What are the differences in these medicines? Can you take them together?
I have always been under the impression that IB was used more for inflammation reduction and acetaminophen was primarily used for pain relief.
I’ve been training with bruised ribs and 8 hour Tylenol works wonders for the pain. I’ve always gotten recommendations for IB for just about any soft tissue inflammation (AT, muscle strain…) Just got me wondering what the differences were and where they both fit into an injury recovery strategy.
Yes, Acetaminophen (Tylenol) is a pain reliever / fever reducer. It does not have anti-inflammatory properties.
Ibuprofen (Advil) is one of many OTC anti-inflammatories (Naproxen (Aleve) in another good one)
If you have inflammation, go with an anti-inflammatory. I don’t think there is a reason you can’t take them both, but Advil or Aleve will usually do a pretty good job with pain as well, depending on the injury. So I wouldn’t bother with both.
As an aside… There is a lot of confusion here. I see a lot of people pop Tylenol before long races. It will just mask injury and do nothing to prevent it. An Anti-inflammatory is probably a better choice, although it has never been *proven *to help, and is suspected to increase the risk of hyponatremia.
Hmmm… I would have to look it up, and I don’t have time right now. But off the top of my head, this is what I think is true- don’t take this as a fact. If you have time go to rxlist.com
There are 2 cyclo-oxygenases (COX) enzymes that are targeted by anti-inflammatory drugs. I think that Ibuprofen is COX-non-specific, while Naproxen has a COX-2 bias. This makes it easier on the stomach and more specific for joint pain. True COX-2 inhibitors include the arthritis meds that have been pulled from the market because of heart attack risk. This has not been found with naproxen.
Could be wrong, because it’s been awhile. If no one else chimes in I’ll write more tonight.
If acetaminophen works for your pain, it’s a safer choice overall, unless you take large doses mixed with a large amount of alcohol, in which case it may damage the liver. For me, it doesn’t work near as well as ibuprofen.
The disadvantages to ibuprofen are that it may cause kidney damage especially if taken long term on a daily basis (e.g. 2 weeks or more), it alters sodium balance if it’s on board while you’re exercising, and it really should be taken with some food to prevent any gastric issues.
No - naproxen blocks COX-1/2 non selectively, just like ibuprofen. The only real difference between the 2 are their half life (4-6 hours for ibuprofen and about 12 for naproxen). Naproxen is also usually compounded with sodium though as well.
The only current selective COX-2 drug on the market is Celebrex (celecoxib) as Bextra and Vioxx have been voluntarily withdrawn (but not FDA mandated). Should be a release this summer with another.
Ibuprofen and other NSAIDS appear to IMPAIR healing of fractures and soft tissues, so other than acute use in the beginning of an injury, I would avoid them for a rib injury. If I recall there was a report of increased non-union of fractures with NSAID use.
Tylenol is a better choice for this, I would say. Long term heavy Tylenol use may damage the kidneys. I think the dose was several KG over a lifetime. High doses of NSAIDS over a period of time can also damage kidneys–remember Kenny Easley–pro football player from UCLA? There were a couple of other athletes who managed this.
They both relieve pain, but by different mechanisms.
You are right!! I would NOT take tylenol or any antiinflammatory before a long race. It can lead to hyponatremia…I know it is routine for alot of people to do this at race time, but, there is evidence that their effect on the kidney can cause hyponatremia…otherwise the other posts look pretty spot on about both meds…
I did a quick pubmed search. It seems that naproxen may actually have the lowest risks of all the NSAIDs of acute myocardial infarction. I found a couple of articles- here is one of the abstracts, which was a meta-analysis:
**1: **Arthritis Res Ther. 2006;8(5):R153. Links Risk of acute myocardial infarction with nonselective non-steroidal anti-inflammatory drugs: a meta-analysis. Singh G, Wu O, Langhorne P, Madhok R.
Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 100 Hamilton Avenue, Suite 225 #42, Palo Alto, CA 94301, USA. gsingh@stanford.edu
The use of cyclo-oxygenase 2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with increased risk of acute myocardial infarction (AMI). The association between the risks of AMI with nonselective NSAIDs is less clear. We reviewed the published evidence and assessed the risk of AMI with nonselective NSAIDs. We performed a meta-analysis of all studies containing data from population databases that compared the risk of AMI in NSAID users with that in non-users or remote NSAID users. The primary outcome was objectively confirmed AMI. Fourteen studies met predefined criteria for inclusion in the meta-analysis. Nonselective NSAIDs as a class was associated with increased AMI risk (relative AMI risk 1.19, 95% confidence interval 1.08 to 1.31). Similar findings were found with diclofenac (relative AMI risk 1.38, 95% CI 1.22-1.57) and ibuprofen (relative AMI risk 1.11, 95% CI 1.06 to 1.17). However, this effect was not observed with naproxen (relative AMI risk 0.99, 95% CI 0.88-1.11). In conclusion, based on current evidence, there is a general direction of effect, which suggests that at least some nonselective NSAIDs increase AMI risk. Analysis based on the limited data available for individual NSAIDs, including diclofenac and ibuprofen, supported this finding; however, this was not the case for naproxen. Nonselective NSAIDs are frequently prescribed, and so further investigation into the risk of AMI is warranted because the potential for harm can be substantial.
I take naproxen because it is longer lasting. But this might be another reason…
From what I recall really BOTH tylenol and nsaids can cause this effect…i don’t take either class of drugs before a race because it appears the risks outweigh the benefits of pain control ( i would rather have pain, than hyponatremia–which would obvoiusly end your day)
.
I found a really good article online a couple of years ago talking about NSAIDs in general, including which organs process which drug, and possible effects on endurance athletes (there was a quote in there from a Dr. who saw someone take over 1000mg of one drug during the course of an IM). Unfortunately, I tried to find it again recently and couldn’t. I’ll try and look for it again, but if anyone knows what I’m referring to and can post a link, please do.
The salt (sodium form) is more rapidly absorbed through the GI tract than the anion form. After oral administration, the sodium form reaches peak plasma levels in 1-2hrs vs 2-4 hours for the anion. Total absorption and peak plasma concentrations did not differ in studies of relative pharmacokinetics.
my doctor told me that, he prefers IB for most sports related issues. However he said, just because 2 work, 4 pills won’t make it even better. He pointed out that way too many people pop IB (that drug in particular for some odd reason) at a very high rate thinking it has no side effects. He recommended using the least effective dose and not staying on it for longer than needed. Common sense, I know, but many people lack common sense (not meaning you;)