It's probably worth mentioning that this drug is called Acetaminophen in the US, and is the active ingredient in Tylenol and other over the counter medicines.
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nine_k · 4h ago
Basically, paracetamol turns out to be mildly contraceptive, by meddling with cell division cycle.
I wonder if it might also slow healing of wounds, or wherever else intense cell division happens.
10-1-100 · 4h ago
The authors touch on potential wider implications in the abstract:
> These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted to substantiate these findings and to elucidate possible implications for other developmental processes, such as gonadal and brain differentiation.
artvandelai · 3h ago
NSAIDs reduce inflammation. Since inflammation is part of healing, they can slow recovery, but they’re useful when inflammation itself is a problem.
e40 · 3h ago
paracetamol is not an NSAID.
artvandelai · 2h ago
Yes, but since the parent was talking about drugs with similar effects slowing healing, I thought it was appropriate to mention.
privacyking · 3h ago
True but one of the proposed mechanisms of action is on the same pathway as NSAIDs
odyssey7 · 4h ago
Unsure if this is related, but I’ve heard that taking painkillers for delayed onset muscle soreness will reduce muscle gains.
stanford_labrat · 2h ago
Painkillers like ibuprofen are NSAIDs which inhibit the enzyme COX1/2, reducing prostaglandin production.
Prostaglandins are an inflammatory hormone that do a variety of things, but specifically PGE2 plays a role in muscle stem cell activation to divide and produce more muscle fibers. The effect is probably realistically small, but you will leave gains on the table by taking ibuprofen after hard workouts.
losvedir · 50m ago
Are you saying that lifting weights makes more muscle fibers? I was under the impression it does not, that it simply makes your existing muscle fibers bigger and stronger.
aeonik · 36m ago
The main muscle fiber cells don't divide (usually), but satellite cells reproduce. Those fuse with the fibers though.
Though the science is not completely established here and there are some exceptions (obvious ones like cancer, etc...)
cenamus · 3h ago
Same goes for icebaths, they reduce inflammation, which is the whole point of working out.
lottin · 1h ago
The whole point of working out is to stress the organism in order to induce a physiological adaptation. Inflammation is NOT the point, but rather an unfortunate side effect.
wiml · 3h ago
Does the opposite hold true as well? If I taunt a wasp nest after hitting the gym will I discover the fast route to mad gains?
rkomorn · 3h ago
You'll certainly get swole.
vanderZwan · 3h ago
What about ginger? Because that apparently only downregulates COX-2 without affection COX-1 (most inflammation-reducing drugs affect both)
antonkochubey · 3h ago
Etoricoxib does just that and is widely available at least in the EU
rkomorn · 3h ago
So, literally "no pain, no gain" ?
15155 · 3h ago
Anti-inflammatories - not all painkillers.
ed · 3h ago
Just NSAID’s - they’re anti-inflammatory and muscle synthesis happens in response to inflammation.
VirusNewbie · 3h ago
The studies I saw had people taking a lot, it wasn’t looking at people taking 400mg once a week of their knee or shoulder got sore during the workout.
oh_my_goodness · 4h ago
I think rapid cell division might occur during embryo development. Not a biologist. Just a guess.
bitwize · 4h ago
The vaccine-autism smoking gun that Andrew Wakefield and RFK Jr. heroically tried to find has, so far, failed to turn up. But there was a study recently that showed that autism is correlated with the mother taking acetaminophen during pregnancy.
epgui · 3h ago
> Andrew Wakefield and RFK Jr. heroically tried to find
I'm not sure if that was supposed to be sarcastic, but these two people have done more harm to public health, and are responsible for more health dis/mis-information, than pretty much anyone I can think of. (I am a biochemist, no conflict of interest)
SoftTalker · 3h ago
The general advice is to not take any medication during pregnancy without a physician’s advice. This includes all over the counter medicines.
unsupp0rted · 2h ago
Physicians find it hard, perhaps impossible, to say "do nothing and go home". They always prescribe something or other.
Okay some don't, particularly North American and Northern/Western European ones.
But mostly, on average, physicians always try to prescribe you something.
adaml_623 · 3h ago
Provide a reference please. Which country is that from?
longhaul · 2h ago
Read a paper long time ago, something to do with increase of sulfur in the brain
SoftTalker · 3h ago
USA, what my wife’s OB told her. 20 years ago.
sarchertech · 2h ago
The OB will give you a list of what you can and can’t take. Tylenol is the only pain reliever you can take.
SoftTalker · 2h ago
I’d say that qualifies as physician advice.
No comments yet
adaml_623 · 2h ago
Oh I was hoping for a written down reference from an organisation responsible for giving medical advice rather than an single doctor.
While they do list some medicines, note that they also say check with your doctor first.
greesil · 3h ago
Or maybe it's genetic. Or whatever. Cite yer sources matey, or it be all hot sargassum.
Terr_ · 4h ago
I've always had an (unreasonable?) dislike of Paracetamol/Tylenol ever since I found out it was the #1 cause of acute liver failure in the US. Liver failure is scary.
The UK started requiring that Tylenol always be sold in blister packs instead of convenient-to-kill-yourself-with whole bottles of pills.
Results: "Suicidal deaths from paracetamol and salicylates were reduced by 22% (95% confidence interval 11% to 32%) in the year after the change in legislation on 16 September 1998, and this reduction persisted in the next two years. Liver unit admissions and liver transplants for paracetamol induced hepatotoxicity were reduced by around 30% in the four years after the legislation. Numbers of paracetamol and salicylate tablets in non-fatal overdoses were reduced in the three years after the legislation. Large overdoses were reduced by 20% (9% to 29%) for paracetamol and by 39% (14% to 57%) for salicylates in the second and third years after the legislation. Ibuprofen overdoses increased after the legislation, but with little or no effect on deaths."[1]
I am familiar enough with the numbers that I am not necessarily surprised, but I still find it emotionally hard to grok that more than one in five would-be paracetamol suicide victims would be dissuaded by having to pop the pills out of a blister pack first.
Dave3of5 · 5m ago
Actually nowadays it's less that it's a problem to pop the pills out the booster pack and more that you are limited to the number you can buy.
So if you're going to off yourself you'd have to stock pile or roam around shops picking up.
There is a not insignificant number of suicides where people just say fck it I'll just kill myself but they don't want to go out to any real bother to do it i.e. they don't pre-plan it it's just spur of the moment. A bottle of kill yo self pills is pretty easy. Cupboard, swallow, drink down some water, die. But having to go out and buy a bunch over a few days or like drive around in your car just buying as many as you can. Like you'd have to look it up to check you're going to buy enough.
