Tylenol AND Ibuprofen?

Michael's post (and the similar one's) hit closest to center-target.

Acetaminophen/paracetamol technically isn't an anti-inflammatory, and that's why ibuprofen generally works better on pain from pulled muscles, sprained ankles, etc. It does work really well on headaches, and is a great antipyretic. Thus, it works well for random viral illnesses or 'flu' that cause fevers, aches, and pains. Also, ibuprofen is notorious for upsetting stomachs, so it is best taken with food.

The good news is that since they aren't in the same class of drugs you can take full doses of both at the same time- as several people have said.

As an aside- another BIG reason that acetaminophen causes so much liver failure in the US is that people think it is pretty safe, and thus depressed people who try to get attention by making a suicidal gesture (but who aren't REALLY trying to kill themselves) will overdose on Tylenol. Little do they know, but they just killed their liver and now need a transplant- IF a liver is available for them. If not, liver failure is an exceedingly undignified way to die…

I cannot take ibuprofen due to warnings on a BP med I take. Tylenol is what I can take. As well, due to my avoidance of artificial coloring, again, old school Tylenol wheels are all I can take.
My husband though takes only ibuprofen.

I carry both due to this. They weigh like air for a couple pills.

I carry Vicodin for migrianes. Say what you want, it has allowed me to keep moving.

Aspirin and paracetamol for me, in combo. If the pain is worse than this, than an opiate needs to be added. But yeah, Tylenol AND Ibuprofen is pretty much the same thing. They target pain and fever in different ways, often synergistically (throw in some caffeine for even better pain relief, AKA "Triple Therapy".

Neither drug is perfect. Both have a role. here is no simple answer.

The FDA is mainly targeting the removal of acetaminophen(paracetamol) products combined with something else. Accidentally doubling up on the paracetamol component (best avoided) was one problem. The other was people becoming addicted to the "other thing" with the paracetamol. Cafeinne or codeine were the classics. You get tolerance to both of these and in a combination pill the only way to get more was to accept the paracetamol that comes with it. The result is a chronic paracetamol overdose.
This FDA move will make it harder to find mild opiates over the counter (eg coedine)to take with you. They are better controlled as they are easily abused if you don't have the risk of paracetamol overdose. Having coedine even with prescription qualifies as trafficking in some countries (Greece most famously)

Paracetamol is actually very very safe unless it is very mismanaged. People are not scared of it so take lots. Ibuprofen misuse normally gives symptoms earlier (eg gastritis) and you realize you should stop taking it.

The medical reasons to avoid paracetamol are basically allergy and liver failure (you probably would not tolerate Ibuprofen in this case). The patient reasons are its lack of anti-inflammatory effect and preference you might need a slightly stronger drug (eg Ibuprofen) anyway and dont want two drugs. Post surgery they force feed regular paracetamol for its morphine sparing effects.
For years in Australia Ibuprofen was prescription only. Of the long list of NSAIDS it still the only one people are brave enough here to sell over the counter in an oral form. The list of reasons not to have ibuprofen is much longer (impaired renal function,diabetes,peptic ulcer histroy, gastric reflux, asthma….) but if you tolerate it well go for it. "The Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) system has estimated that more than 100,000 hospitalizations and more than 16,000 deaths in the United States each year are due to NSAID-related complications with costs greater than $2 billion"
Readers of this forum will probably read the instructions on the box (if only to find the weight of each tablet) so we should use them properly.

I would still carry a bit of both for a longer walk. Mild headache (paracetamol), inflamed knee/PMS (Ibuprofen), broken ankle walking out (overlap the two for the additional pain relief due to different modes of action).

If I was climbing something big for a month I would try to find some easy opiate eg codiene or maybe tramadol (less abuse potential…the most prescribed opiate world wide but may be poorly tolerated by some people)

I take ibuprofen, aleve, sudafed and benadryl.

Anti inflammatory and painkiller for some things = ibuprofen.
Crashing headache that makes me want to gouge my eyes out = aleve + sudafed.
Mild headache that might develop into eye gouging madness = ibuprofen + sudafed.
Allergic reaction to something = benadryl.

