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Tag: Tylenol

  • Advil v. Tylenol: Which to take and when?

    Advil v. Tylenol: Which to take and when?

    When you’re feeling aches and pains or have a cold or the flu, should you take acetaminophen (Tylenol) or ibuprofen (Advil.)  And, how much is too much?

    When do people take Advil? People pop Advil for just about any ache or pain. Advil treats inflammatory diseases, rheumatoid disorders, osteoarthritis, and more. It is a nonsteroidal anti-inflammatory drug (NSAID), which has ibuprofen as its active ingredient.

    What’s the right amount of Advil to take? If you read the manufacturer’s information, you should not be taking more than six 200mg pills a day, one every four hours. But, a lot of people take two or three Advils at once. And, some experts say that you can take up to 12 pills a day, four pills three times a day.

    How quickly will Advil begin working? Advil should take no more than an hour and as little as 30 minutes to take effect.

    What are the risks of taking too much Advil? Advil can harm your gastrointestinal tract, so always try to take it with food, if only a light snack. If you take too much, you can hurt your stomach lining and cause ulcers and GI tract bleeding. According to the FDA, use of NSAIDs, such as Advil (Ibuprofen) and Aleve (Naproxen), increase your risk of stroke and heart attack. As a result, the FDA now requires drug labels for all prescription NSAIDs to warn people of this risk. Over-the-counter non-aspirin NSAIDs also must contain this information.

    When do people take Tylenol? People take Tylenol (Acetaminophen) for headaches and pains, as well as to treat a fever.

    What’s the right amount of Tylenol to take? According to the NIH, you generally have no side-effect risks, so long as you do not exceed the maximum dosage for the drug, 4,000 mg a day.

    What are Tylenol’s side effects? Tylenol’s most common side effect is nausea. It’s unsafe to take Tylenol if you’re on a blood-thinning drug, warfarin or  Coumadin. You should limit your alcohol intake to one or two drinks max when you are taking Tylenol.

    Should you take Advil or Tylenol every day? Do not take Advil or Tylenol every day, unless your physician advises it.

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  • Avoid opioids to treat dental pain

    Avoid opioids to treat dental pain

    Teresa Carr writes for Consumer Reports on the best drugs to treat dental pain. Hint: Avoid opioids. Percocet, Oxycontin, Codeine, and Vicodin are highly addictive and, for the most part, not as good at relieving pain as over-the-counter medicines. Advil and Motrin (ibuprofen) and Aleve (naproxen) are often more effective and come with fewer side effects.

    People continue to die of opioid overdoses. In fact, last year, 31 percent more people died of an opioid overdose than in 2019. The Sackler family just settled a major lawsuit against Purdue for its responsibility in fueling the opioid crisis, essentially promoting opioids as safe pain relief when over-the-counter medicines would be as effective and non-addictive.

    Back in July, several state attorneys general settled a lawsuit against a series of companies that distribute prescription drugs, including McKesson, Cardinal Health and AmerisourceBergen. Johnson & Johnson was also a defendant. They had been charged with significant responsibility for the opioid epidemic in the US. Interestingly, the health insurers, who claim to “manage” people’s care, got off easy, even though the buck stopped with them–they could have denied coverage for opioids except in the most limited of circumstances, as insurers in Germany did.

    Many people do not realize that dentists have been one of the biggest prescribers of opioids. They have also been far more responsible for opioid overdoses–two and a half times more responsible–than other prescribers of opioids, according to one recent analysis published in the American Journal of Preventive Medicine. (N.B. Keep in mind that sometimes dentists perform costly dental procedures that you might not need. Dental fraud is more common than you might think. So, try to get a second opinion before getting dental surgery.)

    The researchers found that dentists prescribed an opioid to more than one in four people, including teenagers, who received dental surgeries between 2011 and 2018. Millions of people who visited the dentist ended up filling opioid prescriptions. And, nearly six in 10,000 overdosed. The researchers posited that we would see 1,700 fewer opioid overdoses each year if dentists stopped prescribing opioids.

