So...They conclude that you can take 2 extra strength Tylenol and 2 regular strength Motrin and get the same pain relief as the narcotics? Perhaps a placebo effect as it is being given in a hospital setting?

I'm not really surprised. When my daughter was severely burned as a toddler, they gave her morphine in the ER before she was airlifted to a burn unit, and one more dose before debriding the wound at the burn unit. After that, all she got was Tylenol.

I remember being worried about how effective it would be, especially once we left the hospital but, the doctors were correct.

Tylenol was all she needed after the initial debridement. We had to scrub her wound every day and change bandages. We would give her Tylenol 30 minutes before a dressing change and it worked.

A lower molar cracked and ultimately needed extraction after efforts to save it were unsuccessful. An infection had developed. Though I was given a prescription for something stronger, both my dentist and the oral surgeon he sent me to suggested I first try alternating a higher than normal dose of Advil and another OTC pain reliever, I forget which, at ( I think) two hour intervals to see if that would be adequate. It was, it worked fine. I had no discomfort at all.

I usually use Excedrin Migraine which is Tylenol/Aspirin/caffeine and it works well for me.

I tried it after knee surgery and no go. I do poorly with Tylenol though, makes me moody. Definitely worth a try though.

One point of the study is to see if there were effective pain killers that are not habit forming/addictive.

I could see where that could be helpful if talking something like a one time dose, but many can't take Advil/nsaids, or can't repeat doses of it. My mothers doctor doesn't recommend them for her age group, risk of stomach bleed or similar. She was taking an Aleve PM at night for sleep, suggested by one of her friends, and he said No! Send them home with your daughter and stick to Tylenol.

Only I can't take them either - my ankles swell. And I keep forgetting to ask my doctor why, I'm not a pound overweight. I haven't taken an OC product in years other than Tylenol.

My sister has the strangest reaction to an nsaid, discovered when she had bursitis and was given one in prescription strength. She cries. Unprovoked and spontaneously. She doesn't even feel especially sad, but she'll cry over nothing at all, all day.

I find Tylenol by itself, to be totally useless. Though it was effective for my children when they were little.

A dentist friend told me that codeine is not as effective for dental pain as it is for other kinds of pain. His practice recommends the combination of Tylenol and ibuprofen. Codeine is the most effective thing for some other kinds of pain.

Elizabeth, I am with you with respect to Tylenol- and aspirin never helped anything either. Ibuprofen was the first thing I could take that would help if I had a headache or something.

I agree with Elizabeth and Rita...I may as well take nothing as Tylenol does nothing at all. I was on a blood thinner for a while after a pulmonary embolism, so couldn't take Ibuprofen for my arthritis pain...doc suggested Tylenol; it gave no relief. She finally prescribed a narcotic pain pill, but it did nothing either. Glad to get off the thinner so I can now take Ibuprofen again.

I like the Excedrin Migraine also. However I would like people to note that Excedrin Migraine, Excedrin Extra Strength and the now discontinued Backache are all exactly the same formula. So buy whatever is on sale.

I also find plain Tylenol useless. I would probably be happy with an aspirin based product with caffeine but they are no longer as available as they once were.

If it's evening and I don't want the caffeine effect I just take plain old aspirin. I don't have health issues that require me avoiding anything.

I absolutely detest Vicodin. Leaves me climbing the walls. I refuse to take it. DS is the same way.

I also have been told to take only Tylenol post-surgery (no nsaids). Like others, it does absolutely nothing for pain for me. But try telling a doctor that...

As others have said, I too find Tylenol alone to be totally useless to relieve pain. Aspirin alone is helpful to a degree for me, but the combination of those two with caffeine, as in Excedrin. works well. These days for minor aches of muscle, one Alieve will do the trick. For a headache which I rarely get, Excedrin is my choice.

Please be very careful with any pain reliever combination you may use. ALL of them, when taken for more than a few days are very, very hard on your kidneys. My DM now has a choice of either NO pain relievers EVER or kidney failure, because she took regular doses of various pain relievers too often over the years.

