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#1
Old 06-04-2010, 02:52 PM
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If I take 1 Tylenol and 1 Advil, will my head asplode?

Would that be just as effective for a headache as taking 2 of the same thing?
#2
Old 06-04-2010, 03:16 PM
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They are two different things and they have different effects depending on the type of headache and your own physiology. Given that you don't have any weird allergies or whatever, it won't kill you. How well it will work is dependent on too many variable to give an answer so just give it a try.
#3
Old 06-04-2010, 03:16 PM
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No, it's better, because they work on different biological pathways. I always do this when I need analgesia.
#4
Old 06-04-2010, 03:17 PM
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You'll need to take a nitroglycerin tablet to get things going.
#5
Old 06-04-2010, 03:21 PM
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They'll actually potentiate each other. That is to say together they will work better then the sum of their parts. If I have a killer headache I'll take two Tylenol and two advils to get rid of it. Now, if I have something that I know is going to be bothering me all day (sore throat, pulled muscles, soreness etc etc etc). I'll take Tylenol, wait two hours, take Advil, wait two hours take Tylenol. That way every two hours I'm getting more meds into me, without overdoing it on Tylenol.
#6
Old 06-04-2010, 03:23 PM
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One Extra Strength Tylenol would be 500mg of Acetaminophen, one Advil would be 200mg of Ibuprofen. They are two totally different medications, and don't interact with each other. You could even take the regular dose of each (two Tylenol, and two Advil), and your head won't explode. That's what I normally do when I have a REALLY bad pain.
#7
Old 06-04-2010, 03:26 PM
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This trick is also approved by my cousin, who's an anesthesiologist. She takes 2 extra strength tylenols and 2 advils.
#8
Old 06-04-2010, 03:30 PM
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Originally Posted by Joey P View Post
They'll actually potentiate each other. That is to say together they will work better then the sum of their parts.
Joey P, I have never heard of Acetaminophen and Ibuprofen having a synergistic effect, as far as I know, the effect is additive, not synergistic. They both work through totally different mechanisms of action (Ibuprofen inhibits the COX enzymes, Acetaminophen works through the Endocanniboid system) Do you have a cite for that statement?
#9
Old 06-04-2010, 03:35 PM
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I take a combination of 500mg Tylenol and 200mg Advil for very bad headaches and it works well for me. Makes me drowsy, though, moreso than either of the drugs alone.
#10
Old 06-04-2010, 03:42 PM
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Throw some ibuprofen and naproxen (Aleve) into the mix and report back here.



Disclaimer: Don't. It probably won't do anything, but don't.
#11
Old 06-04-2010, 03:45 PM
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Originally Posted by thelurkinghorror View Post
Throw some ibuprofen and naproxen (Aleve) into the mix and report back here.



Disclaimer: Don't. It probably won't do anything, but don't.
Now, this you shouldn't do. Both Ibuprofen and Naproxen are NSAIDs, and they work via the exact same mechanism. If you take both at the same time, you greatly increase the risk for stomach ulcers, GI bleeds, and a whole host of other possible side effects...

Mixing Acetaminophen (Tylenol) and a NSAID (Ibuprofen [Advil, Motrin], Naproxen [Aleve], among others) is ok. But never take two NSAIDs at the same time!
#12
Old 06-04-2010, 03:50 PM
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Hirka, are you saying not to take Tylenol and Advil at the same time? How come? What would the side effects be? (No, I'm not asking for medical advice.)
#13
Old 06-04-2010, 03:53 PM
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Originally Posted by Jake View Post
Hirka, are you saying not to take Tylenol and Advil at the same time? How come? What would the side effects be? (No, I'm not asking for medical advice.)
No, that's not what I said, Acetaminophen (Tylenol) and Ibuprofen (Advil) are perfectly ok to take at the same time. What I said was don't take two NSAIDs like Ibuprofen and Naproxen (Aleve) at the same time.
#14
Old 06-04-2010, 04:06 PM
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I've actually been meaning to ask this here for awhile, and I figure this topic would be of help:
In layman's terms (or as close to as possible), what are the difference between Tylenol and Advil in terms of beating my headache?
#15
Old 06-04-2010, 04:19 PM
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Originally Posted by enalzi View Post
In layman's terms (or as close to as possible), what are the difference between Tylenol and Advil in terms of beating my headache?
In layman's terms... If it is a normal headache and not migraines, and you take the medication as needed (i.e. not every day)... Take the one that works for you.