    People with Medicare often do not get to see a dentist because Medicare does not cover dental care and the costs can be prohibitive. But, Congress is working on legislation that is likely to add a dental benefit to Medicare. It should make it easier for older people and people with disabilities to see a dentist.

    When you go to the dentist, keep in mind that there’s generally no need for you to take opioids to relieve dental pain. Over-the-counter medicines are safer and as or more effective than opioids for the majority of people. Drugs like Advil and Aleve are able to keep your gums from swelling. And, Tylenol keeps you from feeling pain.

    Side effects from over-the-counter drugs are also fewer and milder than side effects from opioids. In addition to being addictive, opioids can cause drowsiness, constipation and nausea.

    Talk to your doctor about the drugs you need to relieve any pain you might have from dental care. Remember that even over-the-counter medicines should not be taken in excess. And, if an opioid is warranted because of the intensity of the pain from your dental procedure, make sure to limit your use to what’s needed. Generally, you should be over the harsh pain in two or three days and can then switch to Advil or Tylenol if you still need some pain relief.

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  • One in seven older adults experience harmful drug side effects

    One in seven older adults experience harmful drug side effects

    More than nine in ten older adults take at least one prescription drug; And, half of all older adults take four or more prescription drugs, some of which they may not need. On top of that, many take over-the-counter medications and supplements. Kaiser Health News reports that more than one in seven older adults experience harmful drug side effects. Talk to your doctor about all the drugs you’re taking, why you need them, and whether you can stop taking one or more of them.

    Good primary care doctors and geriatricians oversee their patients’ drug use and try to “deprescribe,” reduce the number of prescriptions their patients are using, eliminating those that are unnecessary or inappropriate. Often, with drugs, less is more. Hundreds of new drugs are harmful or ineffective. And, one in three recently approved drugs may have harmful side effects.

    The most common side effects from multiple medications are dizziness, confusion and falls. But, some side effects are life-threatening. Here is a roundup of Just Care posts on commonly used prescription and over-the-counter drugs, as well as supplements, that have been linked with serious side effects.

    Keep in mind that FDA approval of a drug does not mean that it is safe, only that the clinical trials pre-FDA approval showed that the drug offered a clinical benefit. If possible, stay away from drugs that have been on the market fewer than ten years. Typically, it takes 4.2 years from FDA approval for detection of a new risk for a novel drug. But, it could take ten years after FDA approval for popular drugs to be pulled from the market.

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  • One pharmacy uncovers dangerous chemicals in some common drugs

    One pharmacy uncovers dangerous chemicals in some common drugs

    A small pharmacy based in New Haven is testing the prescription drugs it dispenses for safety. And, it is uncovering dangerous chemicals in some common drugs. Talk to your doctor about the safety of the drugs you’re taking.

    We know that some drugs the FDA has approved have turned out not to be safe. But, how many others are unsafe that have not been reported? Carolyn Johnson reports for  The Washington Post that Valisure, a small online pharmacy, is checking every drug it sells before dispensing it.

    Since it began testing the drugs it dispenses, Valisure has found a sea of drug safety issues and other prescription drug problems. It rejects more than one in ten drugs it tests because it finds either that they contain contaminants or otherwise do not perform as expected. For its part, the FDA says that drug safety is not an issue with its approved drugs.

    Valisure recently found that Zantac, a best-selling drug, is less safe than many people thought. It contains a cancer-causing chemical. Since Valisure’s discovery, 40 countries have stopped allowing it to be sold.

    The FDA has asked for the recall of Zantac and other products with ranitidine and nizatidine. Pepcid, Tagamet, Nexium, Prevacid and Prilosec don’t contain these dangerous chemicals.

    Valisure also found that rapid release Tylenol gelcaps dissolve far less quickly than the less costly Tylenol uncoated tablets. In this case, the problem was the misleading marketing of the product, not its risks. The manufacturer subsequently clarified that its marketing was suggesting only that the rapid-release gelcaps dissolved more quickly than other gelcaps, another reason not to trust the marketing hype on products.