Back when that law came in when they didn't reduce the total amount you could buy at one time so if you went in and bought like 10 packs at the supermarket then the person at the till would be like ok this person's going to kill themselves so again that would require a bit of balls from the would be kill yo selfer.
I think you can buy a bottle of like 100 x 500mg for like $20 in the USA. That's like over 2 weeks swigging at the max amount. Like you don't need that many, 3-4 days is enough shouldn't be taking that much of the stuff.
a3w · 3h ago
Most, if not all, medication would carry a poisonous symbol, if it were not taken out of regulation for that. Mostly, you kill organs by any overdose.
Roughly:
- Paracetamol overdose can cause severe liver damage and may be fatal.
- Ibuprofen in high doses can lead to kidney injury and stomach bleeding.
- Aspirin overdose may result in salicylate poisoning, causing ringing in the ears, confusion, and metabolic acidosis.
kuschku · 3h ago
That's why it's recommended to combine a half dose of ibuprofen and a half dose of paracetamol at the same time. (Plus some vitamin C)
Together they have higher pain killung effects than each alone, and the side effects are reduced as they affect different body parts. And the vitamin C reduces the damage to the stomach lining.
bryanlarsen · 3h ago
Or if you need stronger painkilling you can take a full dose of paracetomol and either ibuprofen or aspirin. OTOH aspirin and ibuprofen use the same pathways so combining a full dose of ibuprofen and aspirin is not recommended.
jeroenhd · 2h ago
Aspirin and ibuprofen are both NSAIDs with not too dissimilar pathways, so combining them won't be as effective as combining either with paracetamol. They'll both do their jobs, but if the ibuprofen is already doing its job, aspirin won't have much work left to do.
Meanwhile, taking ibuprofen can negate the effect aspirin has when taken against cardiovascular diseases. Not a huge problem if you're just taking it as a painkiller, but not everyone can combine the two. That's another potential reason to take paracetamol over some NSAIDs, though you should obviously consult a doctor if you're taking prescription medicine of any kind.
dark-star · 2h ago
Interesting, then why does Aspirin do almost nothing when I have a headache, while Ibuprofen works very well and very quickly?
basisword · 2h ago
Headaches have different causes.
anjel · 3h ago
Adding to this, its the margin between a therapeutic dose and a harmful dose is most relevant. That margin for aspirin is wide, the same effective vs toxic margin for paracematol is shockingly narrow.
Furthermore, the "aspirin is rough on your stomach whereas Tylenol is gentle" turns out to be McNeil Marketing puffery.
Terr_ · 3h ago
"Any medicine can be poison" is kinda missing the point.
There is a rich and varied multidimensional field of danger, from aspects like the safety-margin between regular/dangerous dose levels, the chronology of how it can spike or accumulate, whether there's feedback in advance of damage, etc.
Yeah, I can poison myself drinking clean water, but it's hard.
baxtr · 2h ago
Thank you for this comment
hdgvhicv · 18m ago
You can overdose on water and oxygen too. What’s your point?
formerly_proven · 2h ago
- Metamizole has a tendency to kill some percentage of native Brits and their descendants. Yet globally it's one of the most popular painkillers, it's even OTC in countries with sufficiently low numbers of British and related people. (Has anyone ever done research to try and figure out why Brits are on the order of 1000x-10000x more sensitive to that side effect?)
lr4444lr · 3h ago
It's not just that it causes liver failure: it's that the difference between the therapeutic dosing range for pain relief it's prescribed for is dangerously close to the toxicity level.
Other drugs like theophylline have ceased to be prescribed for a similar reason alternatives were available, but due to drug marketing, acetaminophen is touted as the "safe" pain reliever.
littlestymaar · 2h ago
> but due to drug marketing, acetaminophen is touted as the "safe" pain reliever.
Paracetamol's patents have expired long ago and there's not much profit to be made out of it (nowadays it's mostly not being made in the West, but imported from China, unlike profitable medicine).
The reason why it's still used it's that it's much better than the alternatives, despite the risks (it's only risky if you don't respect the doses by the way).
jonkoops · 3h ago
As with all things, the poison is in the dose. A tonne of incredibly useful medicine can kill you if dosed incorrectly.
pjerem · 3h ago
Sure but it’s pretty easy overdose on paracetamol.
Since it’s a mild and really common painkiller, sometimes seen as not dangerous, someone uneducated about it who is really suffering could easily take 3 or 4 times the dose.
Unlike a lot of drugs, you are not going to have a lot of immediate side effects if you overdose on paracetamol. You’ll just horribly die some days after,
basisword · 2h ago
How can you reach adulthood and think it's ok to take 3 or 4x the specific dose of any medication? If you're in that much pain you go to a doctor. Which makes me think maybe the issue is the private health system and not the drug.
zdragnar · 1h ago
Conversely, my grandmother's Alzheimer's became apparent when she was overdosing on either ibuprofen or aspirin, I forget which.
She would take a dose for a headache, ten minutes later she'd forgotten so she'd take another dose, ten minutes later, she had forgotten, take another dose, rinse and repeat until it's time for a trip to the hospital.
Maybe it wasn't ten minutes between, probably fewer given how much she'd ended up taking. This happened thirty or so years ago.
littlestymaar · 2h ago
> someone uneducated about it who is really suffering could easily take 3 or 4 times the dose.
And the solution is simple: educate people about that.
And it's not something hard to do, just have pharmacists say “respect the dose as it will kill you if you don't” every time they sell things and it'll work.
tobias3 · 3h ago
Also extra damage if the liver is already busy with alcohol. So not good to take for a hangover.
This is why Ibuprofen is perhaps the better default painkiller.
whazor · 3h ago
This send me into a whole rabbit hole. Mostly children get paracetamol overdose. Then I learned that in US/UK kids get paracetamol in liquid form with all kinds of flavours. Which is much harder to dose correctly when the kid spits or drools it out.
Total culture shock for me, as in Europe the default for children is rectal ingestion (which is probably a culture shock as well for Americans). Any how, with pills it is much easier to avoid overdose.
verbify · 2h ago
Recently had a prescription error with my two month old baby. The doctor prescribed 7 times as much iron supplement as they intended (confusing labelling - so while I'm annoyed, I can see how it happened). This went on for a month until we uncovered the error.
