The “Excedrin” combo of acetaminophen, aspirin & caffeine works even better for many.
OK, so doctor’s orders, I bought a big bottle of acetaminophen today. No, it isn’t doing my back ache much good. What I really need is Oxycodine. No I can’t have it. I guess the DEA will hassle doctors that prescribe much of it. It is like a few weeks ago after my last out patient surgery I went through hours of agonizing pain before finally getting enough Demerol to reduce it to severe.
Now I like to have a beer or some wine every night at bed time. So I have to chance rotting my liver because of the drug abusing scum, and still not get the relief I need. This is an outage. Why doesn’t the Tea Party forget about Obama’s birth certificate and demand drug abusers suffer, not cancer victims?
Oh, the doctor says no aspirin because of my bleeding problems. Maybe I will have a heart attack for lack of aspirin.
How long does it take to rot your liver? After all, the doctors keep telling me without major surgery, cancer is going to kill me. Of course after it 50% of th epeople die within 5 years.
So I beat the doctor out of some Hydrocodone. What is in it, 500 mg of the acetaminophen that does nothing for me.
Taken as directed acetaminophen is usually harmless.
Just be sure you are not getting it from other OTC medications.
When in doubt, consult your MD.
One thing nobody brought up is that certain medications make acetaminophen EXTREMELY dangerous to take. Basically, a med that’s extensively processed by liver enzymes will compete with the way that it’s metabolized. The worst offenders are Tegretol (carbemazepine), used for epilepsy and bipolar I and II, and Seroquel (quetiapine), which is supposed to be used only for schizophrenia but has been prescribed for all kinds of off-label things. Your doctor will hopefully tell you about this, but it should be a black box warning.
Years ago (mid 60’s) I began to get very severe migraine attacks - the first one knocked me out cold, felt like I had been stabbed in the back of the neck before the lights went out.
I was prescribed 10mg Valium twice daily, to hold the symptoms at bay.
When an attack came, the pain was so excruciating that I would take all the Valium I had and up to 50 Paracetamol tablets ( a whole bottle).
I was unaware of any side effects (or primary effects).
After ten years the migraine subsided but I would have an almost constant headache that was almost as bad as migraine on occasions and took Paracetomol daily, up to 10 tabs a day and often far more.
I am an infrequent drinker, more so now than then and rarely in great quantities so that has probably not had any bearing but I do seem to have come through that unscathed. No apparent detrimental symptoms and rarely use any medication at all these days other than Ipramatropium for an unrelated allergic condition.
The thing about the liver is that it can take a lot of abuse before signs of liver failure become obvious. The liver has to be very close to completely destroyed before you can tell from symptoms that anything is wrong. I would definitely make sure that your doctors are aware that you’ve used acetaminophen heavily in the past so that they can monitor your liver with bloodwork.
Some 25 years ago a 16-year-old girl came into the hospital I worked at with an overdose of Tegretol and acetaminophen. She was not in good shape (was in the CCU for a time) prior to being transferred into the big city. Hope she survived OK. Very sad.
Indeed, the liver is resiliant. That being said, prior use, or abuse, of acetaminophen has no effect on the present status of the liver.
Phrased differently, acetaminophen toxicity (from taking too much) is strictly an acute phenomenon. There is no cumulative effect. Even in the most massive poisoning/overdose where the liver has been severely injured, if you survive that acute episode, there will be no after effects later on (and no way, either, to know or demonstrate that there ever had been any acetaminophen-induced liver damage). IOW, no need to tell the docs and no need to monitor the liver tests (although it’s a good thing to share a history of what sounds to be substance abuse with the doc).
Yes. Excedrin has been my sole effective means of finding migraine relief for twenty-five years or so. Couple of years back I discovered the Excedrin Migraine product which provides satisfactory and somewhat superior relief than the original recipe.
Oh dear.
I DO realize that the print on the carton and on the bottle label are damned near microscopic, and if you have a headache, trying to read that tiny print is like shoving 4th of July sparklers in your eyeballs.
But “Excedrin” and “Excedrin Migraine” are the EXACT same formulation–same ingredients, same strengths.
~VOW
I don’t know… the placebo effect is very, very powerful, and if someone believes that one formulation is better than another, it may actually work out that way for them, even over a long period of time. Of course you’ve had to go and ruin it now! 
I want to point out, that with most OTC pain relievers, there’s a rather quick level of vanishing returns. After you get to about half-again the rec dose, you really start not getting much added pain relief. In other words, 4 pills are maybe only 10% better than 2, and 10 pills are pretty much a waste- not to mention being dangerous.
I’ll look for a cite, but IIRC, the combo of products in Excedrin was found in a study to provide superior relief for migraines when compared to various other OTC medications. This lead to the manufacturer relabeling the product, after FDA approval.
My guess is that someone whose handle is thelabdude is familiar enough with solubility tables to figure out how to do a fractional crystallization to make that acetaminophen be less of an issue.
Personally, I had a headache just after reading that…
Seriously, though, I’m always amazed that acet (can we just call it that instead of typing it out every time?) is even on the market. SO MANY other drugs are processed either through the CP450 enzymes (liver) or the UGT enzymes (more liver.) One I forgot to add before (in the UGT group) is Lamictal (lamotrigine.) It’s used for epilepsy and, again, BP I and II. Nobody should ever take AC(how about that?) along with it.
No question about the combination of products in Excedrin’s formulation being an effective remedy for some migraine sufferers. My son likes it. I never got much actual migraine relief from it.
But after the study came out, the fine folks at Excedrin tried to capitalize on the results, and released “Excedrin Migraine,” like it was an exciting new product just now available OTC for treatment of migraine headaches.
And I picked up a bottle of “Excedrin” from the shelf, and a bottle of “Excedrin Migraine” and noticed that each bottle contained the exact same ingredients in the exact same amounts.
~VOW
Are the formulations the same? Do they have the same release and absorption profiles? For that matter, are they even the same colour tablets (I’ve never used either)? It’s possible - though it doesn’t seem to be the case - that the drugs are technically different formulations of the same active ingredient.
Googling seems to suggest that they really are the same tablets/capsules/etc packaged differently, but in some cases where it seems that drugs are the same (like some of the varieties of Tylenol) there is a true difference in the formulation of the drug.
I think the idea is to label them so that Migraine sufferers know this is a good thing to take, which is not how regular Excedrin is labeled. It’s not a scam or anything. And there are other versions of Excedrin which do not have the same formulae.