    Quality and safety may be an issue because many drugs are manufactured abroad, with less stringent regulatory oversight than in the US. In 2016, the Government Accountability Office reported that nearly 1,000 of 3,000 foreign manufacturing sites had not been inspected by the FDA. Some believe that inspections alone are not enough to ensure safety.

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  • Six things to know about your over-the-counter medications

    Six things to know about your over-the-counter medications

    Over-the-counter medications are drugs you can buy without a prescription to treat common problems. However, you should still use them with caution. A number of recent studies have revealed worrisome side effects from incorrect use of OTC medicines. Here are six things you should know about over-the-counter medications (OTC) to keep you and your loved ones safe.

    To minimize the risk of harmful drug interactions, always keep a list of all the drugs you are taking in your wallet (both prescription drugs and OTC drugs) and share the list with your doctors and the people you most trust. If you are getting headaches, diarrhea, constipation, or have a dry mouth, it might be a minor side effect of the drugs you’re taking; some side effects can be life-threatening, including severe bleeding or liver or kidney damage.

    1. Just because medicines are OTC does not make them risk-free. Do not assume that because you do not need a prescription for OTC medications that they are always safe to use. Depending upon the other medications you are already taking and your health condition, OTC drugs may be dangerous and can be toxic if overused. While it is generally okay to take the correct dose of an OTC drug for a specific problem (for example, taking ibuprofen to help relieve a headache), all medications carry different risks and benefits. If you have a complex health condition or simply have concerns about an OTC medication, check with your doctor before taking it. People with very bad symptoms, who do not know what is wrong with them, or with long-term medical problems also should check with their doctor before taking an OTC medication.
    2. Our knowledge about the risks and benefits of different OTC drugs is continuously changing. As with other areas of medicine, researchers are constantly learning new things about OTC drugs that change the way they should be used. For example, after receiving numerous reports of severe liver damage associated with the use of acetaminophen (the active ingredient in Tylenol), in 2011 the FDA changed the maximum amount of acetaminophen that could be contained in single OTC dosage to 325 mg. And the risks may differ depending upon your age, weight and medical condition.
    3. OTC drugs may interact with other medications you are taking. Just as two or more prescription medications can interact with one another, creating adverse or unintended side effects, OTC drugs can also change the way a prescribed medication works in your body. If you are taking prescription medications, including opioids, check with your doctor before combining them with an OTC medicine.
    4. OTC drugs may interact with diet or lifestyle factors. OTC medications can be harmful if they interact with alcohol in your system or certain foods in your diet. They can also affect other health conditions. Check with your doctor if you have specific medical or lifestyle considerations that may need to be taken into account when starting an OTC medication. As a general rule, you should not consume alcohol when taking any type of medication, unless your doctor gives you permission to do so.
    5. OTC drugs may affect older people differently. While everyone should be careful when taking medications, older people need to take extra caution. The body changes how it absorbs food and drugs as it ages; and, older people generally take more medications than younger people, putting them at higher risk for adverse interactions.
    6. Your doctor may decide to provide you with different treatments based on the OTC medications you take. Always report your OTC medications to your doctor, whether at check-ups or during hospital visits. Always let healthcare providers know about any medications you are currently taking, including OTC medicines.

    Many people take vitamin and herbal supplements to feel better. As a general rule, eating a healthy diet of foods with different vitamins is the best way to make sure you have the vitamins you need. Like over-the-counter drugs, vitamin supplements are not risk-free. Watch John Oliver explain the issues with vitamin supplements. You can learn more from about vitamin supplements on this site from Dr. Salomeh Keyhani, including vitamin C supplements, vitamin E supplements, vitamin B6 supplements, and vitamin B12 supplements.

