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Thread: Safety levels with Ibuprofen and Tylenol

  1. Default Safety levels with Ibuprofen and Tylenol

    ive seen alot of posts asking about how safe is it to take Advil (ibuprofen) and Tylenol (acetaminophen) and what doses.

    I studied pharmacology and i also have friends that are doctors, you can safely take up to 1,200mg of Ibuprofen and 1,000mg of Tylenol at the same time 4 times a day.

    Thats the equivalent of 6 200mg Advil tablets, and 2 Extra strength 500mg Tylenol tablets. it doesnt matter if the tylenol has codeine or not as that doesnt affect the safety in the same way that these 2 are being considered


  2. #2
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    Tylenol you're right on the money. 1,000mg every four hours, a max of 6 *1,000 or 6g/day because four goes into 24 six times. But motrin/advil/ibuprofen the PA's at the clinic where I used to work used to say that the maximum safe dosage was 800mg four times per day, at a total max daily dose of 4*800 or 3,200mg. Some would err on the side of caution and say no, you can only take it safely 3 times daily. Either way, whenever you exceed the OTC of 200mg, you increase the risk of side effects such as stomach bleeding. Each time you go up, the risk goes up. For instance, at 800mg your risk of stomach bleeding is higher than that of 600mg. So you should only take those dosages under the supervision of a doctor.

    But like I said, you're right on the money with the tylenol. The only thing to keep in mind is that a lot of cough and cold remedies have tylenol in them, so it's easy to accidentally exceed that 1,000mg dosage, depending on why you're taking it.

  3. My dad was taking a lot of advil for about a year straight. He started to get bad stomach pains. Can it cause ulsers? I was really worried about him.
    feeling good

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    @makaveli25 : Ibuprofen as well as other NSAIDs are known to cause ulcers if taken for long periods.

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    When I was in the Army, I took about 3 or 4 of the 800mg ibuprofen(motrin) every day or 1-2 mobic or 1-3piroxicam (all NSAIDs) or 1-3 indomethacin (also an NSAID) throughout 4.5 years to fight knee pain and do my duty rather than cry to the doctor. I never took any antacids or prilosec, though I should have. I never had an ulcer. But I was lucky.

    My brother was prescribed mobic for knee pain, which he took for a short time(less than 3 months). Our family doctor diagnosed an ulcer, for which treatment was prilosec combined with immediate stopping of the NSAID. It's amazing what one body can handle while another can't. But @tinmuning is right. Motrin can cause ulcers, so if you're taking prescription doses (anything above 400mg 3 times day) I recommend a good H2 antagonist like famotidine, or cimetidine, or calcium carbonate, or a proton pump inhibitor like prilosec, to prevent the ulcer. Plus, never take it on an empty stomach, and try to eat with food, and have milk around in case you have stomach pain.

  6. I've had a few pharmacists say 4000mg of apap/tylenol per day is max. That's why hydro's higher than 500mg APAP suck. Sure we could get it with out the APAP but then it would be schedule II drug. How Stupid!

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    @going4broke Those pharmacists were playing it safe. When I was in the hospital for a broken leg once, they administered two 5/500 percocets (5mg oxycodone, 500mg APAP) every four hours for twenty-four hours, waking me up if they had to (usually the pain would keep me awake or I'd wake up on my own every 4 hours), and every two hours in between they would administer anywhere from 3-6mg morphine. The most morphine I've ever received from a nurse at once after falling off the top bunk of a medivac plane full of broken soldiers was 9mg of morphine. That not only took the pain away it got me high.
    Anyway so that's 1,000mg or 1gram of APAP every four hours. 4 goes into 24hours 6 times, so that's a maximum of 6,000mg or 6grams of tylenol in a 24 hour period (safely). Anything over that will damage your liver. But 4-6gm is safe. Scary how much tylenol your liver can take if spread out over time, huh? Tylenol can be one of the most dangerous drugs out there, though, it's extremely hepatotoxic at high doses. Swallow an entire bottle and you might be die from it, but unless they catch it right away and administer n-acetylcystine (mucomyst) you can permanently damage your liver. Swallow two bottles if you can get a hold of an anti-emetic (something to counteract the nausea) and the hepatotoxicity will definitely kill you, but it's a slow death. Lotta stories of people trying to die that way. Believe me, that's not the way to go if you're gonna go.

