Posts Tagged ‘Tylenol’

pain relief medications

Does your back ache? Do you have a headache, toothache or sprained ankle? What medication should you choose for pain relief?

In most cases these types of pain are common and can be treated with over the counter pain medications which make up a $2 billion a year industry. The few basic medications available to treat your pain must be chosen wisely and you must be aware of the possible side effects of these drugs so that they don’t cause more harm than good.

The potential for harm rises with increasing doses of the medication and in taking it for long periods of time. The elderly and those with chronic medical conditions face a greater chance of experiencing troublesome side effects.

In spite of the pharmacy shelves being filled with a mind boggling combination of available pain relieving drugs, they are really all made up of any one of the following types of drug:

Acetaminophen (Tylenol)

This is probably the safest of the drugs when taken at the recommended doses. It is classified as an analgesic (pain reliever) as well as a fever reducer. It can be used by all ages, except infants under 3 months old. It can have a toxic effect on the liver and should be used very cautiously, if at all, by those with liver disease or those who drink more than three alcoholic beverages a day. A big advantage of acetaminophen over the others is its tendency not to irritate or harm the stomach. It can be taken if one is also taking a blood thinning medication. Follow the dosing directions carefully.

Ibuprofen (Advil, Motrin IB)

This is called an anti-inflammatory analgesic because it acts not only on most any type of pain but also on inflammation. Many people use this medication for relief of soft tissue aches and pains associated with vigorous exercise or hard physical labor. Like acetaminophen, it is very effective as a fever reducer for young and old. Do not use in infants under six months of age without consulting your doctor.

Unlike acetaminophen, it does not harm the liver in recommended doses, but, it can be very irritating to the stomach possibly leading to bleeding and/or stomach ulcers. Long term high dose usage has been linked to increase risk of heart and kidney disease. It should not be taken while taking a blood thinning drug.

Naproxen Sodium (Aleve)

This is also an anti-inflammatory drug taken for the same indications as ibuprofen. It can be taken less frequently than ibuprofen and still achieve the same benefit. It causes similar side effects to ibuprofen with perhaps less likelihood of stomach and kidney problems.

ASPIRIN (Bayer, Excedrin)

This time-honored drug is also an anti-inflammatory, analgesic, and fever reducer. Under the care of a physician, it is now being used in a low dose to help prevent heart disease. It’s cheap and plentiful, but has more potential side effects compared to the others. It is more frequently associated with stomach irritation and bleeding. It is not recommended in children less than 16 years old. Because of the potential side effects, I personally would not take aspirin to treat routine pain unless there was no other choice.

The bottom line is that if you have mild pain for whatever reason, any of the above drugs could be helpful, but results vary for each individual. Pay close attention to the various side effects which I have listed and which can be found on the medication label. Be sure to see your doctor if you get no pain relief from these commonly used mentioned medications or if your pain lasts more than a few days.

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I’ve had patients recently voicing their concerns about the “recall” of Tylenol products. I will use the terms Tylenol (the most recognized brand name) and acetaminophen (the chemical name) interchangeably in this article. A Federal Drug Administration panel has recently made several recommendations concerning Tylenol and Tylenol containing products.  Again, these are only recommendations and are not written in law as of this time. The FDA recommendations are as follows:

  • That prescription Vicoden (hydrocodone and acetaminophen) and Percocet (oxycodone and acetaminophen) be banned from further use.
  • That over the counter products that contain acetaminophen (there are literally hundreds of such medications) carry stronger warning labels.
  • Reduce the maximum over the counter strength of a Tylenol pill from 500 mg. to 350 mg.

What’s at issue here is the fact that acetaminophen in high doses can cause liver damage and in very high doses can cause liver failure and death.  This problem usually occurs when patients take more than the recommended daily dose of Tylenol or when they take Tylenol plus another combination drug that also contains Tylenol, such as Theraflu or Nyquil, thus unknowingly exceeding the recommended dose.

Since it is well known that alcohol also has a negative affect on the liver, the combination of alcohol and Tylenol consumption together has an even greater negative affect on the liver.

Tylenol has been around for decades and has been consumed by millions of people worldwide for the relief of pain and fever.  I believe that when taken in recommended doses it is safe and effective.  The alternatives to Tylenol such as aspirin or anti inflammatory drugs such as ibuprofen have their own risks in terms of stomach bleeding.  The decision to take either Tylenol or an aspirin product is a matter of risk versus benefit. You may wish to speak with your doctor about this.

I agree with the panel’s findings and recommend the following:

  • Tylenol or its various products should not be used if one consumes more than two alcoholic drinks per day.
  • The maximum single adult dose should be no greater than 650 mgs.( two 350 mg. tablets)
  • The maximum daily dose should be less than the currently recommended dose of 4,000 mg.  I propose taking no more than 2800 mg. per day which is equal to taking two 350 mg. tablets every six hours.
  • Always carefully read the label on the bottle of any over the counter medication to see if acetaminophen is one of the ingredients.

Be careful but not fearful of Tylenol.  For treating pain or fever it is a very useful medication when used properly.

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