Edited to correct spelling

Yes do use caution on mixing all meds. Sadly, I lost a daughter 11 years ago to the mixing of a low level narcotic for her Rheumatoid Arthritis and her mood stabilizer that she took for bipolar disorder. The narcotic was under investigation at the time and now has been taken off the market.

Please never lose sight of the fact that Tylenol in large doses can cause liver failure - and alcohol enhances the effect. Tylenol, by itself, doesn't do much for me in the way of pain relief

https://media.jamanetwork.com/news-item/no-significant-difference-pain-relief-opioids-vs-non-opioid-analgesics-treating-arm-leg-pain/

https://jamanetwork.com/journals/jama/article-abstract/2661581

At 2 hours pain score (0-10) decreased by:

4.4 - oxycodone 5mg & acetaminophen 325mg

4.3 - ibuprofen 400mg & acetaminophen 1,000mg

3.9 - codeine 30mg & acetaminophen 300mg

3.5 - hydrocodone 5mg & acetaminophen 300mg

ALL of these meds (Tylenol and ibuprofen) can cause liver failure. I don't take pain meds unless I'm in such extreme pain that I want to die (think: pancreatitis or gall bladder attack or broken bone).

Acetaminophen (Tylenol) is more toxic to liver than ibuprofen.

questions mdln, how much does it take to get to that liver toxicity level? I thought most cases were from intentional overdoses?

@ rob333, is your question about acetaminophen or ibuprofen?

Either... I assume acetaminophen is worse, but don't they both cause issues?

@rob333, see above from NIH for ibuprofen & liver.

For acetaminophen & liver, depends on many factors, incl. age, nutritional status, liver function, alcohol use, & other meds. Nice overview: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913076/

Tylenol does nothing for me, and Motrin induces migraines. I can and do use Aleve. But only with a full meal.

I think it's really interesting how many of us Tylenol doesn't work for. I know it's a more likely comment to make, but I thought I was odd in that respect....I'm glad I'm not...

Non pain-relief comment, but my mom can take a half a Xanax and be totally knocked out to the point of being unable to walk properly. I was prescribed Xanax and it had zero effect on me. (And I didn't just think I was fully functioning, either).

I thought ibuprofen is more damaging to kidneys than liver? One of my friends donated a kidney and she's not allowed to use ibuprofen at all. She's always warning me off of it (I take 400 mg a day most days and try to skip some days when I don't need to be ultra mobile).

If you take NSAIDs on a regular basis, you may find this interesting.

http://time.com/4568552/ibuprofen-naproxen-inflammation-safety/

very high level of pain-nothing helps(well didn't try morphine). I had a long scary tooth story..not even Percocet helped. Was climbing up the walls.

Slightly lower level of pain-Percocet

Even lower but still high-Vicodin

BTW I don't find them addicting at all as if the pain goes even a bit down-they especially Vicodin give me awful nausea. hate Vicodin. so I personally never take them the moment I can help that. I have a lot saved from all sorts of painful procedures..what if somebody breaks a bone or something? otherwise all these reactions to pills are highly personal. Have you ever had depressed mood from antibiotics? l I had..from two different ones already. And one of them I was given before several times and never had this side effect. Well now I do. So weird. I won't even start with other bad peculiar reactions to harmless over the counter stuff even..normal people take Melatonin to help them to sleep, I tried-and almost found myself in emergency room. Etc etc. I don't do well with pills, as a rule. Same with alcohol. low tolerance.

on the other hand I take huge amount of Benadryl for example if I need to, and nothing bad happens.

So it all is, again, very weird and personal.

Lower pain-Ibuprofen. But. Advil is better than other forms of it. Why? no idea. just feel the difference, and feel it very well. and should be capsules..

Strangely I also find Tylenol totally useless. Add Aleve to that. And Motrin too. And Excedrin. Not taking these.

But some people are not allowed to take Ibuprophen. My DD for example. She takes Tylenol if she has to.

