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Comment by Alex3917 | Hacker News Reader

At 1200mg/d, I feel like destroying your reproductive system would be the least of your concerns.

Is the /d per day? If so that's well within what I've seen "normal" people take.

A regular Advil is 200mg. The usual dose is two pills, so 400mg. If your larger it's common to take three or four pills. Multiply by a dose ever six hours and it's quite easy to get to 3200mg per day.

Yup; after seeing my mom be recommended 3-4 pills every 6 hours as needed for knee pain, I sure don't bother with just 2 pills as a 200# male if I "need" ibuprofen. I either take 3, or I take nothing.

Fortunately I have no chronic issues, rarely need ibuprofen (in fact I'm paranoid about taking it for muscle aches as I've always felt it must harm muscle development, which seems to be catching traction as a theory), and generally avoid medications altogether, but it seems like if you're taking it, might as well take a dose that will do something.

TIL that my pain is weak and mild, even when I think I'm in a lot of pain. I'm well over 200 lbs (still), but 200mg of ibuprofen usually eradicates whatever pain I have. If it's really bad pain, then I take 400mg.

TIL I have only experienced pain a few times in my life, and this apparently doesn't even include when I have had extensive dental work done as I don't let them give me any novocaine and don't mind them drilling into my teeth or cord packing my gums.

I am really hoping that it isn't just that you all are like, five years older than I am, and so I have to expect that I am going to just end up in pain a lot soon :/.

I think it depends on the person, a friend of mine would act out WWE type stunts: jumping on a trampoline full of tacks, getting hit with a chair in the head and bleeding all over... He says the pain tolerance has stayed with him through the years.

I really have no idea where you got that from in this thread.

A regular dose in the United States is 200mg. In other countries, Spain for instance, you may see up to 800mg over the counter.

I've had two doctors suggest taking over 2000mg a day like it was nothing. One of them was a fellow hiker on the Appalachian Trail and suggested it as a daily regimen for regular joint pain (common for long-distance hikers). The other suggested it for aiding recovery from mild frostnip. (In both cases, I ended up only taking it for a few days.)

Unless you have stomach problems—NSAIDs are linked to ulcers—high doses of ibuprofen have not been thought of as terribly risky.

A nephrologist I went to a year or two ago explained to me that the danger of ibuprofen is total lifetime consumption. Once you approach 9lbs or so (surprisingly easy to hit if your habit is daily) your risk of kidney failure increases exponentially.

Interesting. I guess that's consistent with those doctors' advice since in both cases it suggested for a limited period, a few months and a few days.

That's roughly one pill a day for 50 years.

My nephrologists all say NSAIDs on long term use have a risk for acute kidney failure. They say Tylenol is safe in long term as long as liver is otherwise healthy and you stay under daily dosage limit.

Tylenol definitely accrues liver damage over time.

And your nephrologist is correct about NSAIDs. One of their direct effects is to reduce afferent blood flow to the kidney. Every time you take one you’re telling your kidney, “that amount of blood you think you need? Have a little less.” Blood flow to the kidney is extremely carefully regulated - this is never a good thing.

Yeah, Tylenol damages the liver instead.

I've been prescribed up to 2400mg/d for a few weeks to deal with my knee. Not for the painkilling aspect (Because it wasn't painful), but for the anti-inflammatory.

Same with me, for a pinched nerve. Both for pain and anti-inflammatory.

IIRC, one can take up to 2400 mg/day at 800 mg per dose for up to 10 days on a prescription.

Yeah, I have to say "Common drug X has negative side effects after sustained daily exposure to high dosages" is hardly surprising. The study says participants were given 1200mg per day for six weeks. For reference, a typical ibuprofen capsule in the US is 200mg.

I'm sure this result is useful for the medical community or men specifically dealing with hypogonadism, but it doesn't seem to have a great deal of relevance to the average consumer who uses ibuprofen for occasional pain relief.

> 1200mg per day for six weeks. For reference, a typical ibuprofen capsule in the US is 200mg.

Most people take 1-2 capsules (400mg), and the dosage documentation says no more than 8 per day (1600mg). The study seems to demonstrate people using the drug well within its over-the-counter maximum dosage. (When I tore up my knee as a teenager, my doctor prescribed it at about double that rate.)

If your doctor gives an Rx, they acknowledge that they're making a tradeoff and that it's the most applicable one for your overall health. I'm sure studies like this are helpful information for making such decisions, but this definitely doesn't seem to mean "taking ibuprofen will make you infertile".

For what it's worth, I've also been Rx'd large ibuprofen dosages for a period of weeks at various times, and I've had six mostly-non-defective kids so far. I don't think this study warrants any type of generalized panic...

I think I understand what you're saying, but anecdotal evidence isn't really the point here. The article is pointing toward a societal trend, not one that is likely to be observed on a case by case basis.

That said I do agree. All medications are a trade off of some sort. Usually the consequences aren't as bad as the effects of the drug, and I think this is no exception.

1200mg is only 2 capsules 3 times per day, less than the maximum recommended for over the counter use. However any pharmacist would tell you not to use it for more than a few days in a row without seeing a doctor.

I take a single 400mg pill whenever my head hurts, so I can imagine that 1200mg/day for a more serious issue is not that uncommon.

I used 2400mg/d for a week after getting my wisdom teeth out. It wasn't enough, but it was the maximum dosage according to the package.

That is actually the dose I use for my lower back pain and inflammation when it flares up - for a couple of days perhaps once or twice a year. Dates from a slipped disc about 20 years ago. Never serious enough for surgery, but still unpleasant.

Have you tried dropping the dose and interleaving with acetomenophin? I have been hearing recently that's an increasingly popular strategy, sharing the load between the kidneys and liver.

Because they work in different ways, that's what I'm fond of doing for myself and my children. Start with ibuprofen, then try a table of acetaminophen a couple of hours later.

If it's a really bad headache, start with one of each.

Our pediatrician recommended this when treating a fever. Alternate Tylenol and Motrin, then you can dose every 3 hours instead of every 4.

Ibuprofen doesn’t work as an anti inflammatory until you take at least 2400mg/day.

Here is a study[0] which directly contradicts that claim:

"Thus, the higher dose of ibuprofen (2400 mg per day) was not superior to either the dose of acetaminophen (4000 mg per day) or the lower dose of ibuprofen (1200 mg per day) for pain relief or improvement of function."

http://www.nejm.org/doi/full/10.1056/NEJM199107113250203#t=a...

Have a source on that? When I was in college I had some bad inflammatory issues to the point where I couldn't even walk, but it only took 200mg once or twice a week to completely fix the issue. When I didn't take any at all it would get worse and worse until I couldn't even stand up, but as soon I took it I was completely fine in 20 min or so.

I was recommended 1200mg/day for carpal tunnel inflammation, and it helped.

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