We had blood test done (on the doctor's recommendation), and luckily there is no sign of any damage, but prescription errors do happen (even if they are rare) and it's much easier with liquids (you probably wouldn't give 8 pills to a baby, but 8ml doesn't seem so bad).
whazor · 2h ago
Paracetamol pills are labelled by age (and weight), available over the counter. So quite often we tend to under dose our child as children grow fast.
littlestymaar · 2h ago
> as in Europe the default
There's no “as in Europe”, every European country is different. In France the default is also liquid form, but the pipette is graduated is kilograms of baby weight, which limit the errors you can make (you know your kid doesn't weight 15kg when his weight is around 8).
whazor · 2h ago
Yeah, this is another rabbit hole. It seems to be Northern Europe and Japan that do rectal pills. Some countries only recommend them as backup.
I think the mistakes also come when the child spits out part of the liquid, and parents give another dose.
XorNot · 2h ago
Liquid Panadol flavors were totally useless with my son. He would spit it out or upset himself so much he'd throw it up.
We ended up crushing and diluting tablets in milk, which he would drink (you waste a lot of milk to hit the right factor).
basisword · 2h ago
I'm finding all the 'liver failure' comments on this post fascinating. The dose is on the back on the packet, as is the time interval between doses and the maximum number of pills per day. To overdose you need to ignore that. Given all the mention of 'Tylenol' I'm assuming most of the commenters are American - is this a thing in the US where you just take a random number of pills and ignore the labelling or treat it as a guide? Is it a consequence of the fact you can buy these in bottles by the hundred?
amenhotep · 1h ago
I choose to believe that all of the movies and TV shows showing Americans pouring a handful of pills out of a bottle into their hands and throwing them in their mouths (then chewing them!!!) are 100% accurate to life rather than cinematic shorthand
skybrian · 3h ago
It is scary, but I assume caution improves your chances of avoiding an overdose considerably.
oliveiracwb · 3h ago
I live in Brazil. We have broad access to non-steroidal anti-inflammatory drugs. Even the best-known medicines have unexpected and unknown adverse effects: in general and specifically in people with unexpected genetic, enzymatic, and protein variations. This has no solution. The medicine acts differently in each body, which is subtly diverse from the others. I see a lot of research criticizing any "old" general medicine and introducing the "new" one. I don't know if this is the case. Every medicine has its rush, half-life, and side effects, and its actions are not fully mapped. My preference for long-term treatments is: dipyrone. Short term: ibuprofen. Lymphatic pain: paracetamol. It may not make sense, but that's how I use it.
moritzwarhier · 3h ago
Interesting how you put metamizole at #1 for long-term treatment. As far as my experience goes, many doctors do the same in Germany. On the other hand, I've heard that the medication is banned in many other countries.
I guess the safest way is to take up the treatment in a hospital, to check for immediate bad reactions.
On the other hand, like with many medications, severe allergies and individual sensibilities causing side effects often don't show up often in the short term, but rather suddenly after many dose intakes.
So I'm back where I started. Not disagreeing with what you say. It seems like these non-steroidal pain relief medications are poorly understood regarding their interaction with the whole body though.
Many OTC medications and even some prescribed ones (especially psychiatric medications) suffer from a very poor understanding and apparent lack of effort in improving the understanding of their mechanisms of action.
davikr · 3h ago
Metamizole is safe to take on the long-term, which is not the case for NSAIDs (nephrotoxic) and corticosteroids.
moritzwarhier · 2h ago
I guess that's why metamizole is often a part of the standard treatment for mid-term exogenic pain here, for example after injuries or during some treatments involving pain.
Not addictive, not hepatotoxic, not nephrotoxic.
Seems the reason for the ban / harder regulation in some countries is about the disturbance of blood-forming in some individuals (which can also be deadly, but I have no idea of the quantified risk here).
Ibuprofen and acetaminophen are more common for short-term treatment, at least that's what I've been taught.
Avoid taking them on a schedule, take them as needed and at the lowest effective dosage.
A.s.s. (lol) too, apart from the low-dose usage that some claim to be helpful with heart/artery diseases.
jongjong · 14m ago
It's interesting because my wife has been using Ibuprofen for headache relief, whereas I use Paracetamol. I usually got Paracetamol growing up but recent studies showing adverse effects of Ibuprofen on male fertility solidified my resolve and consistency in choosing Paracetamol. My wife's reason for using Ibuprofen was simply because it worked better for her. Now it's kind of surprising to learn that Paracetamol has negative effect on women's fertility... I guess this means that both drugs are harmful to a different gender? What a coincidence? We were both using the optimal one for ourselves for reasons beyond our understanding... Until more data comes out.
Anyway, I understand arguments for avoiding drugs, medicines and chemicals altogether. Clearly, everything is more complex than it seems and side effects can never be fully known or understood; especially on a case-by-base basis given that everyone's DNA is different and responds differently to chemicals. I only take Paracetamol if I have a migraine with visual aura which is quite rare. I don't take it for standard headaches.
Noe2097 · 3h ago
Isn't paracetamol forbidden in the US for pregnant women already? It is in other countries
mynegation · 5m ago
You are probably thinking of ibuprofen which is considered non safe during pregnancy. Paracetamol is pretty much the only OTC pain relief medication that is recommended for pregnant women.
jeroenhd · 2h ago
As far as I can tell from my local health organisations, paracetamol is one of the safest painkillers for pregnant women.
That doesn't make it very safe, but NSAIDs carry well known risks during later stages of pregnancy, and opiods aren't exactly harmless either. Even aspirin carries risk (and aspirin doesn't even work as well compared to other drugs).
As far as I can tell paracetamol is still the first choice for painkillers while pregnant, but only because none of them are completely safe to use. It's probably fine for short term usage, but that also goes for non-pregnant people to be honest.
sarchertech · 2h ago
No it’s the only allowed pain reliever for pregnant women in the US. It’s also allowed in the UK and the EU from what I can tell. What countries are you talking abou?
moi2388 · 4h ago
“ APAP could contribute to early embryonic loss by impairing initial cell divisions. These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted”
By the same logic it would now be effective against cancer, no?
de6u99er · 4h ago
Can the effects of a drug on the body be reversed after a person stops taking it?
thisislife2 · 4h ago
Yes, in most cases. Or are you specifically asking about Paracetamol?
davikr · 3h ago
For paracetamol intoxication, there is n-acetylcysteine.
epgui · 4h ago
Sometimes yes, sometimes no.
notcodingtoday · 2h ago
Expected in-depth discussions about the topic, but got pseudo-science medical advice instead. I guess HN _is_ a 'social media' after all.
Cornbilly · 1h ago
This site is populated by mid-level code monkeys and “founders” of junk B2B startups. So, two groups that have an inflated sense of their own intelligence and believe everything that leaves their lips (or tips of their fingers) is on level of God’s word.
latchkey · 4h ago
> "Smoking and alcohol are established risk factors for spontaneous abortion, underscoring the importance of the chemical environment during embryonic development."
