acetaminophen and ibuprofen

Original link: https://dbanotes.net/review/paracetamol_ibuprofen.html

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To deal with mild new coronavirus infection, acetaminophen and ibuprofen are the mainstream drugs that the international medical community has reached a consensus on.

Acetaminophen was invented relatively early, in 1877. This year is the third year of Guangxu in the Qing Dynasty. According to folk songs, “In the third year of the reign of Emperor Guangxu, the ears of grain turned to the sky”, the Qing Empire was experiencing the disaster of “Ding Wu Qi Famine”. 1877 was the year of Ding Chou, and 1878 was the year of Wu Yin. The disaster killed between 9.5 and 13 million people.

Acetaminophen was not used in medicine for a long time after its invention. Johnson & Johnson’s acetaminophen tablets have been on the market in the United States since 1955.

Acetaminophen is also generally called “paracetamol”. The translation of this name is very expressive, comparable to the translation of the Chinese name of Coca-Cola. The trade name of acetaminophen is called “Tylenol” and “Tylenol” here.

Ibuprofen was discovered later than acetaminophen and was patented in 1961. The product names here are called Ibuprofen, Fenbid, Merrill…

Acetaminophen (Tylenol) is broken down almost entirely by the liver , while ibuprofen is mostly broken down by the kidneys . Therefore, under the condition of controlling the dose, it should be no problem to mix these two medicines. Professional doctors in some countries now prescribe the same way.

It is safe to take acetaminophen normally, but it will be poisoned if taken too much, and of course it will damage the liver. This is also the main reason why cases of “hepatic acute liver failure” can always be seen in recent days.

How do you call it more? Eating too much at one time, or eating too frequently per unit of time.

According to some research literature: multiple doses of small doses within 24 hours that accumulate to a toxic dose can cause poisoning, long-term daily intake of more than 4 grams can also cause poisoning, and daily intake of slightly higher than 6 grams can cause death. But it should be noted that the 4 grams here is already a dangerous dose for many people, because individual differences and body weight differences must also be taken into account.

What is this concept? Each Tylenol tablet contains 0.65 grams of acetaminophen. The instructions clearly state that you can (only) take one tablet at a time, with an interval of 8 hours, and up to three times a day. 0.65*3 = 1.95 grams is less than 2 grams. safe dose. It also means that under normal circumstances, there is a relatively high risk of more than 2 grams.

If the patient takes some cold medicines of other Chinese patent medicines at the same time, these medicines often contain acetaminophen, which can easily cause overdose. For example, each bag of Ganmaoling Granules contains 0.2 grams of acetaminophen. If you take it at the same time, it is easy to cause a single dose to exceed the standard, and if you are not careful, the amount taken in one day will exceed the safe dose.

The United States stipulated that a single tablet of acetaminophen should not exceed 325 mg (0.325 grams) more than ten years ago, while my country currently allows a single tablet of Tylenol to be 650 mg (0.65 grams). It has to be said that this is also to a certain extent Increased risk of overdose.

Acetaminophen is very safe and very very very cheap. It is listed in the World Health Organization’s standard list of essential medicines and is also one of the essential medicines for the basic public health system. If you buy acetaminophen tablets on an e-commerce platform, a bottle or a box costs about 10 yuan. Offline pharmacies? Because the gross profit is too low, there is a high probability that you will not be able to buy it.

As for Chinese patent cold medicines, the main active ingredient of most of these medicines is the addition of “acetaminophen”. If you buy Chinese patent medicine cold medicine, then the price of a box is probably not less than 10 yuan.

Some Chinese patent medicines for cold medicine will mark the specific content data of acetaminophen. For example, “So-and-so Ganmaoling Granules”, each bag contains 14 grams (including 25 grams of original medicinal materials; 168 mg of acetaminophen). Why can 14 grams contain 25 grams of original medicinal materials? I really didn’t understand it very well, that’s what it says on their official website. Ignore this question, and mainly look at the sentence “contains 168 mg of acetaminophen”.

Another type of Chinese patent medicine cold medicine basically does not label how much acetaminophen it contains. Simply put, there is this ingredient in it. Because of this magical existence, many medical papers study the use of HPLC (high performance liquid chromatography) to measure the acetaminophen contained in this type of cold medicine. Careful netizens will find that this kind of paper also studied the content of caffeine and chlorpheniramine maleate in this kind of cold medicine by the way. What are these two ingredients for? Chlorpheniramine maleate is an anti-allergic drug. This drug inhibits the central nervous system and makes you sleepy after taking it. The effect of caffeine is to make you feel more energetic. You can see that people have blended this ingredient for you… quite wise.

Some people say, why don’t you mention ibuprofen? Is ibuprofen okay? Ibuprofen “overdose can cause nausea, indigestion, diarrhea, nosebleeds, dizziness, and high blood pressure. Uncommon side effects include esophageal ulcers, heart failure, and kidney failure.” Of course, this just sounds scary, and for most people, eating according to the directions is no big problem. Also, be careful not to take this medicine on an empty stomach.

Careful netizens may be curious, why do most of the Chinese patent medicines for colds add acetaminophen instead of ibuprofen? This really stuck with me, and the only reason I can think of is that ibuprofen costs slightly more than acetaminophen.

Remind everyone if you can.

you are welcome.


Supplement: Why are acetaminophen added to most cold medicines in Chinese patent medicines? The main reason should be that acetaminophen is more universal and can be used by children and pregnant women. Also, there are slightly fewer side effects.

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