There really isn't a big difference between the two medications when used for acute pain relief, so it really is, use the one that works best for you.
#16
Old 06-04-2010, 04:22 PM
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I've had our kids' pediatrician suggest the acetaminophen/ibuprofen combo for stubborn fevers. He suggested offsetting them by a couple hours.

I do it if I had a killer headache or similar that's not really getting solved with just one.
#17
Old 06-04-2010, 04:24 PM
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Thanks, Hirka, my ignorance has been fought and defeated. At least on this subject!
#18
Old 06-04-2010, 04:44 PM
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Quote:
Originally Posted by Bearflag70 View Post
Would that be just as effective for a headache as taking 2 of the same thing?
It would have no effect on my headaches. Tylenol has no effect on any pain of mine, and Advil can help other pains, but not headaches. YMMV.
#19
Old 06-04-2010, 04:47 PM
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When you go to the Emergency Room in the middle of the night with a horrible toothache, they tell you to take 4 ibuprofen (prescription dose) every eight hours and then after the first four hours take two Tylenol, and then keep alternating it till you can get to the dentist.

It does work very well for the short term till for a day or two till you get to your dentist.
#20
Old 06-04-2010, 04:53 PM
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Originally Posted by Hirka T'Bawa View Post
Now, this you shouldn't do. Both Ibuprofen and Naproxen are NSAIDs, and they work via the exact same mechanism. If you take both at the same time, you greatly increase the risk for stomach ulcers, GI bleeds, and a whole host of other possible side effects...

Mixing Acetaminophen (Tylenol) and a NSAID (Ibuprofen [Advil, Motrin], Naproxen [Aleve], among others) is ok. But never take two NSAIDs at the same time!
Good to know. I get your caution, but would two pills do much harm? Even the "maximum daily dose" is conservatively low.

I have a bottle of ranitidine (Zantac) that is 75 mg and warns you to take no more than two a day. I also have a bottle of extra-strength ranitidine which is 150 mg and you should take..... no more than two a day.
#21
Old 06-04-2010, 05:05 PM
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My ex-husband's work used to have a pain killer called PainAid for anyone who
needed it. It was half tylenol and half advil. I think they had to stop making it because it was very hard on the kidneys.
I have had 2 surgeries and a broken arm and they told me to take 2 extra-strength tylenols and 2 advils rotated every 2 hours.
They said a test was done (maybe England) and the people who used this for pain relief actually felt better than the people who took a narcotic for pain.

Last edited by osme; 06-04-2010 at 05:05 PM.
#22
Old 06-04-2010, 05:13 PM
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OK, everybody who posted advice here, raise your hand if you are an M.D. or a pharmacist....
#23
Old 06-04-2010, 05:18 PM
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I'd worry about the effects on my liver. Are they metabolized the same way, or can the liver handle both?
#24
Old 06-04-2010, 05:34 PM
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Quote:
Originally Posted by Hirka T'Bawa View Post
Joey P, I have never heard of Acetaminophen and Ibuprofen having a synergistic effect, as far as I know, the effect is additive, not synergistic. They both work through totally different mechanisms of action (Ibuprofen inhibits the COX enzymes, Acetaminophen works through the Endocanniboid system) Do you have a cite for that statement?
For what it's worth, my nursing textbook uses the Tylenol/Ibuprofen combo as the example under the term "potentiate". But I also agree with you - they may or may not literally potentiate one another, since they work (we think) on different parts of the body.
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Originally Posted by Pleonast View Post
I'd worry about the effects on my liver. Are they metabolized the same way, or can the liver handle both?
They are both primarily metabolised by the liver, but while Tylenol is implicated in liver damage, ibuprofen is not. Even when used by alcoholics and those with liver disease, we don't see further liver damage or a change in the effectiveness with ibuprofen (we do with Tylenol.)

Ibuprofen pain relief works primarily by inhibiting the production of prostaglandins. Prostaglandins are released at the site of the problem and make us feel pain there. Tylenol's mechanism of action is less understood, but it's believed to work on the central nervous system, inhibiting the nitric acid pathways that nerves use to sense pain, including inhibiting the production of the famous Substance P.