    What doctors do agree on, I was reading in the New England Journal of Medicine, is that for someone who takes tylenol every 4 hours daily for arthritis, is no worse off taking the full 1000mg of tylenol allowed than if they took only 500mg. In other words, taking 500mg for arthritis every 4 hours will not be any easier on their liver in the long-run. It was in the NEJM, so I believe them.

  8. #8
    I had no idea that you could take that much APAP. There are strong rumblings of the FDA putting pressure on manufacturers to reduce the amount to 325, but you can never trust the government.
    This job would be great if it weren't for all of the f**king customers.

  9. I have read bad things about both acetaminophen and ibuprofin. The former detroys the liver, the latter increases chances of stroke. I develop malaise when I take acetaminophen and I'm afraid of ibuprofin because of the stroke risk. It's best to take the lowest, infrequent dose of these medications as possible.

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    @Pmpdadinc I wouldn't be surprised. Because for one thing, people could still take the 1000mg by taking 3 of the 325 instead of two 500's. For the next, tylenol is in way too many OTC cold medicines, and people are lazy and don't read the labels and end up taking too much tylenol. For instance, one nyquil pill has 325mg, two will have 650, so that means if you take two nyquil you should only take one 325mg pill because if you take a 500mg on top of the 650 you've just exceeded the maximum safe recommended dose by 150mg which won't kill you and probably won't even damage your liver but over the long run it can't be healthy for your liver. I know I hate doing math in my head. But if the gov't switches to 325, people will still exceed the maximum dosages by mistake or due to laziness imho.

  11. If released today, I heard asprin and acetemetophin wouldn't pass FDA standards. Not like I trust them anyway. If you look at all the drugs recalled and all the lawsuits associated with them you realize we are merely phase 4 of clinical trials.

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    @going4broke

    Aspirin and acetaminophen wouldn't pass FDA standards? What kind of bogus nonsense is that? They have been tried and true medicines for decades. Aspirin and acetaminophen are not in any phase of clinical trials---they are far beyond that. Your assertion is ridiculous.

  13. Aspirin and acetaminophen wouldn't pass FDA standards? What kind of bogus nonsense is that? They have been tried and true medicines for decades. Aspirin and acetaminophen are not in any phase of clinical trials---they are far beyond that. Your assertion is ridiculous.


    Ask your local pharmacists, they'll put you straight.

  14. #14
    Quote Originally Posted by Lombard441 View Post
    ive seen alot of posts asking about how safe is it to take Advil (ibuprofen) and Tylenol (acetaminophen) and what doses.

    I studied pharmacology and i also have friends that are doctors, you can safely take up to 1,200mg of Ibuprofen and 1,000mg of Tylenol at the same time 4 times a day.

    Thats the equivalent of 6 200mg Advil tablets, and 2 Extra strength 500mg Tylenol tablets. it doesnt matter if the tylenol has codeine or not as that doesnt affect the safety in the same way that these 2 are being considered
    I think you are correct, however I personally would never take that much of either for long periods of time. Even in moderate doses tylenol takes a toll on the liver over time.

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    @going4broke That's a great counterargument. "Ask your local pharmacist, they'll put you straight."

    Again, you're full of nonsense. Let me share the history of aspirin with you:

    A French chemist, Charles Frederic Gerhardt, was the first to prepare acetylsalicylic acid in 1853. In the course of his work on the synthesis and properties of various acid anhydrides, he mixed acetyl chloride with a sodium salt of salicylic acid (sodium salicylate). A vigorous reaction ensued, and the resulting melt soon solidified.[135] Since no structural theory existed at that time, Gerhardt called the compound he obtained "salicylic-acetic anhydride" (wasserfreie Salicylsäure-Essigsäure). This preparation of aspirin ("salicylic-acetic anhydride") was one of the many reactions Gerhardt conducted for his paper on anhydrides and he did not pursue it further.

