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Whether you have a pounding headache or aching joints, a pulled muscle or menstrual cramps, it’s easy to grab a pill to ease the pain.
Advil And Tylenol The Same
Tylenol, Advil, and other over-the-counter pain relievers are almost always close at hand. Most of us have a bottle tucked away in a medicine cabinet or purse and it’s just a quick trip to the local pharmacy or corner store to refill.
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But while these medications may be as easy to buy as a carton of milk, the pills are not without risks.
A recent study by Danish researchers suggests that ibuprofen, the active ingredient in Advil, may increase the risk of cardiac arrest in some people.
In an accompanying press release, the study authors are calling for restrictions on the drug, including restricting the sale of ibuprofen to pharmacies so that people can consult with a pharmacist about its safety.
Tylenol also continues to make headlines linking the common pain reliever, when taken in higher than recommended doses, to an increased risk of liver damage. In 2016, Health Canada issued new labeling rules for acetaminophen, the ingredient in Tylenol, in part to emphasize the importance of taking the lowest possible dose to prevent harm.
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Instead of scaring people away from using over-the-counter pain relievers, reports of drug-related injuries should serve as reminders that all drugs — no matter how common and easy to buy — should be used with some caution, said Michelle Arnot, an associate professor of pharmacology. and toxicology at the University of Toronto.
“But I don’t think we do because they’re so ingrained in our culture. We see them advertised everywhere, they’re over-the-counter; we think they’re safe without question.”
However, as with all drugs, over-the-counter pain relievers are only safe when other factors, such as the dose of the drug and an individual’s health, are taken into account.
“They are safe for the majority of the population at some point in their lives,” says Arnot. “But it depends on what else is going on health-wise.”
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“It’s about taking the right medicine, at the right time, for the right period of time.”
Allan Malek, a Toronto pharmacist with nearly three decades of experience, says people with drug questions or problems should talk to their family doctor or pharmacist.
“Even if you’re at home and have a question, pick up the phone and call,” says Malek, who is senior vice-president of professional affairs at the Ontario Pharmacists Association.
The biggest problem Malek sees in his pharmacy is that people are buying multiple over-the-counter medicines that contain acetaminophen to help them feel better.
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“If someone takes eight tablets of extra-strength Tylenol in a day, plus a cold medicine with Tylenol, they exceed the daily limit. That’s when you get to toxic levels and the risk of liver damage.”
Arnot agrees that people need to read over-the-counter drug labels carefully to make sure they don’t accidentally double or triple a dose of a particular drug.
“Unless you’re under the care of a doctor, you shouldn’t take ibuprofen every day long-term, especially if you have cardiovascular problems or a family history of cardiovascular problems … You want to get the maximum benefit from a drug with the least possible risk. “
How it works: Acetaminophen works by blocking the pain associated with inflammation. It generally does not reduce the inflammation itself.
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When to use it: A good choice for headaches, general aches and pains and will reduce fevers that come with flu or common colds. It is considered gentler on the stomach than other pain relievers.
When to avoid it: Acetaminophen is broken down by the liver. This is why people with liver or kidney disease may want to avoid this drug; if the liver is not working well, the drug will not be broken down properly, which can lead to toxic accumulations of the drug.
Choose another hangover pain reliever to give your liver a break, as it is already working hard to break down alcohol in your system. People who drink three or more alcoholic beverages each day should also avoid acetaminophen to reduce the risk of liver disease.
Maximum daily dose for adults: 4,000 mg; equivalent to 8 extra strength Tylenol pills or 12 regular strength pills.
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How it works: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen work by targeting specific enzymes in the body that are involved in inflammation and pain. Ibuprofen reduces pain because it reduces inflammation.
When to use it: For pain due to osteoarthritis, muscle spasms and aches, headache, fever, period pain, toothache and other pain caused by inflammation.
When to avoid it: Ibuprofen and other NSAIDs target the same enzymes that also help protect the lining of the stomach and gastrointestinal tract. In high doses, it can lead to GI bleeding and peptic ulcers. Those with inflammatory bowel disease, including Crohn’s disease, colitis, and ulcers, should avoid this drug. So should those with kidney and liver problems and bleeding disorders.
Long-term use of NSAIDs can increase the risk of heart disease and stroke. Consult your doctor or pharmacist if you – or your family – have a history of cardiovascular disease.
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Maximum daily dose for adults: 1,200 mg; corresponding to 3 extra strong tablets. Health Canada says that ibuprofen “is used for a short time (seven days or less).”
When to use it: At higher doses for mild to moderate aches and pains, headache, fever. At a low daily dose, Aspirin is a blood thinner and can be used to reduce the risk of blood clots, heart attack and stroke.
When to avoid it: As with other NSAIDs, Aspirin can irritate the stomach and gastrointestinal tract and slow blood clotting. Avoid it if you have a history of ulcers or intestinal disorders, blood disorders or are prone to bleeding, and have liver or kidney disease.
Consider a different pain reliever if you have heartburn or a sensitive stomach; some versions of Aspirin are coated, which reduces stomach irritation.
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SOURCES: Health Canada; Michelle Arnot, associate professor of pharmacology and toxicology at the University of Toronto; Allan Malek, pharmacist and senior vice president of professional affairs at the Ontario Pharmacists Association.
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Copyright owned or licensed by Toronto Star Newspapers Limited. All rights reserved. Publication or distribution of this content is expressly prohibited without the prior written consent of Toronto Star Newspapers Limited and/or its licensors. To order copies of Toronto Star articles, go to: www.TorontoStarReprints.comMy doctor told me to take Advil for my recent knee injury, but all I have at home is Tylenol. Is it OK to take instead?
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Advil is a brand name for ibuprofen, just like Motrin. Ibuprofens are a type of NSAID, or non-steroidal anti-inflammatory drug. Aleve is the brand name for naproxen, another type of NSAID. These types of medications are often used for injuries due to the anti-inflammatory component. Tylenol is a brand name for acetaminophen, which is a pain reliever and fever reducer but has no anti-inflammatory properties. Your doctor likely recommended Advil because it can help with swelling and inflammation often seen after an injury or sprain. Ibuprofen should not be used in people with kidney problems, and paracetamol should not be used in people with liver problems, so be sure to ask your doctor if you have any problems before using these medications.
I am 30 years old and recently gave birth to my second child. While nursing, I felt a tender mass in my left breast. My mother and my aunt both have a history of breast cancer in their 40s. What should I do?
A breast mass in a patient requires further evaluation by your doctor. After a thorough history and breast exam is completed, your doctor will likely request a mammogram or ultrasound to further evaluate this mass. While it’s reassuring to know that most postpartum breast lumps are benign, don’t wait until you stop breastfeeding to get the lump examined.
Breast self-examination is an important means of early identification of breast masses that may be cancerous, and early detection makes successful treatment more likely. I commend you for finding this mass on the introspection. Not all cancers can be found this way, but it is an important step you should take for yourself regularly.
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Women should have their first baseline mammogram at age 35 followed by annual mammograms starting at age 40. You have a family history of breast cancer at a very young age, so starting screening mammograms at an earlier age may be necessary. I would also encourage you to discuss with your doctor whether genetic testing may be indicated.
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