I’m another one of those people that gets no benefit from Tylenol.
Ibuprofen works really well for me. Same fir my brother, after his last oral surgery I gave him some and he told me they worked better than “the ones the doctor prescribed”, which were some variation of opiates.
Ibuprofen works better for me for both headaches and post oral surgery pain….which is what I’ve typically used them for. I think it’s because of the anti-inflammatory effects.
But while the ibuprofen is a better pain reliever, the opiate pain relievers make me feel better about being in pain.
When Tylenol became an OTC drug, it was for me like he clouds opened and angels sang.
That stuff works so well for me, I rarely even need the max dose-- I’m kind of bummed that no one makes regular strength (325mg) in generic. It works for toothaches, cramps, and post-operative pain. Which is fortunate, because after a couple of days, I start getting headaches on steady narcotics. As soon as I can, I’d rather take them before bed only, and take Tylenol during the day.
Albeit, after my last abdominal surgery, I got something brilliant-- a device that delivered a steady dose of a local anesthetic internally to the area of the surgery. I woke up with both that and a fentanyl drip on a button. I think I pushed the button twice-- once about two hours after I woke up, and once when I was ready to sleep the first night-- mostly as a knock-out med, because I’m not great at sleeping on my back.
I said I didn’t think I’d be using the fentanyl, and so it was gone the next day.
I had the local in place for five days, and 500mg Tylenol when I asked. The second night, the gave me Ambien.
Tylenol even helps with migraines-- although, it wouldn’t do crap by itself, I’m the first to say. I need 200mg of sumatriptan, if that’s all I take, but I just need 50mg if I also take 500mg Tylenol, and 100mg caffeine.
I’m pretty sure Excedrin Migraine has acetaminophen (Tylenol generic) in it-- isn’t it aspirin, acetaminophen & caffeine?
Acetaminophen has never had any pain-relieving effect on me whatsoever. Hydrocodone, oxycodone, demerol, any opiate/opioid has always worked great, with no need or desire to up the dose over time.
With all the praise for ibuprofen, I think it’s time for me to switch to that from Aleve, which doesn’t seem to do much for my knee pain.
A side question on dosages: does the size of a person make any difference to OTC dosages? I’m twice the size of my husband (for example) by weight; it seems intuitive to me that I might require, and be able to handle, higher dosages than he would. I’ve never seen this addressed.
Acetaminophen works okay for me for fever and the general achiness of a cold or flu. It seems to help a little for headaches (but not migraines). However, for post-surgical pain, the only way it gives me relief is if it’s in a pill with a narcotic. As for arthritis pain, I strongly suspect that’s it’s just as effective as a placebo.
I’ve been specifically told by my doctors not to take any NSAID after surgery because of the increased risk of bleeding, and the older I get, the more my doctors discourage me from using them at all. Apparently the risk for GI bleeds increases with age.
Narcotics are a terrible choice for chronic pain, and I understand why doctors are reluctant to prescribe them long-term. However, as a short- term measure against acute pain, they’re a godsend for a lot of people and it makes me angry that heavy-handed measures for addiction prevention are making doctors so leery of prescribing then even when they’re appropriate. If I’m in the ER with an injury or I’m a few days postop, you bet your ass I’m drug-seeking - they keep telling us it’s crucial to keep pain levels down in order to heal, and OTC meds aren’t going to cut it in those first few days!
I’m convinced that when it comes to pain, medicine really doesn’t have many answers. Half the time, it feels like they could be waving a and and chanting a spell. It’s different for each patient, it’s hard to quantify, and a drug that works for one person - or even at different times for the same person - won’t work for another.
That’s what my wife was told — also for pre-surgery for a week.
And in the personal and unusual anecdotes department, she hadn’t used acetaminophen for decades, and thought it provided no pain relief —then discovered it was quite effective in the pre-surgery time.
But, post-surgery when she was prescribed Tylenol with hydrocodone she developed allergy symptoms (irritated throat and extreme nervousness), which vanished when she switched to her normal ibuprofen and unalloyed hydrocodone. So she now believes she’s allergic to acetaminophen, which is very uncommon.