Both of my parents are/were heavy smokers drinkers from their teenage years. Mom died of lung cancer from smoking. Kind of wild to think that the odds were really stacked against my birth.
roughly · 4h ago
Nature really, really, really wants you to have kids. It took us collectively as a species most of our existence to find genuinely effective methods to alter our biology sufficient to block this process, and we still have a hard time doing it without dramatically impacting the host organism.
AngryData · 40m ago
Smoking certainly isn't good, but it also isn't some super-poison like some people like to pretend. Nearly half of US smoked in the 40s and 50s and they had no problem having tons of kids.
latchkey · 35m ago
> but it also isn't some super-poison like some people like to pretend
My mom's dead from lung cancer, and my dad is basically on palliative care. He's a barely walking billboard for "smoking is bad for you".
bena · 4h ago
This is probably one of those things where the risk is normally small, so small increases cause large changes in percentage.
For instance, if spontaneous abortion is normally 1% and smoking increases it to 2%, then that’s a 100% increase. Now, I don’t know the actual numbers, and smoking is just generally not good for one’s health, but I wouldn’t go as far to say things were stacked against you.
docfort · 3h ago
The article says that implantation fails in humans 10-40% of the time. Your point is still valid, but the scale in reality is very significant.
SoftTalker · 3h ago
Millions of kids have been born to parents who smoked and drank all the way through their pregnancies, especially before the 1970s or so. It raises risks, but doesn’t guarantee bad outcomes.
rendx · 2h ago
Many, many more but here's a few you might want to start with:
"The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring."
Mohammadian M, Khachatryan LG, Vadiyan FV, Maleki M, Fatahian F, et al. (2025) The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring: A systematic review and meta-analysis. PLOS ONE 20(2): e0317112. https://doi.org/10.1371/journal.pone.0317112
"Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures."
Coles, C.D., Shapiro, Z.R., Kable, J.A., Stoner, S.A., Ritfeld, G.J. & Grant, T.M. (2024) Prenatal alcohol exposure and health at midlife: Self-reported health outcomes in two cohorts. Alcohol: Clinical and Experimental Research, 48, 2045–2059. https://doi.org/10.1111/acer.15441
"Our results indicate that perinatal exposure to maternal smoking is associated with increased risks of CVD events, and such relations are modified by adulthood smoking behaviors."
H., Liang, Z., Wang, H., Cardoso, M. A., Heianza, Y., & Qi, L. (2021). Perinatal exposure to maternal smoking and adulthood smoking behaviors in predicting cardiovascular diseases: A prospective cohort study. Atherosclerosis, 328, 52–59. https://doi.org/10.1016/j.atherosclerosis.2021.05.009
"Our findings support previous findings suggesting the detrimental effects of prenatal binge drinking on child cognition. Prenatal alcohol exposure at levels less than daily drinking might be detrimentally associated with child behavior. The results of this review highlight the importance of abstaining from binge drinking during pregnancy and provide evidence that there is no known safe amount of alcohol to consume while pregnant."
Flak, A. L., Su, S., Bertrand, J., Denny, C. H., Kesmodel, U. S., & Cogswell, M. E. (2014). The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis. Alcoholism, clinical and experimental research, 38(1), 214–226. https://doi.org/10.1111/acer.12214
You may not not want to hear this, but let's put it plainly: Prenatal smoking and alcohol is clear and obvious child maltreatment.
scns · 2h ago
> "The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring."
The implied causation annoys me. ADHD is hereditary, even if if the mother does not smoke. People with ADHD smoke ten times more often.
SoftTalker · 2h ago
Don’t misunderstand that I’m advocating it.
ck2 · 4h ago
Acetaminophen/Paracetamol is a cox3 inhibitor
it also messes with bone formation so be careful using it for any length of time
especially after athletic activity
dbg31415 · 1h ago
What scares me about this is that Tylenol is a drug that's been handed out to everyone, for everything, for decades. And if we could miss how dangerous this one is, what are the odds other drugs aren't just as risky?
Side note, here's a Scrubs clip from 2001 that shows just how ubiquitous Tylenol was.
I know the anti-vax crowd is full of homeopaths, chiropractors, and tarot readers. But they're not wrong about one thing: drug companies make money by selling drugs. If we can't guarantee real oversight before those drugs hit the market, we're in deep trouble.
mythrwy · 3h ago
I won't take acetaminophen (usually) learning of the liver toxicity and low overdose potential. And I have a friend that destroyed his kidneys with ibuprofen and is on a transplant list.
But from what I understand acetaminophen also dulls emotional pain like from being fired or breaking up with a girlfriend which is interesting.
I still prefer to take neither if I can avoid it and I'll hurt a little bit instead. Hurt a lot and I'd probably change my mind though.
javcasas · 1h ago
> And I have a friend that destroyed his kidneys with ibuprofen
Acetaminophen is not ibuprofen. But I also don't like planes because a friend of mine died in a car crash.
mythrwy · 1h ago
I know and don't believe I implied they were.
There is also the final sentence about preferring to take "neither". Which of course indicates _two_ substances.
But just to be safe, I don't think the liver and the kidneys are the same organ either :)
thrance · 3h ago
I'm sure an untreated infection might be more upsetting.
hollerith · 3h ago
Except that paracetamol does not treat infections.
WorkerBee28474 · 2h ago
There is mounting talk of a link between Paracetamol/Acetaminophen/Tylenol and autism.
Question: Does acetaminophen use during pregnancy increase children’s risk of neurodevelopmental disorders?
Findings: In this population-based study, models without sibling controls identified marginally increased risks of autism and attention-deficit/hyperactivity disorder (ADHD) associated with acetaminophen use during pregnancy. However, analyses of matched full sibling pairs found no evidence of increased risk of autism (hazard ratio, 0.98), ADHD (hazard ratio, 0.98), or intellectual disability (hazard ratio, 1.01) associated with acetaminophen use.
Meaning: Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analyses. This suggests that associations observed in other models may have been attributable to confounding.
zoeysmithe · 2h ago
It tends to be poor scholarship imho.
Autistic moms are more likely to have chronic illness, sensory issues, auto immune issues, etc thus are more likely to be taking medications. In the end, the autistic mom just passes her autistic genes to the baby.
nikolay · 2h ago
I never took Tylenol/Paracetamol/acetaminophen, or anything containing it or given it to my children. We never reduce fever below 39.5/103.1 either - risks of febrile seizures are overstated and if you're a responsible parent, not a lazy one, you can see if things are going South, but there are other traditional means to lower fever. People are just too spoiled nowadays!
