Problems with Tylenol

[rodmur]

This is probably a little off topic, but I couldn't find a better group. I had aorta and aortic valve replacement in January.

So after having heard the latest This American Life show about Tylenol, I'm kind of annoyed. If you hadn't heard, it doesn't take much acetaminophen to overdose, much less than aspirin or ibuprofen. Currently, Tylenol/acetaminophen is pretty much the only pain reliever I can take, because I take Coumadin. Aspirin or any other NSAID is a no-no. It really makes me think that we need a lot more research into safe pain medications that do not effect INR. I get pains and I would like to not to have to risk of accidently killing myself from taking it.

http://www.thisamericanlife.org/radio-archives/episode/505/use-only-as-directed

 

[Fundy]

I took the bottle stated max dosage(4000mg) daily for over a year for pain several years ago. My doctor told me I could actually take more, I forget how much though.

I doubt there is actually anyone dying from the max daily dose or less , unless they have severe liver problems already.

Have you met many people in your lifetime that were actually killed by tylenol? I haven't met any myself. If you think you really need the tylenol for pain, I think you should just take it and not get stressed about it.

 

[dick0236]

I have taken 1000mg(two 500mg tabs) daily for back pain for 15+ years with no problems or effect on INR. From time to time I take a few additional tabs for flu, headache, etc. So long as I don't exceed 3000mg daily(very infrequently), I ain't gonna worry about it. Reminds me of an ole saying...."everything good in life is immoral, illegal....or ain't healthy".

 

[epstns]

I'm in the same boat with ibuprofen. My wife read the Fox News (tabloid) version of a medical study that ibuprofen can cause heart failure and heart attacks, so she tries to get me not to use it. Right now, ibuprofen is the only OTC med that keeps my pinched lumbar nerve pain under control. I take a grand total of 4 to 6 tabs a day (200 mg each), and will probably need it for a couple of months until the nerve heals. She is worried about this. When I followed ALL the links back to the original study I found that indeed ibuprofen can be linked to heart problems. . . IF the patient has been taking LARGE doses (defined as being in excess of 2400 mg/day) over LONG periods of time (defined as years). So, I am taking less than half the "dangerous" dose, and probably for a much shorter time. I'm not worried, but our wonderful news media (include Fox and MSN in that category) have taken remarks out of context and blown the whole thing out of proportion.

I feel sorry for the folks who are not savvy enough to doubt the media and to find the real data for themselves.

 

[tom in MO]

My cardio said there is no specific effect to the heart or body due to a combination of ibuprofen and warfarin. The risk comes from over use of ibuprofen, which can irritate the stomach and lead to stomach bleeding (ulcer?) in some people. Stomach bleeding while taking warfarin is a BIG problem. He told that I can take ibuprofen, but to limit it to the minimum dosage I need and not to take more than the maximum recommended OTC dose and not to take it continuously for more than a month.

 

[epstns]

Tom - Your doc seems to be giving you some very realistic advice. I would do just what he says. . . at least in this case.

 

[tom in MO]

Steve, I have "pump bump" or Hagland's deformity, which is a bump on your heel. My orthopedist told me if I was not on warfarin, he'd have me take ibuprofen. That's why I quizzed my cardiologist. So I got two different reads on the issue, but the cardios is supported by the drug's more specific and detailed safety information. Luckily for me, physical therapy took care of the "pump bump."

However, I am entering the arthritis zone, and when it hits my lower back or hip, a couple of ibuprofens are better than a cold beer on a hot day. For some reason acetaminophen just doesn't do it.

 

[neil]

sorry to hear of your problems tom

 

[epstns]

Whenever a doc tells me to take Tylenol, I just laugh and tell them that I may as well eat the buttons from my shirt. Tylenol does absolutely nothing for me.

Whatever happened to APC tablets? They contained aspirin, phenacetin and caffeine. All through the 1940's through 70's (I think), this was the best over-the-counter remedy for headache and other minor pain. Some do-gooder must have found that if they fed enough of the stuff to a rat, the rat died. Well, sure, if you feed 500 tabs a day to a 1/4 pound animal, it dies. . .

 

[Agian]

You mean the Bex tablets? They were banned because they caused kidney damage.

 

[rodmur]

I still take Tylenol, it works for minor headaches, I don't usually go anywhere the problem levels. I do occasionally take Aleve if I'm having back issues, I tolerate it pretty well, so I'm not too concerned about getting ulcers from it, I don't take it regularly in any case.

 

[Cooker]

I use Tylenol with no problem. There are times when Tylenol just doesn't do the job so I take Aleve. I know I know I'm not suppose to but when I need it I take it and have no problems. Moderation is the key. My internist had a fit over it but my cardiologist is a bit more relaxed about it.

 

[Paleowoman]

Whenever a doc tells me to take Tylenol, I just laugh and tell them that I may as well eat the buttons from my shirt. Tylenol does absolutely nothing for me.
.

Same here, paracetamol (Tylenol) has never done anything for me. Ibuprofen (is that the same as Aleve ?) works for me but I had a duodenal ulcer int he past so I'm not supposed to touch those meds.

The other thing about pain meds - ones that are commonly used after OHS such as codeine, co-codamol, dihydrocoeine, tramadol, oxycodone - the ones in that group all need a particular liver enzyme to work: enzyme CYP2D6 which converts them to morphine. Something like up to 10% of people are deficient in that enzyme and so they don't metabolise those pain killers effectively, in essence they don't work or don't work well, doesn't matter how strong the dose.

 

[epstns]

I don't have any problems with narcotic pain meds working. . . but they "block" me up something awful.

I do use ibuprofen, for almost any nasty pain -- arthritis, headache, dental work, etc. It works for me, but I try to only use it when I really need some relief. I used to use it a lot more, but then the research came out about all the bad effects, and I cut down. Now, with all my other meds in line, I rarely need anything for any sort of pain.

 

[dornole]

Well, if you like your pain relief to come with caffeine and are supposed to protect your stomach lining, you could try Midol ( acetaminophen plus caffeine and an antihistamine). My sister (a doc) swears by caffeine for migraines. Though she prefers to take pain pills plus a Diet Coke.

 

[Paleowoman]

Well, if you like your pain relief to come with caffeine and are supposed to protect your stomach lining, you could try Midol ( acetaminophen plus caffeine and an antihistamine). My sister (a doc) swears by caffeine for migraines. Though she prefers to take pain pills plus a Diet Coke.

Acetaminophen is paracetamol so that's no use for those of us with whom paracetamol doesn't work. I have to put up with pain…...…. ​though when it was extremely bad earlier this year from 'dry socket' following wisdom tooth extraction my doc gave me Oramorph (morphine) which worked. It tried to block me up but doc prescribed lactulose for that.