Tylenol and Ibuprofen rotation for pain?????

[nerdgettingfit]

I went in to the dentitst for a tooth ache. Turns out I need a root canal. My dentist referred me to someone else who can't get me in for two weeks. So my dentist told me to do the tylenol and ibuprofen daily rotation until I can get the root canal done. Now I am not one of those that listens to everything my doctor tells me. I am not ragging on doctors or anything but they are human and just like any other profession you got your good eggs and your bad ones. I tend to always research anything my medical professionals tell me. There is a lot of research out there that supports the idea of liver damage caused by these drugs (especially tylenol). Now most the stuff I read suggests that you have to take either more than the recommended single dose or more than the recommended daily dose or both in order to cause damage. But some reports say that there are people that have ended up with liver damage just by taking the max recommended dose. Though in a lot of these cases people were taking the medicine for much longer than two weeks. In the past I have never had issues with either drug. But I have never taken them for more than 3 or 4 days. Now I am being asked to take both daily for two weeks straight.

I was researching some more natural, herbal remedies. I found one called feverfew that is supposed to be good for tooth aches. Of course no place around me carries it so I would have to order it online. Has anyone ever used feverfew? If so how well did it work? Does anyone have any other thoughts or suggestions? Am I just being worry wart?

[azotus]

First off:

Tylenol contains acetaminophen, which works differently than ibuprofen. Acetaminophen works to reduce pain, and that one can cause liver damage if taken in excess for a long time. If you follow the instructions on the bottle, you should be okay for 2 weeks. People with chronic pain conditions who take the medicine for years, especially alongside alcohol or other liver sensitive medicines are the ones at most risk, also people who overdose and don't follow the restrictions.

Ibuprofen is a non steroidal anti inflammatory drug (NSAID) that is in the same family as naproxen and aspirin. It works to reduce swelling and inflammation in areas like a tooth cavity, thus reducing pain.

I don't think your current 2 week regimen looks excessive, but ask your doctor before starting any herbal remedies, as believe it or not, they can interact with other medications. If you're still worried, you can always ice the affected area to control swelling and discomfort without drugs

[doc_apoo]

So.  Being a dude on the internet, take this with a grain of salt.

 

The problem with "herbal" medication is there is no regulation.  None.  I can sell you some online right now and put whatever I want into it.  There is no regulation on dosage, or proper dosage or contents or ingredients.  It's a total crapshoot everytime and there a lot of shady and underhanded people selling snake oil at a premium.  Look at all the stuff that Dr. Oz is going through.  He's a board certified cardiac surgeon and he's being lambasted for pushing shady suppliments.

 

You know what we call alternative medicine that works?  Medicine.  Thanks NTD!

 

Yes, there are negative side effects with any medication that you take and there is always a very very small chance of long-term damage.  2 weeks is not a lot of time in a drug regimen.  I've taken the very max dosage of ibuprofen, 800mg 3 times a day for 30 days with no adverse effects.  It's when people overdose or underdose or don't follow instructions that things can get dangerous.  Patient compliance is the number one reason for medication failure.  And those herbal suppliments?  They can negatively affect the medication that you are taking.

 

But hey, like I said, I'm just a dude on the internet.

[hwrdfrnd]

The purpose of the rotation, I believe, is so that your body can have time to filter out your last dose of tylenol before your next dose, and so on. It is what we did anytime one of the kids had a fever.

[doc_apoo]

The purpose of the rotation, I believe, is so that your body can have time to filter out your last dose of tylenol before your next dose, and so on. It is what we did anytime one of the kids had a fever.

 

Close, it's because acetaminophen and motrin affect two different systems in the body.  Just think of it like train tracks.  You have two different schedules on the same track.  Each train has to get there on time and let the passengers off before loading up new ones.  The two trains can't get to the same stop at the same time, so you space it out.

[DocKnight]

There isn't anything magical about taking both. It's really just treatment for your pain. I would try just using Ibuprofen every 6-8 hours as it has a better anti-inflammatory effect than Tylenol, then using an occasional dose of Tylenol if needed for additional pain relief. 

 

I treat my patients with NSAIDS (Aleve, and other stronger prescriptions) at over twice the OTC (over the counter) dose on a regular basis for years to treat auto-immune inflammatory arthritis. Just take it with food to prevent stomach irritation and make sure you stay hydrate to perfuse your kidneys well.

 

I have never had a patient experience liver issues with long term treatments, but I did have a patient develop liver failure due to herbal supplementation, so you can guess my stance on the herbal remedies.

[Tanktimus the Encourager]

I've done exactly what your dentist suggested after having my wisdom teeth out, I had no adverse effects other than having to wake up multiple times in the night to get my doses in (if I skipped one it hurt).  The reason they can overlap has already been explained well enough.  You have to really take a lot of either to actually damage organs.

[Vian]

Ibuprofen is also metabolized by the kidneys, not the liver, so if you OD it would cause kidney damage/failure. NSAID's also cause stomach bleeding, so always take them with food. The absolute max dose of ibuprofen is 2400mg per day (divided into at least 3 doses of 800mg, 8 hours apart) but that should only be done under a doctors supervision. OTC versions of it limit you to 1200mg for safety reasons. If you stick to 1200mg per day (I'd do 400mg every 8 hours) you should be fine for 2 weeks. it says not to take it longer than 10 days without a doctors approval. So long as you are relatively healthy, don't have a history of liver or kidney damage, and stay away from the alcohol, and drink plenty of water, it should be fine. 

 

As for natural remedies though, there is one thing that is excellent for toothaches: clove oil. Put a drop on the spot where it hurts and it actually numbs the area. It's amazing. I use an essential oil blend called Healthy mouth blend by Orawellness that includes clove oil and if I get some directly on a part of my mouth and not diluted by saliva or toothpaste, it numbs the area instantly. Make sure not to use essential oils straight, you have to mix them with a carrier oil or they can be harmful.

[Vian]

I've done exactly what your dentist suggested after having my wisdom teeth out, I had no adverse effects other than having to wake up multiple times in the night to get my doses in (if I skipped one it hurt).  The reason they can overlap has already been explained well enough.  You have to really take a lot of either to actually damage organs.

I wass taking the maximum dose of ibuprofen for about 2 weeks (doctor prescribed for a medical procedure) it was 800mg every 8 hours. On days 10-14 my kidneys started to hurt, so I stopped taking it unless I really needed it, since the pain was much less than it had been. I'm healthy with no history of kidney failure or disease...so, even just the max prescribed dose can start to cause problems with organs in a relatively short amount of time. as soon as I stopped taking it, the pain in my kidneys went away.

[DocKnight]

I wass taking the maximum dose of ibuprofen for about 2 weeks (doctor prescribed for a medical procedure) it was 800mg every 8 hours. On days 10-14 my kidneys started to hurt, so I stopped taking it unless I really needed it, since the pain was much less than it had been. I'm healthy with no history of kidney failure or disease...so, even just the max prescribed dose can start to cause problems with organs in a relatively short amount of time. as soon as I stopped taking it, the pain in my kidneys went away.

Damage to the kidneys from NSAID use doesn't cause pain. The kidney damage usually leads to gross hematuria. On a retrospective review over a 2 year period of time with our patients (100s on NSAIDS) the only presenting sign/symptoms was hematuria (brown/dark urine). This occurred only in two kids who had 1 year and greater use of maximal dose NSAIDS on a scheduled basis. Because of that, we don't even do screening labs or urine test on these kids with long term use. We just ask about urine color.

The pain experienced was likely stomach irritation (gastritis or ulcer), which can sometimes present as back pain like the kidneys, depending on the area of ulceration/irritation.