I tested positive with COVID-19 on Tuesday and had a pretty high fever (103) with a terrible headache, but I didn't take ibuprofen. First, because it could lower my fever, second, because its anti-inflammatory effect would compromise my immune system response to the pathogen. Most people I know immediately try to lower their fever to reduce their discomfort and would immediately take it for headaches, too.
efnx · 2h ago
I’m not a doctor but I’m pretty sure ibuprofen is _not_ acetaminophen.
nikolay · 46m ago
Of course it's not - I clearly said I never take acetaminophen, if for headache/fever I would rather take ibuprofen instead... but I don't take even that w/o a solid reason!
tralarpa · 1h ago
I have not found any study published after 2020 (the year when the French minister made the statement) that advises against ibuprofen for COVID-19. But I'm not a doctor, so I'd be interested to know your source.
nikolay · 45m ago
Studies showed negative efficacy. At best, no difference. [0]
People do that because they haven't been "educated" (even superficially) about what fever really is, which is your body working hard to fight of the infection. And messing with it is counterproductive.
They also do it with their kids because they want to help them. Also, some people have a lot on their plate, calling them lazy is not right thing to do. I have health insurance that covers me when my kids are sick (not in the US), so I can take care of them "properly ". This doesn't make me more responsible and someone else that works two jobs and can't afford to have sick kids lazy.
Also, I don't lower fever, even with my kids unless it prevents them from sleeping. But overstated is relative, it's happened to the kid next door from me. You don't want to be careless with infants.
nikolay · 13m ago
They are lazy if they don’t educate themselves about what they are doing and what they are giving their children. Don’t get offended. I’ve never done anything health-related to my kids without doing thorough research. I’ve witnessed four major medical mistakes made right in front of me in Orange County, California, in some of the best medical facilities and by the best pediatricians in the area! That’s why I don’t blindly trust anyone, whether it’s a doctor or not. I use critical thinking and always look for alternative advice. Doctors often find me a nuisance, but that’s okay with me. Just try asking a doctor when they prescribe Tylenol for a fever: “Why should I try lowering their fever?” or “Why should I give them Tylenol exactly?” The hepatotoxicity of acetaminophen occurs when the production of the toxic metabolite NAPQI exceeds the liver’s glutathione detoxification capacity, which can happen quite frequently during infections! So, then ask your doctor: “Doesn’t it make sense to give them NAC with Tylenol as well, just in case?” They won’t know what to say, trust me!
littlestymaar · 2h ago
> risks of febrile seizures are overstated and if you're a responsible parent, not a lazy one, you can see if things are going South
Not always. Blaming “lazy” and irresponsible parents is disgusting.
nikolay · 41m ago
But it's the truth. Something that has just a 2% incidence should not dictate 98% of the treatments. Compromising the innate immunity of the 98% is more disgusting!
propter_hoc · 4h ago
Acetaminophen is actually a terrible drug. It is barely effective as an analgesic, and the liver-failure dose is so close to its effective dose (about double) that it's very easy to accidentally overdose. Now this too.
Nobody should ever take it, ibuprofen is better in every way.
I won't get into the history of why people take so much acetaminophen despite how crappy a drug it is.
Edit: I appreciate everyone's anecdata about their kids, but studies show it's no more effective than placebo:
> Nobody should ever take it, ibuprofen is better in every way.
Please don't give health advice on the internet. I'm not a doctor but I'm a biochemist, and there are MANY situations where ibuprofen is less safe.
Rebellos · 3h ago
Not denying that acetaminophen/paracetamol has a horrible therapeutic index, but there are reasons why it is still so widely used. Despite potential hepatoxicity, it is considered the safest pain relief drug (this emerging research notwithstanding)
Ibuprofen is not better in every way. For instance ibuprofen, as well as other NSAIDs, is much less gentle on gastrointestinal tract and puts much more strain on kidneys.
Some people (e.g. with inflammatory bowel diseases or renal diseases) do not tolerate NSAIDs well, which is why acetaminophen is on the same step of analgesic ladder - it is still considered better in some cases.
Both are also used complementary to each other in pediatrics.
propter_hoc · 3h ago
Your comment is fair; obviously I wrote a pretty flippant comment, but the message is largely useful for most people.
The fact is that (largely due to the incredible marketing of Johnson & Johnson's Tylenol brand in the US) way too many people think acetaminophen is "safe and effective" when it's actually both pretty unsafe and pretty ineffective. Most people just "pop a Tylenol" by default without realizing it's not much better than placebo.
Sure there are cases where people have unique risks and should avoid NSAIDs. But for the vast majority of the public, if they or their kid are dealing with a headache, fever, menstrual cramp, or other transient pain or fever, they should reach for ibuprofen (with a snack) over acetaminophen. It's not remotely a close call.
I'm frankly pleased that people are becoming more aware of this and I don't mind taking a couple correction comments for presenting the info in a superficial way.
sarchertech · 2h ago
NSAIDs can cause GI issues if taken with or without a snack.
They reduce production of the stomach’s protective mucous lining. Snacks don’t help with that.
They can also cause kidney damage.
Occasional use for an otherwise healthy person is fine. But Tylenol as long as you are careful not to take too much is generally safer.
tylerhou · 4h ago
> ibuprofen is better in every way.
Taking ibuprofen (or other NSAIDs) long-term can wear away the stomach lining, causing ulcers. Acetaminophen is generally better tolerated to manage mild long-term pain than NSAIDs, as long as you don't overdose / take with alcohol.
propter_hoc · 4h ago
Yes, you need to take it with food, but it won't cause liver failure.
epgui · 4h ago
> take it with food
That's not helpful for the various categories of people who are more prone to gastrointestinal bleeding.
davikr · 3h ago
Yeah, but on the long-term it will cause kidney injury.
naijaboiler · 4h ago
This is a dangerous advice. Please folks. disregard this OPs comment. I doubt he is a doctor.
Ibuprofen is not better in every way. Ibuprofen is active in so many different parts of the body at the same time that inevitably it has unintended effects which is more pronounced especially in the elderly. It's bad for stomach, bad for kidneys, bad for mental status. and very bad with long-term use.
TLDR. Both aren't great for different reasons. Tylenol can be acutely OD'd and evidence is starting to show it isn't great embryos. Outside of those 2 situations that can be easily avoided, it is overall less bad than ibuprofen.
fredley · 4h ago
Barely effective? The difference 20 minutes after my toddler takes a dose is astonishing.
dreamcompiler · 2h ago
It's also a very effective drug for reducing high fevers in infants and children.
There are legitimate reasons to complain about APAP but calling it a placebo is nonsense.
soVeryTired · 4h ago
> I won't get into the history of why people take so much acetaminophen despite how crappy a drug it is.