So it's entirely fair to say that they work differently, and combining the two will relieve often pain better. Ibuprofen works at the site of the pain, and Tylenol works on the nerves that sense pain.


(Not an MD, but a nursing student studying pharmacodynamics during my summer off.)
#25
Old 06-04-2010, 05:44 PM
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Help me wrap this up: separate by two hours or simultaneous?
And: when pain is coming on, right, After its settled in you're screwed right?. (I get migraines.)
#26
Old 06-04-2010, 06:09 PM
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When it comes to migraines, you want to take meds the very second you feel it, if you get auras (I don't) take the meds then.
As for at the same time or separate, I take them both at the same time for things like headaches where one dose should get rid of the problem, but for things that will come back when the meds wear off (back pain, muscles aches, sore throat) I space them apart. Since you should only take each one of them every four hours, if you alternate your getting something every two hours.

Also, when it comes to migraines, for me, the only things that work are Maxalt (I like the minty dissolvable ones) or injectable Imitrex.
#27
Old 06-04-2010, 06:15 PM
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Quote:
Originally Posted by Leo Bloom View Post
Help me wrap this up: separate by two hours or simultaneous?
And: when pain is coming on, right, After its settled in you're screwed right?. (I get migraines.)
Pain is always easier to treat when it's mild or absent (that is, keep on top of it, don't space out your doses so far that you have break through pain, as long as you follow directions and don't overdose.) I can bore you with the details if you'd like, but let's just say that the "light" pain fibers respond better to pain relief than the "deep" pain fibers. Once you feel a lot of pain, it takes much longer and much higher doses of meds to make it go away again.

It's kind of a pain (ha!) that the dosing schedules don't match up. Tylenol should not be taken more frequently than every 6 hours. Ibuprofen is every 4-6 hours. I set the alarm in my cell phone so I don't get confused.

If you need the ibuprofen only every 6 hours, then take both at once, every 6 hours.

If you need ibuprofen more frequently, a sample schedule might look like:

8 AM - Tylenol and Ibuprofen
Noon - Ibuprofen
2 PM - Tylenol
4 PM - Ibuprofen
8 PM - Tylenol and Ibuprofen
Midnight - Ibuprofen
2 AM - Tylenol
4 AM - Ibuprofen

Of course, always check with your doctor or pharmacist for the pain regimen best suited to you, your body and your type of pain.
#28
Old 06-04-2010, 06:17 PM
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Quote:
Originally Posted by Joey P View Post
When it comes to migraines, you want to take meds the very second you feel it, if you get auras (I don't) take the meds then.
As for at the same time or separate, I take them both at the same time for things like headaches where one dose should get rid of the problem, but for things that will come back when the meds wear off (back pain, muscles aches, sore throat) I space them apart. Since you should only take each one of them every four hours, if you alternate your getting something every two hours.

Also, when it comes to migraines, for me, the only things that work are Maxalt (I like the minty dissolvable ones) or injectable Imitrex.
Thanks. I get headaches where I throw up, but no auras, etc., so I never investigated "migraines" per se. New guidelines, new diseases....
#29
Old 06-04-2010, 06:23 PM
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Originally Posted by Leo Bloom View Post
Thanks. I get headaches where I throw up, but no auras, etc., so I never investigated "migraines" per se. New guidelines, new diseases....
I used to get those too, about once a week. Pain that was so bad all I could do was lay in my bed. Even changing positions made my head POUND, throwing up was awful. Every single week. My doctor gave me imitrex pills, but because of the nausea, I couldn't swallow them. The injections where a godsend. A shot in the arm and I could feel the effects within seconds. The excruciating part of the pain would be gone in minutes, the majority of it was gone in 10 to 15 minutes and the rest lingers for another hour, but I could be up and moving within 5 minutes. Gotta love it. Using pills instead of the injectables (imitrex, maxalt) works, but instead of the pain being gone in minutes, IME it takes about two hours. Still worth it though since Tylenol and Advil don't even put a dent in a migraine.

ETA, luckily I only the the OH MY GOD I'M GOING TO DIE, KILL ME NOW migraines about once a year. I still get migraines several times a month, I still give myself a shot of imitrex to get rid of them, but they aren't debilitating anymore.

