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Table of Contents. Frequently Asked Questions. What Is Chronic Inflammatory Disease? Headache Treatment: Tylenol or Advil? Acetaminophen Warnings Acetaminophen liver toxicity is a serious problem in the U. Aspirin Warnings Aspirin should be avoided in children with fever due to the risk of Reye's syndrome , which is a form of encephalopathy a brain disease. Ibuprofen Warnings Ibuprofen and all NSAIDs except aspirin may increase your risk of heart attack or stroke, which can happen suddenly and be fatal.
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What's the Difference Between Advil and Aleve? In fact, the difference between many over-the-counter pain relievers can have various effects on your body. The U. Each can reduce fever and relieve headache, muscle aches, menstrual pain, toothache, and similar discomfort—although they differ in their effectiveness against certain of these symptoms. The active ingredient in aspirin is acetylsalicylic acid which inhibits the body of prostaglandins, concentrated substances where we feel pain.
Prostaglandins increase the perception of pain, fever, redness and inflammation that may occupancy injuries. In short, aspirin reacts with your blood chemistry to inhibit the volume of prostaglandins.
Aspirin is most often used to relieve minor pain, fever and inflammation, but it does have a unique set of drawbacks. That being said, aspirin is still the most common over-the-counter pain reliever and now plays a huge role in the prevention of heart disease. While many people have never heard of acetaminophen, everyone has heard of the pain reliever brand Tylenol. Another noteworthy difference is that while consuming alcohol it is NOT recommended to take acetaminophen in any amount because the liver becomes more susceptible to damage.
Doctors also argue that acetaminophen is easier to overdose than its peers which could result in fatality. I used to take acetaminophen usually referred to by its brand name, Tylenol for the occasional headache or sore muscle, mostly because that's what we used in my house growing up. I didn't think much about whether it was more or less effective than any other type of over-the-counter pain reliever, and I suspect the same is true for many folks.
Acetaminophen, after all, is the most popular over-the-counter painkiller worldwide. So I was surprised when I found out there's a huge gap between how pain researchers think about this drug and how the public does. More specifically, every researcher I contacted for this piece said some variation of what Andrew Moore , a pain researcher at Oxford University, told me: Tylenol doesn't actually work that well for pain.
To be more exact, he said, "I can't imagine why anybody would take acetaminophen. Moore has done a number of systematic reviews on over-the-counter pain medications, looking at all the available evidence to figure out which ones work best for various problems.
I asked him to describe the overall success rates for the most common three: acetaminophen like Tylenol , ibuprofen like Advil , and aspirin. For acetaminophen at doses of to 1, mg, about 40 percent have a success. For ibuprofen, in its normal formulation at something around mg or two tablets, about 50 percent have success.
Now, Moore was referring here to acute pain that strikes after a specific event, like a surgery , a cut, or a burn, but his message was simple: Ibuprofen seems to work best, followed by acetaminophen, and then aspirin. For ongoing or chronic pain — a sore lower back, say, or the kind of degenerative arthritis that typically develops with age — ibuprofen still outperforms acetaminophen. As the researchers wrote, "We found that [acetaminophen] is ineffective on both pain and disability outcomes for low back pain in the immediate and short term and is not clinically superior to placebo on both pain and disability outcomes for osteoarthritis.
A limitation of the study is that the evidence on acetaminophen was mainly for acute low back pain, but as the University of Leeds's Philip Conaghan explained, "T here is very little long-term data [on chronic back pain], and if a drug doesn't work in the acute problem, it seems unlikely to work in the chronic phase — though back pain may be even more complex than osteoarthritis pain.
The study also noted that patients on acetaminophen "are nearly four times more likely to have abnormal results on liver function tests compared with those taking oral placebo.
Other studies, like this well-designed randomized control trial of people with knee pain, have similar conclusions: Acetaminophen doesn't perform as well as ibuprofen, and it's linked to higher rates of liver problems.
Ibuprofen also has potential side effects; more on that below. It turns out this is another fascinating problem area for pain researchers. Moore has looked at all the evidence for what he calls "infrequent tension headaches" and found "it is surprising how poor [the research] is and how little it tells us.
Between and , acetaminophen was the leading cause of acute liver failure in the US. There are also hundreds of related deaths every year — though keep in mind that millions of people take drugs with acetaminophen, so these more extreme side effects are rare especially if you're only taking them in small doses occasionally.
Still, for the drug's minimal pain-killing benefits, the risks may not be worth it. He advised people to see their doctor if they're taking any of these painkillers for more than a few days — particularly if they're on other drugs already.
Kay Brune , a professor of pharmacology and toxicology at Germany's Friedrich-Alexander University who has also studied the toxicity of painkillers, was even more direct in his thoughts on acetaminophen: "It's an old drug, obsolete, and should be avoided altogether.
Aspirin is safer than acetaminophen, he said, though to be used as a pain reliever it requires much higher doses — which can have side effects like stomach upset.
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