I'd love if you did. What's the story there?
propter_hoc · 4h ago
Basically, the pharma industry's most successful marketing campaign ever. Here's an article from 1982:
Give me paracetamol over ibuprofen in most cases. Ibuprofen is much more likely to cause stomach issues than I am to miscalculate "take 2 paracetamol every 4-6 hours".
Analemma_ · 4h ago
Naproxen sodium is also a lot better, and is slightly safer than ibuprofen to take for extended periods. I had severe sciatica for the better part of a year, and the only thing that kept me somewhat functional was ~1000mg/day of naproxen, which isn’t great for you but would’ve been a lot worse if it had been ibuprofen (never mind opiates or something).
opan · 3h ago
Did your sciatica go away on its own or did you introduce some new exercises to your routine? I've had some pain in my left leg for a few months now that is likely sciatica. I did go to the doctor, but it wasn't a particularly helpful visit.
init2null · 3h ago
It's also even worse at gastrointestinal problems, for those affected. That's why it's less commonly used.
__alexs · 3h ago
I have an emergency Naproxen stash for the occasional gout flare-up and it's so much more effective than Ibuprofen it's amazing.
propter_hoc · 4h ago
That's fair, but naproxen is OTC or prescription-only in many jurisdictions.
Xenoamorphous · 4h ago
I think Paracetamol is better for fever, but for other pain I always prefer Ibuprofen.
propter_hoc · 3h ago
From wikipedia:
At a standard dose, paracetamol slightly reduces fever,[13][17][18] though it is inferior to ibuprofen in that respect[19]
[13] Warwick C (November 2008). "Paracetamol and fever management". J R Soc Promot Health. 128 (6): 320–323. doi:10.1177/1466424008092794. PMID 19058473. S2CID 25702228.
[17] Chiumello D, Gotti M, Vergani G (April 2017). "Paracetamol in fever in critically ill patients-an update". J Crit Care. 38: 245–252. doi:10.1016/j.jcrc.2016.10.021. PMID 27992852. S2CID 5815020.
[18] de Martino M, Chiarugi A (December 2015). "Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management". Pain Ther. 4 (2): 149–68. doi:10.1007/s40122-015-0040-z. PMC 4676765. PMID 26518691.
[19] Pierce CA, Voss B (March 2010). "Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review". Ann Pharmacother. 44 (3): 489–506. doi:10.1345/aph.1M332. PMID 20150507. S2CID 44669940.
beejiu · 3h ago
> At a standard dose, paracetamol slightly reduces fever,[13][17][18] though it is inferior to ibuprofen in that respect[19]
It's good you can take both at the same time then! (For adults.)
No comments yet
I wonder if it might also slow healing of wounds, or wherever else intense cell division happens.
> These results suggest that APAP should be used with caution by women attempting to conceive. Given that cell division is fundamental to all development, further investigation is now warranted to substantiate these findings and to elucidate possible implications for other developmental processes, such as gonadal and brain differentiation.
Prostaglandins are an inflammatory hormone that do a variety of things, but specifically PGE2 plays a role in muscle stem cell activation to divide and produce more muscle fibers. The effect is probably realistically small, but you will leave gains on the table by taking ibuprofen after hard workouts.
Though the science is not completely established here and there are some exceptions (obvious ones like cancer, etc...)
I'm not sure if that was supposed to be sarcastic, but these two people have done more harm to public health, and are responsible for more health dis/mis-information, than pretty much anyone I can think of. (I am a biochemist, no conflict of interest)
Okay some don't, particularly North American and Northern/Western European ones.
But mostly, on average, physicians always try to prescribe you something.
No comments yet
https://health.clevelandclinic.org/pregnancy-safe-medication...
While they do list some medicines, note that they also say check with your doctor first.
https://en.wikipedia.org/wiki/Paracetamol_poisoning
Results: "Suicidal deaths from paracetamol and salicylates were reduced by 22% (95% confidence interval 11% to 32%) in the year after the change in legislation on 16 September 1998, and this reduction persisted in the next two years. Liver unit admissions and liver transplants for paracetamol induced hepatotoxicity were reduced by around 30% in the four years after the legislation. Numbers of paracetamol and salicylate tablets in non-fatal overdoses were reduced in the three years after the legislation. Large overdoses were reduced by 20% (9% to 29%) for paracetamol and by 39% (14% to 57%) for salicylates in the second and third years after the legislation. Ibuprofen overdoses increased after the legislation, but with little or no effect on deaths."[1]
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC526120/
So if you're going to off yourself you'd have to stock pile or roam around shops picking up.
There is a not insignificant number of suicides where people just say fck it I'll just kill myself but they don't want to go out to any real bother to do it i.e. they don't pre-plan it it's just spur of the moment. A bottle of kill yo self pills is pretty easy. Cupboard, swallow, drink down some water, die. But having to go out and buy a bunch over a few days or like drive around in your car just buying as many as you can. Like you'd have to look it up to check you're going to buy enough.
Back when that law came in when they didn't reduce the total amount you could buy at one time so if you went in and bought like 10 packs at the supermarket then the person at the till would be like ok this person's going to kill themselves so again that would require a bit of balls from the would be kill yo selfer.
I think you can buy a bottle of like 100 x 500mg for like $20 in the USA. That's like over 2 weeks swigging at the max amount. Like you don't need that many, 3-4 days is enough shouldn't be taking that much of the stuff.
Roughly:
- Paracetamol overdose can cause severe liver damage and may be fatal.
- Ibuprofen in high doses can lead to kidney injury and stomach bleeding.
- Aspirin overdose may result in salicylate poisoning, causing ringing in the ears, confusion, and metabolic acidosis.
Together they have higher pain killung effects than each alone, and the side effects are reduced as they affect different body parts. And the vitamin C reduces the damage to the stomach lining.
Meanwhile, taking ibuprofen can negate the effect aspirin has when taken against cardiovascular diseases. Not a huge problem if you're just taking it as a painkiller, but not everyone can combine the two. That's another potential reason to take paracetamol over some NSAIDs, though you should obviously consult a doctor if you're taking prescription medicine of any kind.
There is a rich and varied multidimensional field of danger, from aspects like the safety-margin between regular/dangerous dose levels, the chronology of how it can spike or accumulate, whether there's feedback in advance of damage, etc.
Yeah, I can poison myself drinking clean water, but it's hard.
Other drugs like theophylline have ceased to be prescribed for a similar reason alternatives were available, but due to drug marketing, acetaminophen is touted as the "safe" pain reliever.
Paracetamol's patents have expired long ago and there's not much profit to be made out of it (nowadays it's mostly not being made in the West, but imported from China, unlike profitable medicine).
