Sounds like the industry responding with "we cant really know guys, right?"
I'm throwing away my Advil right now. Screw that.
In fact, i cannot think of any disease that literally kills. Even with the big stuff like cancer or aids, it is always the symptoms that get you. They damage body systems and the decline of those systems (aka symptoms) eventually causes the cardiac arrest or internal bleeds that shut off nutrients to the brain. Those symptoms are just as lethal no matter thier cause. A massive fever that stops normal body chemistry, whether caused by flu or ebola, will kill you just the same.
For those talking about hyperthermia killing, yes but in almost all those cases the cause is not an infection.
In fact, I would say that paracetamol kills a hell of a lot more patients than it actually ‘saves’.
A study I have taken to heart is that permissive hyperthermia (up to 40 deg c) in ICU patients has a greater survival than those where fever is treated aggressively.
Physiologically, this resonates because high temperatures activate the immune system and raised temperatures are non-optimal for bacterial proliferation; so the immune system is primed by fever; suppressing it can dull immune system response.
In fact, malaria was used as a treatment for syphillis in the early parts of the 20th century because high temperatures kill spirochetes. There are also a decent number of case reports of cancers going into remission following fever.
However in my quick mobile google then I could only see the following study that demonstrated no advantage for either control of permissive hyperthermia group in ICU patients; so perhaps I was relying on a study that has been superceeded.
You don't want to stop a fever ~ just keep it within the safe zone where it's healing, but not dangerous.
And an acetaminophen tablet is a painkiller. While your statement is in fact true, ibuprofen is still a better choice for a fever. The latter is also generally considered a safer alternative, especially in long-term use — even though alternating the two would be ideal.
On top of that numerous recent studies have shown many potential problems.
https://www.webmd.com/drug-medication/news/20150302/does-lon...
> Heavy use of acetaminophen is associated with kidney disease and bleeding in the digestive tract, the paper reports. The medication also has been linked to increased risk of heart attack, stroke and high blood pressure, the study authors noted.
> One cited study even showed that overuse of acetaminophen can increase a person's risk of early death as much as 60 percent, the study authors found.
What's wrong with cannabis-derived solutions, again?
Also, FWIW, in the past, I tried both CBD and THC without any luck where Ibuprofen helped so it's certainly not 1:1
What forms did you try? What brands? Were they lab tested?
Like any "new" drug - there's a lot of nonsense floating around.
Please don't simply buy CBD capsules from Walmart, and say "this shit doesn't work for me".
And others.
True or not, parent wasn't just making up the empathy-painkiller association.
(Even though it's clearly not net-helpful due to the serious physiological side-effects.)
That's amazing!
... why isn't there more research on isolating this particular side-effect?
To me and his parents this was pain management gone way over dose! But we’re not medical experts and should not be doing clinical decisions since at one end of this rabbit hole you will find anti-vaccination and other nut jobs.
So what to do?
There is nothing wrong with opiates being used for acute pain relief. They are a modern miracle when put to such uses.
The problem comes when you start using them for long-term pain relief - a use-case in which they are neither appropriate or effective.
A typical 2-3 day prescription after major dental (or other) work is not remotely a problem, and I really have no idea why this is where the focus is. It's always been long-term abuse as the actual problem - the weird overreaction over a few days use for acute pain is utterly absurd and only hurts people in some bizzare way for folks to feel they are "helping" fix the abuse problem.
I had Oramorph for abdominal pain (in hospital, no surgery thankfully). The condition may have been caused by medium term use of Ibuprofen (in my non-medical opinion).
One thing is not to put medicines, OTC or not, into the trash. They are nasty stuff to have in the dump.
As for the drugs: don’t take analegics if you don’t need to; do if you can’t tolerate the pain. Everybody has a different level of pain and tolerance and I bet the prescription said something along the lines of “...as needed”
As for other prescriptions, do your research; odds are you do need it but not always.
My recommendation is to go and talk to your doctor and confront him or her with this "finding".
Also, most importantly, this "finding" has been out for almost a year now. I wonder what's the more recent development on it.
These doctors don’t just give pills out randomly, they do it for a reason based on evidence and science. A side note is that my pharmacist made it very clear to only use the painkillers as necessary. You should always consult the doctor and pharmacist after major surgery to clarify these things if needed.
IMHO the doctors should prescribe less at first and see if it would be enough, but I also get that they are overcrowded and the same patient coming back for just more painkillers might be a little too much.
Regarding opioid based pain-killers... for all the negative attention they get, they're also usually fine for most people - when used as directed and, again, for a short-period of time.