Last edited by Joey P; 06-04-2010 at 06:24 PM.
#30
Old 06-04-2010, 06:38 PM
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Originally Posted by CookingWithGas View Post
OK, everybody who posted advice here, raise your hand if you are an M.D. or a pharmacist....
[Half raises hand], I'm not a pharmacist yet... but I am currently in pharmacy school, and am a licensed Pharmacist Intern. I am as of today, 380 days away from graduation.
#31
Old 06-04-2010, 06:43 PM
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This has been a great thread for me - I don't get migraines, but I get bad headaches that are just a touch worse than just a couple of Tylenol can handle. I'll add in the ibuprofen and see how that goes next time I get one.
#32
Old 06-05-2010, 01:33 AM
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Originally Posted by Pleonast View Post
I'd worry about the effects on my liver. Are they metabolized the same way, or can the liver handle both?
It's been already said- Acetaminophen is the big bad for the Liver (though there are studies out there that say in high doses it can impair your kidneys, but usually your liver's taking the hit first in those high level doses). NSAIDs on the other hand (COX-1,2 inhibitors- your Aspirins, Ibuprofens, and such) cause more problems for your Stomach and your kidneys. So the NSAIDs aren't really going around trashing your liver, but they will cause stomach ulcers and can cause renal complications in higher doses. That's why if you're taking brand name medications, it's always good to read your labels and see what's in each one- especially when combining medications.

The problem with Tylenol overdoses is REALLY not a pretty sight, and it's quite insidious, as people tend to feel sick and awful, but then they'll feel better- there's a slight upswing and then it's 24 hours or so later that the liver completely crashes, and the jaundice and liver failure really starts to kick in.
#33
Old 06-05-2010, 03:07 AM
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Originally Posted by Markxxx View Post
When you go to the Emergency Room in the middle of the night with a horrible toothache, they tell you to take 4 ibuprofen (prescription dose) every eight hours and then after the first four hours take two Tylenol, and then keep alternating it till you can get to the dentist.

It does work very well for the short term till for a day or two till you get to your dentist.
Nitpick: We will tell you this if you don't have any of the contraindications for taking higher, prescription strength NSAIDS. If you do, or if you're not sure, you should probably be careful about trying this at home.
#34
Old 06-05-2010, 03:16 AM
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Originally Posted by Hirka T'Bawa View Post
No, that's not what I said, Acetaminophen (Tylenol) and Ibuprofen (Advil) are perfectly ok to take at the same time. What I said was don't take two NSAIDs like Ibuprofen and Naproxen (Aleve) at the same time.
From what I read, Ibuprofen and Naproxen can be taken at the same time (but remember you have to count the dose for each additively.*) However, Aspirin and Naproxen (Aleve) should never be taken together.

wiki " Naproxen is also not recommended for use with NSAIDs of the salicylate family (Aspirin) (drugs may reduce each other's effects) or with anticoagulants (may increase risk of bleeding)."
--------------------------------------------------------------------------------------------
* In other words, you can use Acetaminophen with Ibuprofen/Naproxen and count the dose of Acetaminophen seperately from the Ibuprofen/Naproxen but those two must be added together, so if the daily dose is (for example only)
4=Naproxen or
8=Ibuprofen or
8=Acetaminophen

You could then (using our example, I am not suggesting this) take 2 Naproxen and 4 Ibuprofen in a day (spread out) AND 8 Acetaminophen. But NOT 4 Naproxen + 8 Ibuprofen. You should consult your MD before taking any OTC medication for an extended period, he may suggest less or even more (My Doc sez I can take up to 8 Naproxen a day for the arthritus, but he knows my system very well and I get regular check ups, etc).

Warning about Acetaminophen/Tylenol. It is in many OTC cold etc remedies. So, it may be very bad to take the normal daily dose of Tylenol, and also the normal daily dose of Nyquil. READ THE LABEL!

Cat Whisperer- the combo of aspirin + Acetaminophen + caffiene (which is what Excedrin is) seems to be very effective on headaches for many. You can find generic combos of the three, or just take a regular dose of the two pills and a cuppa.