The reason why it's still used it's that it's much better than the alternatives, despite the risks (it's only risky if you don't respect the doses by the way).
Since it’s a mild and really common painkiller, sometimes seen as not dangerous, someone uneducated about it who is really suffering could easily take 3 or 4 times the dose.
Unlike a lot of drugs, you are not going to have a lot of immediate side effects if you overdose on paracetamol. You’ll just horribly die some days after,
She would take a dose for a headache, ten minutes later she'd forgotten so she'd take another dose, ten minutes later, she had forgotten, take another dose, rinse and repeat until it's time for a trip to the hospital.
Maybe it wasn't ten minutes between, probably fewer given how much she'd ended up taking. This happened thirty or so years ago.
And the solution is simple: educate people about that.
And it's not something hard to do, just have pharmacists say “respect the dose as it will kill you if you don't” every time they sell things and it'll work.
This is why Ibuprofen is perhaps the better default painkiller.
Total culture shock for me, as in Europe the default for children is rectal ingestion (which is probably a culture shock as well for Americans). Any how, with pills it is much easier to avoid overdose.
We had blood test done (on the doctor's recommendation), and luckily there is no sign of any damage, but prescription errors do happen (even if they are rare) and it's much easier with liquids (you probably wouldn't give 8 pills to a baby, but 8ml doesn't seem so bad).
There's no “as in Europe”, every European country is different. In France the default is also liquid form, but the pipette is graduated is kilograms of baby weight, which limit the errors you can make (you know your kid doesn't weight 15kg when his weight is around 8).
I think the mistakes also come when the child spits out part of the liquid, and parents give another dose.
We ended up crushing and diluting tablets in milk, which he would drink (you waste a lot of milk to hit the right factor).
I guess the safest way is to take up the treatment in a hospital, to check for immediate bad reactions.
On the other hand, like with many medications, severe allergies and individual sensibilities causing side effects often don't show up often in the short term, but rather suddenly after many dose intakes.
So I'm back where I started. Not disagreeing with what you say. It seems like these non-steroidal pain relief medications are poorly understood regarding their interaction with the whole body though.
Many OTC medications and even some prescribed ones (especially psychiatric medications) suffer from a very poor understanding and apparent lack of effort in improving the understanding of their mechanisms of action.
Not addictive, not hepatotoxic, not nephrotoxic.
Seems the reason for the ban / harder regulation in some countries is about the disturbance of blood-forming in some individuals (which can also be deadly, but I have no idea of the quantified risk here).
Ibuprofen and acetaminophen are more common for short-term treatment, at least that's what I've been taught.
Avoid taking them on a schedule, take them as needed and at the lowest effective dosage.
A.s.s. (lol) too, apart from the low-dose usage that some claim to be helpful with heart/artery diseases.
Anyway, I understand arguments for avoiding drugs, medicines and chemicals altogether. Clearly, everything is more complex than it seems and side effects can never be fully known or understood; especially on a case-by-base basis given that everyone's DNA is different and responds differently to chemicals. I only take Paracetamol if I have a migraine with visual aura which is quite rare. I don't take it for standard headaches.
That doesn't make it very safe, but NSAIDs carry well known risks during later stages of pregnancy, and opiods aren't exactly harmless either. Even aspirin carries risk (and aspirin doesn't even work as well compared to other drugs).
As far as I can tell paracetamol is still the first choice for painkillers while pregnant, but only because none of them are completely safe to use. It's probably fine for short term usage, but that also goes for non-pregnant people to be honest.
By the same logic it would now be effective against cancer, no?
Both of my parents are/were heavy smokers drinkers from their teenage years. Mom died of lung cancer from smoking. Kind of wild to think that the odds were really stacked against my birth.
My mom's dead from lung cancer, and my dad is basically on palliative care. He's a barely walking billboard for "smoking is bad for you".
For instance, if spontaneous abortion is normally 1% and smoking increases it to 2%, then that’s a 100% increase. Now, I don’t know the actual numbers, and smoking is just generally not good for one’s health, but I wouldn’t go as far to say things were stacked against you.
"The meta-analysis showed a significant association between maternal tobacco smoking during pregnancy and increased risk of ADHD in offspring."
Mohammadian M, Khachatryan LG, Vadiyan FV, Maleki M, Fatahian F, et al. (2025) The association between maternal tobacco smoking during pregnancy and the risk of attention-deficit/hyperactivity disorder (ADHD) in offspring: A systematic review and meta-analysis. PLOS ONE 20(2): e0317112. https://doi.org/10.1371/journal.pone.0317112
"Compared with unexposed controls, individuals with PAE reported significantly higher frequencies of problems with hearing, dentition, heart, cancer, gastritis, kidney stones, bladder, diabetes, thyroid, skin, and seizures."
Coles, C.D., Shapiro, Z.R., Kable, J.A., Stoner, S.A., Ritfeld, G.J. & Grant, T.M. (2024) Prenatal alcohol exposure and health at midlife: Self-reported health outcomes in two cohorts. Alcohol: Clinical and Experimental Research, 48, 2045–2059. https://doi.org/10.1111/acer.15441
"Our results indicate that perinatal exposure to maternal smoking is associated with increased risks of CVD events, and such relations are modified by adulthood smoking behaviors."
H., Liang, Z., Wang, H., Cardoso, M. A., Heianza, Y., & Qi, L. (2021). Perinatal exposure to maternal smoking and adulthood smoking behaviors in predicting cardiovascular diseases: A prospective cohort study. Atherosclerosis, 328, 52–59. https://doi.org/10.1016/j.atherosclerosis.2021.05.009
"Our findings support previous findings suggesting the detrimental effects of prenatal binge drinking on child cognition. Prenatal alcohol exposure at levels less than daily drinking might be detrimentally associated with child behavior. The results of this review highlight the importance of abstaining from binge drinking during pregnancy and provide evidence that there is no known safe amount of alcohol to consume while pregnant."
Flak, A. L., Su, S., Bertrand, J., Denny, C. H., Kesmodel, U. S., & Cogswell, M. E. (2014). The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis. Alcoholism, clinical and experimental research, 38(1), 214–226. https://doi.org/10.1111/acer.12214
You may not not want to hear this, but let's put it plainly: Prenatal smoking and alcohol is clear and obvious child maltreatment.
The implied causation annoys me. ADHD is hereditary, even if if the mother does not smoke. People with ADHD smoke ten times more often.
it also messes with bone formation so be careful using it for any length of time
especially after athletic activity
Side note, here's a Scrubs clip from 2001 that shows just how ubiquitous Tylenol was.
https://www.youtube.com/watch?v=EcDWj7kZcRc
I know the anti-vax crowd is full of homeopaths, chiropractors, and tarot readers. But they're not wrong about one thing: drug companies make money by selling drugs. If we can't guarantee real oversight before those drugs hit the market, we're in deep trouble.