Not everybody who takes a few Oxycodone tablets winds up addicted and then reduced to using heroin to get their fix.
I finally caved and then took a half dose right after the extraction because I was fearing terrible pain, especially since the surgeon said mine was a fairly difficult job that would probably end up causing more pain than is typical.
The half dose of painkiller made me extremely nauseous, and so I decided to just try the 800mg of ibuprofen, and it did the job perfectly. I did feel a little sore and stiff, but never in pain unless I waited too long for another ibuprofen dose. It was the same for my girlfriend, who was also prescribed the pain killer but didn't take it because she didn't feel she needed it either.
The pain killer being prescribed didn't bother me per se, and neither did the recommendation, and I don't think anything nefarious was going on. Also, everyone's body is different. But given the side effects, and potential side effects, I just felt that even a simple "we recommend you get this prescription filled, but please see how the ibuprofen works first, and only take the pain killer if you can't handle the pain on ibuprofen alone" would have been a better way to handle it.
https://www.mdmag.com/medical-news/is-there-a-link-between-l...
I honestly think the obstacle to Cannabis legalization in the US is social conservatism, not industrial lobbying.
I’m taking 5Mg capsules 2x a day.
This is news to me. What exactly does "toxic" mean? Do you have a citation I can read?
Acetaminophen is not for inflammation anyway.
In fact, paracetamol poisoning is the primary cause of death in overdoses (in the US, UK, Australia and New Zealand)[2]. And in 2006, [3] found it was the most commonly used compound for intentional overdosing (i.e. suicide by overdose).
But of course, this depends on taking a very high dose -- paracetamol isn't dangerous in moderate doses.
[1]: https://en.wikipedia.org/wiki/Paracetamol_poisoning [2]: https://www.ncbi.nlm.nih.gov/pubmed/18312195 [3]: https://www.ncbi.nlm.nih.gov/pubmed/16805658
Sure, and drinking too much water causes hypernutremia that can also kill you. Toxicity is always dose dependent, so the initial unqualified claim seemed to imply toxicity at normal dosages.
Paracetamol poisoning is fairly common, hypernutremia isn't. Don't get me wrong, I disagree with the original statement that paracetamol is toxic (with the implication that this is a reason not to use it in normal dosages). But it's definitely not harmless.
Probably the closest to harmless you can get are the inert gasses, and even then they can cause harm by displacing oxygen to deadly levels.
This doesn't really undercut anything you say, but if I was given accurate information I assume a subset of those acetaminophen OD deaths are from people abusing painkillers it's combined with. I haven't looked into it, but I assume this is also a partial explanation of why OTC cold medications with Dextromethorphan in them tend to be combined with a relatively high dose of acetaminophen. I would guess there are other good examples of abusable pharmaceuticals combined with acetaminophen.
However, there's a more important medical reason: acetaminophen accentuates the analgesic affects of opioids, although the mechanism for this is not clearly understood. This makes acetaminophen-enhanced opioids more effective drugs.
Opioid abuse has become so rampant, though, that we're moving away from prescribing acetaminophen-enhanced opioids like Vicodin and Percocet to try to stop them entering the recreational drug market. As opioid use has increased, so has the number of liver toxicity deaths due to the acetamiophen in some prescription opioid drugs.
But the original point was about whether paracetamol is toxic, not how often people overdose on Panadol (though that does happen in suicides). And the answer is "yes, but not in the dosages you'd normally see".
No, it isn't, and for the people who die from paracetamol it's an intentional overdose, it's very rarely an accidental overdose.
In the US about 500 people die each year from acetaminophen overdose per year, compared to over 70,000 from opioids.
Your link number 3 is talking about compounds containing paracetamol. For example, this includes coproxamol. Anyone overdosing on coproxamol was dying from the opioid (dextropropoxyphene), not from the paracetamol.
In the UK we have the ONS deaths related to drugs poisoning. Figure six shows deaths compared by drug type, and paracetamol clear isn't the highest: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsde...
We also have the NCISH data. Item 120 here: https://documents.manchester.ac.uk/display.aspx?DocID=38469
3095 deaths by self-poisoning.
Substance Number
Opiates/opioids 947 33%
- opiates only 746 26%
- paracetamol/opiate compound 201 7%
Non-opiate analgesics 205 7%
Antipsychotics 302 11%
Antidepressants 587 21%
- tricyclics 271 9%
- SSRI/SNRIs 260 9%
- other antidepressants 56 2%
>resulted in the clinical condition named "compensated hypogonadism," a condition prevalent among elderly men and associated with reproductive and physical disorders. In the men, luteinizing hormone (LH) and ibuprofen plasma levels were positively correlated, and the testosterone/LH ratio decreased.
