Why not Ibuprofen or Aspirin?
The two together work better than they do alone. Also, I have read that the acetaminophen combination is supposed to discourage people from taking larger than prescribed doses, because acetaminophen overdosing is quite dangerous. NSAID combinations are available, but aren’t usually prescribed.
Opiates are available with ibuprofen, aspirin, and I believe without any “mixer”, but I think the reason acetaminophen is used most often is, as **cj ** says, to punish addicts.
I may be wrong because I’m not a doctor. Probably Qadgop will be along to set us straight.
I have wondered that myself but that is a really odd reason if it is true. True addicts don’t tend to pay much attention to safety warnings. It seems more than a little unethical to make something more dangerous in order to discourage drug abuse but I could be wrong. Still, I don’t think your average opiate addict is going to care in the short-term if they destroy their liver with generic Tylenol as long as they get their fix.
I believe, as was said already that Hydrocodone was paired up with apap to try to keep people from taking too much. However, they’ve recently been reducing the amount of apap. Up until recently “Vicodin” (written as just Vicodin) had 500mg of apap in it, but to help keep people from destroying their livers, they’ve reduced it to 300mg. I beleive, however, that a doctor can write it as 5/500 or some other combination (7.5/500 etc) if they want to, but if they continue to write “Vicodin”, it’s 5/300. IIRC, that caused both minor and major headaches a few years back when doctors, patients and pharmacists had to write and rewrite scripts to get everything filled properly.
As for the rest of the OP, there is Vicoprofen but I don’t know why it isn’t used more often. I can only assume either because of stomach issue or because of how common regular Vicodin is, it’s just easier to go with one drug and tell people to take Advil if they need more.
They do have them without any other drugs mixed in, that’s what Oxycontin is. There’s also straight up hydrocodone (and, I assume, codeine), but like Vicoprofen, I’ve never heard of it be prescribed to anyone.
Acetaminophen is actually a stronger analgesic than most people would think. I found that out while working at a pizza place before starting pharmacy school, and burned my hand on the oven. All the painkiller I had was some Tylenol, and two of them took the pain away. :eek: I was very pleasantly surprised.
That it also discourages abuse (sort of) is another reason why it’s included. There’s also Vicoprofen (hydrocodone with ibuprofen) and that is very rarely prescribed. When I worked at the grocery store, I had a customer who took it regularly (and did not abuse it) but that was about it.
Any narcotic works better with acetaminophen. The idea behind having both in the same tablet was to limit overprescribing of narcotics such as morphine and hydromorphone by having a medication that has a maximum daily dose based on the acetaminophen content. The trade off used to be that norco (the hydrocodone with acetaminophen combo) was a schedule III medication while morphine, hydromorphone, etc. are schedule II. Essentially physicians could prescribe norco without having to apply for privileges to prescribe schedule II medications. That all changed recently when norco was also moved up to schedule II. Now with the change in schedule for norco, throwing in the acetaminophen no longer really serves a purpose. It used to be to help prevent overprescribing, but now it’s just as easy for a physician to prescribe an equi-analgesic dose of morphine and add Tylenol separately if that helps control the patient’s pain. Norco is still used quite a lot, but I think that’s mostly due to physicians being used to using it when it was still schedule III.
Huh. I had some pretty major foot surgery recently, enough that I was writhing in pain for about 3 days. Previous rounds a few years ago, they gave me a vicodin script pretty much every time. Would generally be for about 30 of them - enough that I had probably 5 bottles and maybe 100 to 150 of them leftover.
I’m one of those who doesn’t abuse the shit - that’s why I have so many left. I’ve sparingly taken just one or 2 on a rare occasion when in severe pain, and that’s added up to maybe 10 of them taken in 5 years.
Anyways, I left the tablets at a house I couldn’t get to after the surgery, and because of some other assholes getting addicted, I had to stack ibuprofen and tylenol at their maximum allowed doses to shittily relieve the pain.
Ever heard of denatured alcohol? I don’t know if tylenol is added to the pills for the same reasons, but there is certainly precedent for adding poison to an addictive substance to prevent abuse.
Looking around the web one point made in several discussions about this is that tylenol has anti-inflammatory agents that hydrocodone doesn’t and there are pure hydrocodone pills available so abuse prevention has nothing to do with it.
I agree with the the “punishing the addict” theory. It used to be relatively easy to remove the Tylenol via the cold water extraction method. The pills are now specially formulated to prevent this.
Wow. After surgery years ago I was sent home with Tylenol with codeine. I did cold water extraction to avoid the acetaminophen (I like to drink alcohol and avoid acetaminophen).
Keep in mind denatured alcohol is not meant to be ingested at all. It is used as a fuel, disinfectant, or solvent.
Acetaminophen is not an anti-inflammatory.
5/300 should cure most headaches, no? 
There’s also the issue that if a patient is already taking a crapload of pills having a combo or two reduces the number of those.
The use of Tylenol is discounted, but it’s an integral part of my spouse’s cancer treatment and he finds it effective as part of the over all pain cocktail. Anything effective against cancer pain is not to be sneezed at. If people discount acetaminophen it’s more because it’s so common and OTC so it’s perceived as not as strong as something that requires a doctor’s Rx
After I had foot surgery twice, I was on Demerol and taking Advil in between the Demerol to keep the pain under control because a lot of pain is caused by inflammation. I agree with you. I have always heard Advil for pain, Tylenol for fever.
As a former migraine sufferer, my anecdotal experience is that Vicodin was pretty much useless for that kind of headache. Your run of the mill headaches can be alleviated with Tylenol just as effectively as with Vicodin.
The reason it is denatured is to poison people who try to drink it.
Yes, Acetaminophen actually does the heavy lifting as far as actual pain relief goes. The hydrocodone does give you a fuzzy, euphoric feeling and makes it easier to go to sleep.
Unlikely as acetaminophen was combined long before the really knew the dangers of acetaminophen overdosing.