But from what I understand acetaminophen also dulls emotional pain like from being fired or breaking up with a girlfriend which is interesting.
I still prefer to take neither if I can avoid it and I'll hurt a little bit instead. Hurt a lot and I'd probably change my mind though.
Acetaminophen is not ibuprofen. But I also don't like planes because a friend of mine died in a car crash.
There is also the final sentence about preferring to take "neither". Which of course indicates _two_ substances.
But just to be safe, I don't think the liver and the kidneys are the same organ either :)
Some links:
https://hsph.harvard.edu/news/using-acetaminophen-during-pre...
https://jennifermargulis.substack.com/p/why-this-doctor-is-c...
Question: Does acetaminophen use during pregnancy increase children’s risk of neurodevelopmental disorders?
Findings: In this population-based study, models without sibling controls identified marginally increased risks of autism and attention-deficit/hyperactivity disorder (ADHD) associated with acetaminophen use during pregnancy. However, analyses of matched full sibling pairs found no evidence of increased risk of autism (hazard ratio, 0.98), ADHD (hazard ratio, 0.98), or intellectual disability (hazard ratio, 1.01) associated with acetaminophen use.
Meaning: Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analyses. This suggests that associations observed in other models may have been attributable to confounding.
Autistic moms are more likely to have chronic illness, sensory issues, auto immune issues, etc thus are more likely to be taking medications. In the end, the autistic mom just passes her autistic genes to the baby.
I tested positive with COVID-19 on Tuesday and had a pretty high fever (103) with a terrible headache, but I didn't take ibuprofen. First, because it could lower my fever, second, because its anti-inflammatory effect would compromise my immune system response to the pathogen. Most people I know immediately try to lower their fever to reduce their discomfort and would immediately take it for headaches, too.
[0]: https://c19early.org/ib
They also do it with their kids because they want to help them. Also, some people have a lot on their plate, calling them lazy is not right thing to do. I have health insurance that covers me when my kids are sick (not in the US), so I can take care of them "properly ". This doesn't make me more responsible and someone else that works two jobs and can't afford to have sick kids lazy.
Also, I don't lower fever, even with my kids unless it prevents them from sleeping. But overstated is relative, it's happened to the kid next door from me. You don't want to be careless with infants.
Not always. Blaming “lazy” and irresponsible parents is disgusting.
Nobody should ever take it, ibuprofen is better in every way.
I won't get into the history of why people take so much acetaminophen despite how crappy a drug it is.
Edit: I appreciate everyone's anecdata about their kids, but studies show it's no more effective than placebo:
https://www.news.com.au/lifestyle/health/health-problems/med...
Please don't give health advice on the internet. I'm not a doctor but I'm a biochemist, and there are MANY situations where ibuprofen is less safe.
Ibuprofen is not better in every way. For instance ibuprofen, as well as other NSAIDs, is much less gentle on gastrointestinal tract and puts much more strain on kidneys.
Some people (e.g. with inflammatory bowel diseases or renal diseases) do not tolerate NSAIDs well, which is why acetaminophen is on the same step of analgesic ladder - it is still considered better in some cases. Both are also used complementary to each other in pediatrics.
The fact is that (largely due to the incredible marketing of Johnson & Johnson's Tylenol brand in the US) way too many people think acetaminophen is "safe and effective" when it's actually both pretty unsafe and pretty ineffective. Most people just "pop a Tylenol" by default without realizing it's not much better than placebo.
Sure there are cases where people have unique risks and should avoid NSAIDs. But for the vast majority of the public, if they or their kid are dealing with a headache, fever, menstrual cramp, or other transient pain or fever, they should reach for ibuprofen (with a snack) over acetaminophen. It's not remotely a close call.
I'm frankly pleased that people are becoming more aware of this and I don't mind taking a couple correction comments for presenting the info in a superficial way.
They reduce production of the stomach’s protective mucous lining. Snacks don’t help with that.
They can also cause kidney damage.
Occasional use for an otherwise healthy person is fine. But Tylenol as long as you are careful not to take too much is generally safer.
Taking ibuprofen (or other NSAIDs) long-term can wear away the stomach lining, causing ulcers. Acetaminophen is generally better tolerated to manage mild long-term pain than NSAIDs, as long as you don't overdose / take with alcohol.
That's not helpful for the various categories of people who are more prone to gastrointestinal bleeding.
Ibuprofen is not better in every way. Ibuprofen is active in so many different parts of the body at the same time that inevitably it has unintended effects which is more pronounced especially in the elderly. It's bad for stomach, bad for kidneys, bad for mental status. and very bad with long-term use.
TLDR. Both aren't great for different reasons. Tylenol can be acutely OD'd and evidence is starting to show it isn't great embryos. Outside of those 2 situations that can be easily avoided, it is overall less bad than ibuprofen.
There are legitimate reasons to complain about APAP but calling it a placebo is nonsense.
I'd love if you did. What's the story there?
https://www.washingtonpost.com/archive/politics/1982/10/02/h...
https://archive.md/rssPI
Give me paracetamol over ibuprofen in most cases. Ibuprofen is much more likely to cause stomach issues than I am to miscalculate "take 2 paracetamol every 4-6 hours".
At a standard dose, paracetamol slightly reduces fever,[13][17][18] though it is inferior to ibuprofen in that respect[19]
[13] Warwick C (November 2008). "Paracetamol and fever management". J R Soc Promot Health. 128 (6): 320–323. doi:10.1177/1466424008092794. PMID 19058473. S2CID 25702228.
[17] Chiumello D, Gotti M, Vergani G (April 2017). "Paracetamol in fever in critically ill patients-an update". J Crit Care. 38: 245–252. doi:10.1016/j.jcrc.2016.10.021. PMID 27992852. S2CID 5815020.
[18] de Martino M, Chiarugi A (December 2015). "Recent Advances in Pediatric Use of Oral Paracetamol in Fever and Pain Management". Pain Ther. 4 (2): 149–68. doi:10.1007/s40122-015-0040-z. PMC 4676765. PMID 26518691.
[19] Pierce CA, Voss B (March 2010). "Efficacy and safety of ibuprofen and acetaminophen in children and adults: a meta-analysis and qualitative review". Ann Pharmacother. 44 (3): 489–506. doi:10.1345/aph.1M332. PMID 20150507. S2CID 44669940.
It's good you can take both at the same time then! (For adults.)