good idea for a variety of reasons. Here’s one…
According to this… “While it is well recognized that taking multiple NSAIDs can lead to gastrointestinal problems, it is not known whether there is a relationship between patients taking more than one NSAID and their health-related quality of life. A new study published in the February issue of Arthritis Care & Research (http://www.interscience.wiley.com/journal/arthritiscare) found that taking two NSAIDs was associated with lower scores on a health-related quality of life assessment.”
Tylenol is not an NSAID. My pediatrician has said I can alternate giving my children Tylenol and Ibuprofen as long as neither one exceeds recommended dosage by itself.
You mention liver damage, which is an issue with acetaminophen (Tylenol) but not NSAIDs.
Ibuprofen is often prescribed in doses higher than the OTC versions. Once I was taking it for inflammation and my doctor told me he could give me a prescription, or I could just double the OTC dose.
I don’t know about combining Ibuprofen with other NSAIDs like naproxen. However, they have similar side effects which would probably be intensified if you combine them, like blood thinning (I am not a medical professional).
IMO, you should not take multiple NSAIDs at once even if none of them exceeds its recommended dosage.
Although you wouldn’t risk OD’ing on any one of them, they all have similar actions in the body and, in particular, may individually cause/promote things like high blood pressure, salt retention, and reduced kidney filtration of the blood. Taken together, I would worry that their individual effects on those things may sum to cause considerable salt retention, reduced kidney function, etc.
You shouldn’t take multiple drugs at once, in general, without discussing possible interactions with a doctor or pharmacist. This is especially true for drugs which have related effects. Sometimes a half-dose of one and a half-dose of another can have larger side effects than a full dose of either one separately.
Agreed that I’d be worried about taking multiples of the same class. Frankly, if it hurts that much you should just go to the doctor and ask about a prescription painkiller.
Yes, this. Taking both Tylenol and Ibuprofen is routinely recommended for post surgical pain when the patient can’t take or doesn’t want to take narcotics. I used it myself when my idiot ex-husband lost my Vicodin scrip on the way to the drugstore after my c-section. Worked just as well as the Vicodin I was taking at the hospital, without the constipation. The only annoying thing is that Tylenol should be taken every 6 hours and Ibuprofen every 4, so you can only take them at the same time twice a day. I set alarms and kept a written log to keep them straight.
Tylenol isn’t an NSAID and it works (we think, maybe, we really don’t know how it works for sure) on different pathways in the pain reception dance. It is often combined with NSAIDS, including in prescription strength Maxigesic sold in New Zeland (but I don’t know of a combo brand sold in the US).
When I sprained my knee last year, my doctor OK’d using 800mg ibuprofen every 6 hours. I just bought a big cheap bottle of it, used it for a couple weeks (along with a gastric protectant, I’m already on omeprazole, but I would have at least taken famotidine while taking that dose of ibuprofen, if I wasn’t already on something), and then gave the rest to the community medication drawer at work.
I have bad knees plus frequent brain injury migraine. Excedrin Migraine is a combo of tylenol, aspirin, and caffeine, great for migraine in about 50% of people. Ibuprofen is great for joint pain. My Doc said the max dose should be four tablets 3 times a day, I might take 4 advil in the morning, maybe again after lunch, then 4 excedrin if I feel a migraine firing up. She says you can mix and match and less is better but don’t go over 12 otc tablets any day. Susceptibility to liver damage/death seems to be genetic, I think the only way you find out about is when you die after 4 tylenol and a couple shots of Tequila.
I love me some hillbilly heroin which is a good reason to stick with nsaids.
Warning: Don’t drink alchohol with your medication except when you want to feel better.
You do risk injuring the liver … ibuprofen may inflame your liver, which then causes the acetaminophen to be processed far slower, which results in build up of acetaminophen.
Go to the pharmacy for something stronger if the regular headache tablets aren’t enough.
Codiene + NSAID is the next stronger.
In Australia we can buy Panadiene, which is codiene and acetaminophen ( aka paracetemol.). Drink plenty of water and try to eat high fibre food, as codiene tends to cause constipation.
No form of codeine whatsoever is available over-the-counter in the United States, that I know of. You gotta get an Rx for that. Our national hysteria about “drugs” here is beyond raving psychotic irrational. See prior threads about pain meds, especially that long-running one that obbn started.
I got told by an emergency department nurse unit manager that it was OK to take paracetamol and ibuprofen at the same time as they work on different pain receptors, provided you don’t exceed the recommended dose of either.
It works quite well if you have something intense and temporary although the combination seems to knock some people around a bit and make them drowsy.
We were told to do it when our son had febrile seizures to keep the fever low. But do be careful - there are lots of pain relievers out there and you are looking for the acetaminophen and ibuprofen combination - with nothing else.
I went to the funeral of a 23 year old who died from medication interactions + alcohol - if you have ANY doubts, call your doctor. And don’t drink while doing this.
I’ve found that painkillers start to wear off before the time limit is up, too. What I do for that is to stagger them-- e.g., if I can take 2 ibuprofen every 4 hours, I’ll take 1 ibuprofen every 2 hours, so that only half the dose will wear off at once.
Actually, Codeine is supposedly legal OTC in Virginia, but good luck getting some. I tried it once - went to several different pharmacies. The message I got from pharmacists was…