    Dr. Keyhani’s evidence comes largely from Cochrane.org, which is an independent group that analyzes a range of studies and summarizes the best evidence from research. Also keep in mind that vitamin supplements you buy at the drugstore or other retail stores are not regulated by the Food and Drug Administration, and so they may not be what they appear to be, as the New York Attorney General’s office found. 

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  • Talk to your doctor before taking a cold medicine

    Talk to your doctor before taking a cold medicine

    With cold and flu season in full swing, people with high blood pressure that is not controlled well or who have heart disease need to be careful with over-the-counter cold medicines, as they may cause a spike in blood pressure.

    Many cold medicines contain decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs), both of which can raise blood pressure. Examples of decongestants are pseudoephedrine and phenylephrine. Some NSAIDs are Advil (ibuprofen) and Aleve (naproxen).

    “People with uncontrolled high blood pressure or heart disease should avoid taking oral decongestants,” Sondra DePalma, a physician assistant at UPMC Pinnacle in Pennsylvania, told American Heart Association News. “And for the general population or someone with low cardiovascular risk, they should use them with the guidance of a healthcare provider.”

    Guidelines released last year by the American Heart Association and the American College of Cardiology dealing with high blood pressure management say that decongestants should be used for as short a time as possible, and to try alternatives such as nasal saline or antihistamines.

    Regarding NSAIDs, guidelines say to use Tylenol (acetaminophen) or topical NSAIDs as other options.

    Healthcare professionals also say if your cold symptoms are mild or moderate, rest and drink plenty of fluids. Avoiding dehydration can help reduce body aches and may reduce the need for decongestants.

    This article was originally published in Medshadow.org

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  • How to soothe a sore throat

    How to soothe a sore throat

    It is that time of year when many of us find ourselves with a sore throat. And, most of us are looking for some way to ease the symptoms, if not cure the sore throat altogether, ideally, without antibiotics. Here’s how to soothe a sore throat.

    Britain’s National Health Service recommends taking ibuprofen, along with lots of cool or warm drinks and cool soft foods, and avoiding hot drinks. Tylenol can also help ease the pain. Even if your sore throat makes it difficult to drink, it is really important to keep up your fluid intake! Your throat pain will get worse if you let yourself, and the lining of your throat, get dry.  

    The National Health Service further recommends homemade gargling with a mouthwash of salty water and sucking on lozenges and hard candy. Lozenges containing menthol may be helpful. Honey is also good. Put some in your tea! The honey helps to soothe the throat as you swallow. You will want to avoid acidic food and drinks, and spicy dishes; they may be irritating. Also, you should not smoke.

    Harvard Health recommends getting plenty of rest, drinking a lot of water, and using a cool mist vaporizer.

    When do you need antibiotics for a sore throat? Cochrane, an independent network of researches that uses high-quality information to help you make health decisions, advises that antibiotics are of limited use in treating sore throats. They have unpleasant adverse side effects such as diarrhea and rashes.

    Cochrane further reports that some Chinese herbal medicines appear to be effective in curing a sore throat. But, it cannot recommend any specific medicines because no trials of these medicines were designed well enough to provide compelling evidence.

    Do not waste your time or money on probiotics or special xylitol-based chewing gum for your sore throat. They are not effective, according to a new report in the Canadian Medical Association Journal.

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  • Tylenol and other painkillers with acetaminophen can be toxic when overused

    Tylenol and other painkillers with acetaminophen can be toxic when overused

    Millions of Americans can and do safely rely on painkillers with acetaminophen on a regular basis.  They also take acetaminophen to lower fever.  According to the NIH, they generally have nothing to worry about so long as they do not exceed the maximum dosage for the drug, 4000 mg a day.

    If you are taking multiple medications, however, make sure that those drugs do not contain acetaminophen.  You could be exceeding the maximum daily dosage and doing harm to your liver.

    It’s also unsafe to take acetaminophen if you’re on warfarin, a blood-thinning drug, sometimes known as Coumadin.

    And the NIH warns that you should not have more than two alcoholic drinks a day when you are taking acetaminophen.