As always consult your MD.
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#35
Old 06-05-2010, 05:06 AM
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Originally Posted by ToeJam View Post
. . . Acetaminophen . . . can impair your kidneys, but usually your liver's taking the hit first in those high level doses). . .
This is often stated but I doubt you'll find a cite to back up the claim that acetaminophen is toxic to the kidneys except, perhaps, as a result of chronic, high dose use. In other words, even in massive acetaminophen overdose, there is no ill effect on the kidneys (except, possibly, that which sometimes occurs secondarily as a result of liver damage from the acetaminophen).
#36
Old 06-05-2010, 08:19 AM
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Quote:
Originally Posted by Hirka T'Bawa View Post
Joey P, I have never heard of Acetaminophen and Ibuprofen having a synergistic effect, as far as I know, the effect is additive, not synergistic. They both work through totally different mechanisms of action (Ibuprofen inhibits the COX enzymes, Acetaminophen works through the Endocanniboid system) Do you have a cite for that statement?
I have no idea about a synergistic affect between those two drugs, but since it hasn't been mentioned here, I would like to point out that caffeine does potentiate analgesics. It's why some medicines (e.g. Excedrin) are acetaminophen, aspirin, and caffeine.
#37
Old 06-05-2010, 11:17 AM
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Originally Posted by KarlGauss View Post
This is often stated but I doubt you'll find a cite to back up the claim that acetaminophen is toxic to the kidneys except, perhaps, as a result of chronic, high dose use. In other words, even in massive acetaminophen overdose, there is no ill effect on the kidneys (except, possibly, that which sometimes occurs secondarily as a result of liver damage from the acetaminophen).
Yep, I wasn't even going to mention the Kidney thing until I looked it up and saw it in a few sources, the numbers were something like around 2% of overdoses of Tylenol lead to renal failure and such, so I had to throw that out there, but normally I didn't tend to associate the two together.
#38
Old 06-05-2010, 11:37 AM
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While we're here, does anyone know if Ibuprofen does anything to GABA receptors and, if so, whether A or B?

Oh, and the doctor told my mother to do the 2 hour switch thing, as long as it's not long term.

Finally, does anyone know why, when I was younger, it seemed like you were told to take 3 advil, and now are told to take 1, and then another if it doesn't work? Or was I just misinformed as a kid?
#39
Old 06-05-2010, 12:04 PM
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My oral surgeon told me about the ibuprofen/acetaminophen thing after I had a tooth pulled. I discovered at that time that it also helped my severe menstrual cramps. YMMV.
#40
Old 06-05-2010, 04:53 PM
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Quote:
Originally Posted by Leo Bloom View Post
Thanks. I get headaches where I throw up, but no auras, etc., so I never investigated "migraines" per se. New guidelines, new diseases....
Migraines don't always produce auras. I had migraines for a couple of decades before I got one spectacular aura, and it never repeated. My mother, on the other hand, got auras very frequently, but never with a headache.
#41
Old 06-05-2010, 05:02 PM
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Originally Posted by panache45 View Post
Migraines don't always produce auras. I had migraines for a couple of decades before I got one spectacular aura, and it never repeated. My mother, on the other hand, got auras very frequently, but never with a headache.
Never had an aura either. From what I understand they're quite a bit easier to control if you get them. They only way I know a non-debilitating headache is a migraine is if two doses of Tylenol spaced about 45 minutes apart (I know) don't put a dent in it or it continues to get worse. Then I pull out the heavy artillery (6mg Sumatriptan IM).
#42
Old 06-05-2010, 07:07 PM
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Thanks to Excedrin, I assume there's no problem with Tylenol + aspirin (in general, provided you don't take excessive doses of either) but what about ibuprofen + aspirin? Is that going to do anything bad (again assume the doses for each aren't excessive on their own).

And then there's three. Would the Tylenol + aspirin + ibuprofen combo be problematic (assuming normal doses of each again)?
#43
Old 06-05-2010, 08:24 PM
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Aspirin and Ibuprofen are both NSAIDs- so you're basically increasing the effects of the same drug (see all those stomach ulcers and kidney issues and such things from above).