    Six years later, in 1859, von Gilm obtained analytically pure acetylsalicylic acid (which he called acetylierte Salicylsäure, acetylated salicylic acid) by a reaction of salicylic acid and acetyl chloride.[136] In 1869, Schröder, Prinzhorn and Kraut repeated both Gerhardt's (from sodium salicylate) and von Gilm's (from salicylic acid) syntheses and concluded both reactions gave the same compound—acetylsalicylic acid. They were first to assign to it the correct structure with the acetyl group connected to the phenolic oxygen.[137]

    In 1897, chemists working at Bayer AG produced a synthetically altered version of salicin, derived from the species, which caused less digestive upset than pure salicylic acid. The identity of the lead chemist on this project is a matter of controversy. Bayer's official story is the work was done by Felix Hoffmann, but the Jewish chemist Arthur Eichengrün later claimed he was the lead investigator and records of his contribution were expunged under the Nazi regime. The new drug, formally acetylsalicylic acid, was named Aspirin by Bayer AG after the old botanical name for meadowsweet, Spiraea ulmaria. By 1899, Bayer was selling it around the world.[138] The name Aspirin is derived from acetyl and spirsäure, an old German name for salicylic acid.[139] The popularity of aspirin grew over the first half of the 20th century, spurred by its supposed effectiveness in the wake of the Spanish flu pandemic of 1918. However, recent research suggests the high death toll of the 1918 flu was partly due to aspirin, as the doses used at times can lead to toxicity, fluid in the lungs, and, in some cases, contribute to secondary bacterial infections and mortality.[140] Aspirin's profitability led to fierce competition and the proliferation of aspirin brands and products, especially after the American patent held by Bayer expired in 1917.[141][142]

    The popularity of aspirin declined after the market releases of paracetamol (acetaminophen) in 1956 and ibuprofen in 1969.[143] In the 1960s and 1970s, John Vane and others discovered the basic mechanism of aspirin's effects, while clinical trials and other studies from the 1960s to the 1980s established aspirin's efficacy as an anticlotting agent that reduces the risk of clotting diseases.[144] Aspirin sales revived considerably in the last decades of the 20th century, and remain strong in the 21st century, because of its widespread use as a preventive treatment for heart attacks and strokes.[145]


    Now, are there clinical trials going on involving aspirin? Of course. Go to clinicaltrials.gov and plug in aspirin and you'll get 647 studies involving aspirin. But NONE of them are to gain FDA approval for its use an OTC analgesic or prescription antiplatelet drug.

  16. #16
    @QVC1212 awesome article, yet again...however, doesnt lend any relative info the topic at hand....just the "history" of aspirin and its competitors.

    But, your first post here and this last post...hot damn, nice man

    combined and i feel a bit smarter :P

    G
    And if someone gave you a pile of gold, you'd probably complain that it was too heavy.

  17. Ibuprofen is bad if you have stomach or intestinal issues. I have an intestinal disease and everytime I take advil or anytype of NAISD I end up having severe abdominal pain. My doctor stricly advised not to take NAISD's

  18. Quote Originally Posted by QVC1212 View Post
    @going4broke

    Aspirin and acetaminophen wouldn't pass FDA standards? What kind of bogus nonsense is that? They have been tried and true medicines for decades. Aspirin and acetaminophen are not in any phase of clinical trials---they are far beyond that. Your assertion is ridiculous.
    I've heard the same assertion elsewhere, but the point is that the FDA now has far higher standards for OTC approval than it use to and that aspirin and acetaminophen have been grandfathered in because they were already on the market.

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    Not to disagree as you are correct QVC that 4-6 gm tylenol per 24 is probably safe for most people for brief periods of time , those taking doses over or even at 4 gm /day for prolonged periods such as 2 weeks or more can be at an increased risk of developing liver toxicity which can and has resulted in serious consequences . and Although it is true that many who are on combination opiates long term often develop a tolerance to the toxic effects of tylenol , it is thought this is due to gradual dosage increases over time .
    Additionally, things such as alcohol intake , health status and other medications can reduce the safe level to far lower daily doses .
    Again, this post is not to disagree in any way to what has been previously posted by others, but moreso to clarify so that readers will understand that there can be other issues at play and that safe tylenol levels can vary between individuals . Tylenol toxicity can be deadly and most people, although there are exceptions, should not be taking doses of even 4 gms a day for prolonged periods of time unless they are having their liver enzymes monitored to ensure hepatic function is intact.
    Lastly , I want to mention that I am a clinical pharmacologist . I say this not to sound authoritative , but only so that readers will know that I have researched that which I am saying

  20. I had the worst experience with ibuprofen, after taking it at doses of around 1000 mg/day for about a month or two. I was coming off surgery, so I tried alternating with some degree of success. Ibuprofen is just too hard on my stomach and I can't see how taking it for an extended period of time would be healthy, esp. given how ineffective the thing becomes. I imagine if I mentioned my concerns to my dr, he'd just prescribe something to mask it.


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