Migraine prone plus bad sinuses plus allergic to pine pollen… pills pills pills. I am a happier camper without the headache that potentially leads to vomiting and light sensitivity. Since I've never had any hint of altitude difficulty (the headaches are status quo at 500 feet of elevation where I live as well), and the pills always make it go away, I'm concluding that I have what I need. I have prescription Maxalt for the migraines, but taking the ibuprofen or aleve pre-emptively means I don't have to carry it. Vicodin made me hallucinate purple creatures on the walls, so any narcotic is right out.

…

I've found mixing the two (i.e. one of each) more effective (meaning faster and better) than taking two of either.

"I've found mixing the two (i.e. one of each) more effective (meaning faster and better) than taking two of either."

Ouch! Ben, don't do it! Taking ibuprofen and acetomyicin together can do serious damage to your kidneys! And those kidney dialysis machines are just so darn heavy to pack!

Stephen:

I talked to two different pharmacists before I started mixing. Got full blessing from both. But I am interested in your findings. Do you have a link?

You're good. Acetaminophen is a straight analgesic processed by your liver…be very very careful about not OD-ing on it. 4 grams a day is the max (I think…check the label) and respect that.

Ibuprofen is a non steroidal anti inflammatory that can be detrimental to your kidneys and stomach if taken in high doses and for long periods of time, but for most healthy people a bit is just fine.

No worries about mixing the two.

Now aleve and ibuprofen…a common mix in my patients…THAT'S bad. And taking multiple things that have acetaminophen in them is also harmful…you lose track of how much you've taken.

What you wrote is consistent with what my pharmacists told me. Mixing is fine. Overdosing is not.

except in very rare circumstances, you're not gonna run into trouble combining these two meds.

i bring both to use "just in case" — the combination of the two works better than either alone. in order to get the anti-inflammatory component of ibuprofen you need to take at least 600 mg.

for me — if i'm injured and need the pain relief, i'm taking 600 mg ibuprofen and 1000 mg tylenol together. not something i would recommend long-term, but as an acute treatment, works great.

I used to be an occasional Ibuprofen user. The ultramarathon runners used to refer to it as Vitamin I.

Then my physician told me to take daily low dosage aspirin. I asked if Ibuprofen was OK. He said that each Ibuprofen pill that I consumed negated the positive effects of each aspirin pill, at least for my medical state.

So, before you take much of anything, you might want to consult with your physician.

–B.G.–

You're correct, Jennifer, the FDA says no more than 4 grams of Tylenol per day. However, Johnson & Johnson (makers of Tylenol) recently reduced their recommendation to 3 grams per day. I think the problem is that so many other OTC drugs (and Rx drugs too, like Vicodin) contain "hidden" Tylenol, and the company thought they should drop their max dosage recommendation to compensate for people not reading the labels.

I have aspirin, ibuprofen, Tylenol and Diclofenac (Voltarin) in my kit. Diclofenac is hard on the tummy and a prescription only med, but it is a potent anti-inflammatory. Each has it's own uses and I won't mix any of them without a physician's advice and especially in the backcountry: it is the last place I want complications.

I carry the aspirin for blood thinning properties and it can be used for tooth pain, letting it dissolve up against the tooth– a last ditch effort when away from home. Don't give it to kids.

Ibuprofen is my usual go-to for fever or inflammation. +1 on 600mg to get good effect with inflammation. Take it with food.

Tylenol is my go-to for fever and/or non-inflammatory related pain. It is easier on the stomach. Best alternative for kids.

Diclofenac needs to be taken with food and I would only use it if really hurting from inflammation.

I am usually on short trips and only carry 2-4 tablets of each, so it doesn't add up to much weight or bulk.

When you have a condition which requires constant fever reducer or pain reliever, doctors used to say to alternate tylenol and Ibuprofent to lessen the impact on stomach and kidneys.

I have had a kid come down with 102 fever the 2nd night out on a 4 day trip. Ibuprofen let him complete the trip in relative comfort. I was very glad I had it. Carried 4 days supply of IB/Tylenol combined.

Ben,
It was my doctor, and honestly, I can't remember if it was liver or kidney or what, as it was over 5 years ago. Probably the underlying issue is overdosing, which might be more of a CYA issue for the doc.

It isn't just a CYA by the doctor. There's no chance I'm going to sue my MD wife and she's told me the same thing. Also, you can get a little more complete pain relief (without going to higher dosages or narcotics) because they work through different mechanisms.