The only extra thing will be that the aspirin will also thin your blood, but it's a COX inhibitor just like Ibuprofen, and so it's like taking the same medication again. (Same issue for when you take 3 medications- you're basically just taking Acetaminophens and two NSAIDs- which are the same medication) You are just increasing the amount of NSAIDs you're taking, it's just redundant- you'd get the same effect if you took an equal amount of tylenol and either of the two NSAIDs, you'd get the equivalent to your 3 combination.
The major different in Aspirin and Ibuprofen is they both have anti-clotting effects, but aspirin lasts longer, while Ibuprofen is considered to have a slightly stronger analgesic component.
(Aspirin has always been considered a "weak" analgesic in the NSAIDs family, and better suited for inflammation and anti-clotting effects more so than pain relief when prescribing it- easier to go with another NSAID for pain relief and not have the side effect anti-clotting issues to deal with- that was an issue in another GQ Question thread if I recall, about a week or so ago).
~~~~~
As for the GABA issue, that deals with Neurotransmitters more so (things like benzos and such drugs deal with GABA). NSAIDs are non-steroidal anti-inflammatories, and they work on COX 1 or COX 2 receptors (or both in some drugs), not GABA receptors.
#44
Old 06-05-2010, 09:00 PM
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Originally Posted by DrDeth View Post
<snip>

Cat Whisperer- the combo of aspirin + Acetaminophen + caffiene (which is what Excedrin is) seems to be very effective on headaches for many. You can find generic combos of the three, or just take a regular dose of the two pills and a cuppa.

As always consult your MD.
I can't tolerate caffeine, so I think I'll just try the two together.
#45
Old 06-10-2010, 01:26 AM
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I'm kind of lost here, I'm feeling a migraine starting right now (not too bad, took two ibuprofen). When I wake up in the morning, if I still have it, could I please have the recipe one more time, spelled out slowly and carefully for this hurtin' dummy ?

I have ibuprofen, aspirin, Tylenol, and Advil. How many of what again, and when?
#46
Old 06-10-2010, 01:45 AM
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I'm on my phone, so forgive any grammar errors.

You can take 400mg of ibuprofen (two OTC tablets) and 1000 mg acetaminophen (two extra strength tylenol) at one time. You can take that every 4 to 6 hours. Maximum of 3200mg of ibuprofen and 4000mg of acetaminophen in 24 hours. As long as you don't have any other health conditions.

Oh, and advil is a brand of ibuprofen, so they are the same thing.
#47
Old 06-10-2010, 02:11 AM
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Join Date: Nov 2005
Location: republic of california
Posts: 5,328
Ibuprofen and advil are exactly the same drug, generic name and brand name. Ibuprofen and aspirin are both members of a group of drugs called NSAIDS which stands for non steroidal anti inflamatory drugs. This group of drugs also includes things like Voltaren, Alleve, and Toradol. As such, they all have similar side effect profiles, esp being hard on the stomach and potentially causing GI bleeding, and you should probably only be taking one med, from this class of meds, at any one time.

Standard short term dosing for Tylenol is 650mg (2 regular) to 1000mg (2 extra strength) every 4-6 hours.

Standard ibuprofen dosing is 400mg (2tabs) every 6 hours. Prescription strength ibuprofen is usually every 8 hours with a little something in your stomach to protect it.

As noted above, Tylenol is found in many combination OTC drugs. Any
sneezing-sniffling-achy-so-you-can-rest' probably has tylenol in it.

You should also know that some prescription pain relievers also have it. PercoCET, DarvoCET have aCETaminiphen (Tylenol), as does Vicodin, you should not take tylenol and these meds at the same time.

As always, this is general information readily available online, I don't know shit about your personal health.

Last edited by outlierrn; 06-10-2010 at 02:13 AM. Reason: and I see Hirka posted while I was composing
#48
Old 06-10-2010, 05:01 AM
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Posts: 721
The combination of ibruprofen and paracetamol are these Maxigesic tablets. Available, at least on the NZ market, over the counter at pharmacies.
#49
Old 06-10-2010, 06:47 AM
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Quote:
Originally Posted by Markxxx View Post
When you go to the Emergency Room in the middle of the night with a horrible toothache, they tell you to take 4 ibuprofen (prescription dose) every eight hours and then after the first four hours take two Tylenol, and then keep alternating it till you can get to the dentist.

It does work very well for the short term till for a day or two till you get to your dentist.
It sounds like a good way to destroy your liver. People on this board have dealt with liver failure taking too much Tylenol.
#50
Old 06-10-2010, 09:03 AM
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Quote:
Originally Posted by Harmonious Discord View Post
It sounds like a good way to destroy your liver. People on this board have dealt with liver failure taking too much Tylenol.

It sounds like pretty standard tylenol dosing to me.
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