NSAIDs like ibuprofen and naprosyn are safer than acetaminophen (which can easily damage your liver if you’re not careful), but they’re not perfect. Also already noted, they can cause bleeding. They can also cause kidney damage. I learned that the hard way when caring for my dad in the last few years of his life. He developed bursitis in his hip, for which the doctors okayed prescription-strength ibuprofen. His kidneys shut down after a few weeks, and he had kidney damage for the rest of his life. The combination of ibuprofen and lisinopril (his blood pressure medication) was particularly bad.
When I got CAR T-cell therapy at MD Anderson, I got a few fevers of over 100°F and the first line for that there was Tylenol and ice packs for my armpits. The fevers didn’t last long, so that’s some (weak) evidence that Tylenol does something for fever in my case.
I would disagree with that. Toxicity from acetaminophen is unlikely in an adult in single doses under 8 grams. Once the dose is 12 grams or higher toxicity is very likely though. Other mitigating factors such as chronic alcohol consumption, recent chronic alcohol cessation, and other factors. It truly takes a deliberate and significant overdose to get the vast majority of folks into dangerous territory. It’s the deliberate intentional overuse that causes most morbidity and mortality. The drug is relatively safe otherwise.
Meanwhile, the NSAIDs, at normal dosage, increase the risk of kidney dysfunction, GI and other bleeding, cardiac dysfunction, etc.
Personally I’ve seen far more illness and death caused by patients taking NSAIDs than I have from them taking acetaminophen.
And overall, the medical community considers acetaminophen safer than NSAIDs. However, individual circumstances vary widely. Hence the need for taking a good medical history before recommending one over the other.
When I’ve needed a few days of pain relief, Codeine has been a huge help. I do drink more alcohol than the average person, so I shy away from acetaminophen and NSAIDs.
When my doctor prescribes acetaminophen with codeine, it is simple kitchen chemistry to isolate the codeine and pour the acetaminophen down the drain.
With usual caveat that no one here is my doctor, don’t know my history, for entertainment purposes only:
I’m one for whom Acetaminophen does very little for pain management, even generic headaches.
A couple times a week 65ish me would take one or two Ibuprofen at bedtime to mute the minor aches so I can sleep well.
But I’ve recently been put on Eliquis, and taking NSAIDs is contraindicated.
So what can I do, that is effective, for these minor aches or headaches, particularly at bedtime?
When it’s been particularly bad, I will take one Ibuprofen at bedtime, but only occasionally.
Risky?
I am not your doctor. Internet advice is often worthless and you should see your own doctor who knows your history and inform your doctor of what you do.
That said, the standard advice might be:
take a full dose of Tylenol for one day to fairly evaluate it, two 500mg tablets every six hours, works way better than just one occasionally
consider creams, including capsaicin and menthol, A535, heat or cold patches
NSAID lotions like Voltaren might affect your INR less than tablets but should be discussed with GP
headaches might be caused by sinuses, stress (WHO is your headache), too much caffeine, too much medication and many other things
It’s never worked well for me. And apparently the ‘effective dose’ and the ‘toxic dose’ are unpleasantly close? Would it even have been approved under current guidelines?
There’s a vast difference between medications given by IV or injection and the same medication taken orally. The Demerol I took in pill form was very effective at managing pain but it didn’t create any noticeable opioid high. When I got a Demerol injection in the hospital prior to getting a dislocated finger reset, I was higher than a kite! The world was suddenly a beautiful place and I watched with unconcerned mild interest as the doctor forcibly snapped the finger back into place.
As part of my previous job I used to hand out OTC painkillers to students. They were not suposed to keep their own.
I always asked them; "would you like to destroy your liver, (acetaminophen), or your kidneys (ibuprofen). They are both very bad for you to keep relying upon for discomfort, and that is what most pain is, discomfort. If it is something more then you need further medical treatment of some kind. OTC pain meds are very bad for you to keep taking long term.