And yes, once I took too much of it, and it started hurting ..luckily the pain passed the next day, but got me scared all right.

it's bad with migraines because this freaking Sumatriptan also makes me very nauseous. But you can't beat migraine with Advil. You just can't. And other pills they're not for that kind of pain. I take three Advils plus Sumatriptan then need to wait out this nausea thing..then it'll get somewhat better then better..if i caught it in time.

I struggle to never take more than one Sumtriptan per day even though you're usually allowed to take two..no..I remember last time I took two..horrible.

Oh wow long post. yet again. lol.

I took a free senior class that was an overview of the field of genetics. If Advil (for example) works for you but not for your friend, it's NOT in your mind, it's in your genes. Maybe we will live long enough to have the doctor sequence our genes before prescribing pain medication.

That brings to mind science fictiony type Monsanto thoughts of pain genes lovingly created by those who of course then have the exact pain medication needed- for a price.

had OTC/prescription pain killer adventure around this time last year. had hurt my back well over 20 years ago... lifting something way too heavy... an injury that i think never really goes away. SWORE i'd never lift anything heavy again, but have had re-injury from doing pretty much nothing a few times. early in school year do "something" to back and started doctoring myself with ibuprofen. at first was doing the trick but when i needed more than recommended, went to real doctor. he sent me for bone scan (another story all together) and gave prescription for Tramadol. warnings scared me to death. i took exactly as prescribed and it was n't really doing much. eventually ended up in hospital with stomach bleed... 3 days in ICU... apparent interaction between OTC and prescription.

broke arm in mid-June and came home with prescription for percocet, again WARNINGS scared me to pieces. i really don't know if it was better at stopping pain than a few extra strength Tylenol, but it sure helped me sleep right after surgery. after a few days was alternating percocet and Tylenol... saving percocet for bedtime.

Ditto on the antibiotics....this was years before you could just use Google to check to see if you were alone.

At the time, I knew I just felt "funny"....it wasn't something I could put my finger on (and it really was nothing for me to worry about....). Once again, doctors just looked at me and nodded. Even my husband told me that antibiotics don't "work that way"--and he's a microbiologist.

Point is nobody should discount what you know about yourself.

Also Advil...I have insomnia and when it gets to be like I can't function and can't stand it, I take Advil PM, which is simply regular Advil plus Benadryl (diphenhydramine). HOWEVER I have taken the combination of these two together and it does NOT work as well... Which, scientifically, makes zero sense. But that's my truth.

My mom has told me that her complaints of a migraine resulted in a pat on the hand by the doc. Ditto that menopause wasn't mentioned due to docs thinking that a woman was simply going off the rails...

Anyway...we're getting to the point where patients are being listened to and (dare I say??) trusted JUST A LITTLE....albeit very slowly and with some cynicism.. :)

PS. Goodness. Aren't you glad I'm not in your houses? I sure can have a good natter...

There seems to be a pill for everything. I try not use anything unless I really hurt. I take xtra strength tylenol if I need something. I tried to wean myself off nexium but it just didn't work. After a week my stomach felt like it was ready to explode. My doctor said to try pepcid but that didn't help. So I'm back on the nexium. Plus my prescription is $25 for a 3 month supply which is a lot cheaper than an over the counter antacid.

I wish I could take plain old aspirin again. (My sinuses and throat engorge.) I can't take any NSAIDs.

AFAIK only aspirin works at the site of the inflammation, while acetaminophen (Tylenol) works in the brain. Isn't the active ingredient in the NSAIDs aspirin -- or a close relative?

I'm not sure why the whole world of medicine left aspirin for acetaminophen. It's easy enough to take a cracker or two with aspirin to prevent stomach irritation. Was this an overboard reaction to children developing Reye's syndrome when taking aspirin for flu?

Does anyone here take just plain aspirin as needed? (With food, I hope.)

I would love to take bayer aspirin, but I think that's what gave me my stomach problems years ago. After I had my daughter 41 years ago, aspirin was the only thing that help relieve the pain from my stitches.