Fuck that.
I wonder what I should give my kids when they have fevers though
You don't have to give them anything. Ibuprofen doesn't make the underlying infection causing the fever go away any quicker, it just alleviates the symptoms. It's a trade off between reducing short-term suffering and risking long-term defects. Personally my parents never gave me painkillers for fever and I'm grateful for it: fever pain is just a temporary feeling, but some of the uncommon side effects of painkillers are much longer-lasting.
*Edit: To whomever downvoted, I'm curious what part of what I said you disagree with.
Ibuprofen's main use is to help to keep the body temperature in check. When your body temperature goes too high you can lose consciousness and even die. I had a very high fever once and didn't want to take any medicine until I started to lose consciousness and I almost fell while waiting in a line in pharmacy. I was able to go through it only because I was adult. Children are more fragile. Fever is the reason people died so much before discovery of antibiotics.
You are right that it alleviates the symptoms, and it's actually better not to use it when the temperature is moderate because high temp kills some germs. But if it goes too high, you have to stop it before it's too late.
I thought bacterial infections were the response were the reason people died before antibiotics. Fever is the body's response to infection, a primitive means of fighting it. If somebody has a serious infection and you give them anti-fever medication but no antibiotics, they're still at serious risk of death even if their fever goes away.
According to the first article I found while Googling: https://www.google.com/amp/s/www.nytimes.com/2018/05/11/well... :
"The best evidence suggests that there is neither harm nor benefit to treating a fever with fever-reducing medications like acetaminophen or ibuprofen."
"In 1997, these data led to a large, randomized, placebo-controlled trial of ibuprofen in 455 patients with sepsis, a life-threatening infectious condition. In this study, ibuprofen failed to prevent the worsening of sepsis and failed to decrease the risk of death."
So there's no evidence that such drugs actually stop fever "before it gets too late" in adults, as they don't reduce risk of death. I had wrongly assumed the same applies to children.
As often as you need when they have a fever. Modern thermometers can give you the temperature in a minute or so.
There should be no major variation then. On the other hand, if the child reaches 38+ or so, you need to be on the lookout...
"The best evidence suggests that there is neither harm nor benefit to treating a fever with fever-reducing medications like acetaminophen or ibuprofen."
"In 1997, these data led to a large, randomized, placebo-controlled trial of ibuprofen in 455 patients with sepsis, a life-threatening infectious condition. In this study, ibuprofen failed to prevent the worsening of sepsis and failed to decrease the risk of death."
The science doesn't seem to support the notion that reducing fever will reduce the risk of fatality in the general case. I had assumed the same thing also applied to children, as before this thread I'd never heard of children getting seizures from fever (at least not from any of the children/parents I knew growing up in rural Australia).
Seems like teaching kids to meditate would have all sorts of benefits, including drug free pain management.
https://www.psychologytoday.com/us/blog/mindfulness-in-frant...
Do you give your children general anesthesia when they are in pain? E.g. they've fallen and bummed their knee or something?
Why not, since it would be the ultimate pain-killer? Because it's both dangerous and unnecessary.
The parent has the same reasoning for other unneeded and dangerous drugs.
Why can discuss whether they're really as unneeded and dangerous as the author implies, but that's another question, not loaded with "why don't you love your children" implications...
Thought effect: if you had the option to eliminate a kid's pain with an 0.01% chance of causing a lasting defect, would you do it? Not everybody would; different people have different time preferences.
That’s the more shocking belief from my perspective.
Or are you OK with hurting your kids, as long as they don't feel the pain?
(I'm putting the questions in the same tone you put yours)
Would you also give your kid anti-diarrhea and let the disease spread in order to stop the immediate unpleasantness?
[1]https://www.health.harvard.edu/diseases-and-conditions/fever...
Strong fevers should be controlled usually
Also don't forget about patient comfort (if it gets too high it feels awful)
You can use any drug containing Paracetamol (Tylenol, Panadol). It isn't that effective, but it works and as far as we know it's perfectly safe if you adhere to dosage recommendations.
My sons hated taking medication. I gave them non drug options on a routine basis for minor ailments because they didn't want to take drugs if they didn't have to.
How much/often were those people taking ibuprofen to have those effects? And how worse were they than the baseline? From what I see, they took 3 times a day for 2-3 weeks (not just to pass a small fever), and they were older men to begin with (e.g. already on a downfall for testosterone).
https://www.mayoclinic.org/diseases-conditions/reyes-syndrom...