I too come from a country where this is called paracetamol, and here too, over the counter usage is very common. I'm surprised more people are not worried about the alcohol interaction.
Another commenter alluded to why it is the number 1 cause of acute liver failure in the US: that’s because we can buy bottles of a couple hundred pills and thus the majority arise from suicide attempts.
The British used to have a big problem with paracetamol (what Tylenol/acetaminophen is called there) and acute liver failure, so they mandated only blister packs for the medication, no ability to buy large bottles. Suicide rates due to paracetamol and acute liver failure decreased as a result. In fact, aspirin is also an issue in the UK, and this mandate also helped with that.
Whereas acetylsalicylic acid ("Aspirin") was the example of heirloom drugs still in prescription free use only for historical reasons. 'If you came requesting approval for ASA today they'd laugh in your face. "With that side effect profile!"'
The maximum safe dose for Tylenol is 4g per day. The low end of the toxicity range is a daily dose of 7.5g-10g for an adult, ~2.5X the maximum recommended dose - or just 12 grams spread over 2 days. The effects are exacerbated by alcohol use. And worst of all, people take it for hangovers. [1]
So, the toxic dose of Tylenol is only 2.5X the active dose, whereas for ASA it's 8X, for ibuprofen it's roughly 10X, and naproxen is about the same. Tylenol is much more dangerous than Aspirin.
Tylenol leads to 50,000 ER visits per year and 25,000 hospitalizations. It would lead to way more deaths if left untreated.
[1] https://www.uspharmacist.com/article/acetaminophen-toxicity-...
The effective dose starts at 500mg. Most people are likely going to be taking 1 or 2x 500mg tablets for acute issues - and I'd argue that's often enough for most cases where you want short-term analgesia. Both 500mg and 1000mg will improve SPRID6 scores (dental; https://www.cadth.ca/sites/default/files/pdf/htis/june-2016/...).
Where I've complained of medium term pain (expected duration: weeks to months) my GP has suggested NSAIDs instead. They're not without their own problems but I think I'd personally prefer their safety profile to long-term Paracetamol.
People can and do exceed these numbers hence the 50,000 ER visits per year. It is the leading cause of acute liver failure in the United States.
The bar shouldn’t be “often enough for most cases” when 1.5X the dose for 2 days can kill you. Either the safety margin is too low or the warnings aren’t nearly big enough, but the numbers don’t lie, the status quo is bad. Especially when the alternatives require way less diligence on your part and are sold as equivalent adjacent products.
It’s a well tested and safe drug. Both aspirin and ibuprofen have significant risks if used daily. Aspirin causes stomach bleeding, and ibuprofen causes significant kidney issues over time.
They were both diphenhydramine HCL, 25mg. Both tablets. The only differences were the labels, the pill colors (blue for ZZZZ, pink for allergy), and the price.
And the other benefit to stocking single-drug medications is more flexibility. I imagine some hapless guy whose has pain in the morning, but sees only "Advil PM" in the medicine cabinet.
If I need Advil PM, I'll take a regular ibuprofen and a regular diphenhydramine.
It took everything I had to not start literally climbing up the walls. My anxiety and energy level skyrocketed.
One of kids is the same way on Benadryl.
Apparently 5% have such a reaction.
I got tired of explaining the reaction to doctors and nurses, (got called a liar several times). Although I had one nurse almost in tears as she had same reaction, but no one would believe her.
So on forms I put I’m allergic to allergy medication.
Just to add, most nootropics are cholinergics in some way or another. Take a look at choline supplements, or racetams (from Wikipedia: "Racetams are understood to work by activating glutamate receptors that are colocalized with cholinergic receptors, thus increasing the frequency of activation of the latter."). They are supposed to help people with Alzheimer's disease, improve their memory and whatnot. There are many studies around to support this. There is also Huperzine A that has been investigated as a possible treatment for Alzheimer's disease and there was a meta-analysis that found it efficacious in improving cognitive function (see https://en.wikipedia.org/wiki/Huperzine_A for more).
But yeah, anticholinergics are known to be bad for people with Alzheimer's disease, and some cholinergics are known to be effective in improving cognition of those who have it. Of course there are other medications that are supposed to be avoided, here is more about it for the curious (it mentions DPH, too): https://www.mind.uci.edu/medications-and-patients-with-alzhe...
The pharmacist explained that caffeine reduces headaches. Well that's great, but I didn't have a headache, I had muscle aches, and I was trying to sleep. He looked at me like I was crazy.
Or so my pet monkey told me.
A cup of green tea is enough to ruin my day and possibly the next week.
Also, IIRC, caffeine specifically has been identified to help with migraines, not headaches more generally.
When I'm healthy and working, I regularly drink about three espresso shots a day. If I'm sick, that plummets to zero while I'm lying in bed and feeling miserable. Invariably, I'll get a killer headache, which the paracetamol alone doesn't fix. I know this, and either I just ignore the headache or make myself some instant coffee at home.
But a badly run scientific study would not control for this quantifiable effect: Sick people get headaches, and dosing them with caffeine reduces the headaches! Ergo... caffeine reduces headaches.
However, I very much doubt that caffeine has a headache reducing effect in sick people that aren't also having caffeine withdrawal.
Imagine a world where most office workers would regularly partake in, say, Opiates to "take the edge off" their stressful jobs. In that world, researchers would confidently conclude the OTC pain relief medication should include Naloxone!
This isn't even that outlandish a scenario. There are countries where people living at high altitude habitually chew Coca leaves to counteract altitude sickness. Should OTC pain killers in those countries include Propranolol? Is it right to force tourists wanting ordinary Paracetamol to also take drugs for acute Cocaine withdrawal just because most locals feel better if they get it?
It's absurd to mix drugs like this, if you think about it a little...
I had a chat with my chemist about why a small bit of caffeine was in the more expensive brands of acetaminophen / paracetamol. I asked if it was used as a kind of pick me up to feel more awake.
He said that the dose of caffeine was very very small and not for that, but it actually helps the paracetamol work better or faster.
Acetomeniphin Ibuprofen Benadryl Pseudoephedrine
Covers almost all of the many combinations for sale at the drug store.
Yes, but according to the post, the single-active-ingredient version of acetaminophen might make you less cautious and more risky, and lead you to buy multiple-action drugs!
:-)
Aspirin causes blood to thin and could exacerbate ulcers and such, not good to take for cuts and bruises etc
Safety margin on aspirin is huge, you tend to notice your blood is very thin before you get any worse symptoms. Massive doses of aspirin have also been used to treat various illnesses.
Until you get to your doctor, be in the know, read these:
https://www.healthline.com/health/aspirin-overdose
https://www.mayoclinic.org/drugs-supplements/aspirin-oral-ro...
This is actually a good summary. As mentioned in sibling threads, most pharmaceuticals that could potentially be enjoyable are formulated stateside in combination with things that will either make you feel terrible or outright kill you at high enough doses.
I bought a massive sack of kosher salt because it was a good deal. It's a stupid amount. Doesn't mean I overdose on salt with every meal, it's going to last me a long, long time. Might become a family heirloom.
You'd be silly to lecture me about salt intake.
I buy Costco's kirkland branded acetaminophen and ibuprofen. it's like 500 pills in a 2 pack, 500mg pills (extra strength) like every 1-2 years
You can purchase over the counter, most grocery stores and gas stations carry it. Pick it up at the "dollar mart" too.
I was taking 2000mg of each at the same time, for bad tooth pain for a week.