Ibuprofen, Acetaminophen, or Aspirin?

[Fairweather]

Just curious what most here use/keep on hand during mountain trips or for prolonged strenuous activities. I'm not a big fan of Tylenol and have always had success with Bayer Aspirin, but I recently tried Motrin and noticed it really knocks out joint pain and headaches effectively. Any thoughts on pro/cons of each? I've read Motrin can be hard on the kidneys when used in high doses, but is there any kindey danger using this in normal doses while dehydrated?

Is Motrin a better anti-inflamatory drug than aspirin?

[iain]

I'm a big fan of Excedrin. It is a cocktail of acetaminophen, aspirin, and caffeine, and can make those long exits a little nicer. Otherwise, I carry ibuprofen in loading dose perscription quantities (800mg) for serious musculoskeletal injuries, less for minor pain.

[ChestBeater]

 

 

Naproxen Sodium (Aleve) knocks the socks off all that crap.

 

Carry some oxycodone (or other opiate painkiller) for when the shizzle really hits the fizzle.

[iain]

Naproxen-based products like Aleve can increase your skin's sensitivity to sunlight, if that is important to you. Nothing a sunscreen can't fix.

 

As far as I know, basic Motrin is just ibu, so the generic 200mg tablets will do the same job for much cheaper.

 

If narcotic analgesics are on the table there's a whole world of things to play with. But not exactly a first choice for "joint pain". If you have given your partner narcotics like oxycodone while waiting for an evacuation, be sure to remember to let the medic know before they administer morphine, etc. when they arrive. It would be easy to forget in the chaos.

[Dr_Flash_Amazing]

Dunno about its applicability for end-of-a-long-ass-alpine-beat-down relief, but you really ought to look into Bromelain as an alternative to the pharmaceutical crap. DFA and one of his associates have had excellent results using it as an anti-inflammatory (it's also used as a digestive aid). The Doctor wouldn't know about any of the claims made regarding cancer-fighting or other wonder-drug properties that have been attributed to bromelain, but it is definitely a worthy anti-inflammatory, and apparently helps in the absorption of glucosamine as well (apparently the mechanism by which it does this can increase the levels of other medications you may be taking in your bloodstream, so talk to your doc if you're taking anything else).

 

More info:

http://www.thorne.com/altmedrev/fulltext/bromelain1-4.html

 

http://www.wholehealthmd.com/refshelf/substances_view/1,1525,760,00.html

[DPS]

I second naproxen.Its what I take into the hills.

[selkirk]

I second naproxen.Its what I take into the hills.

 

600mg every 12 hours can do wonders! Probably not a good idea for daily use, but that's what i've had prescribed for inflamed rotator cuffs in the past.

[Gary_Yngve]

If narcotic analgesics are on the table there's a whole world of things to play with. But not exactly a first choice for "joint pain". If you have given your partner narcotics like oxycodone while waiting for an evacuation, be sure to remember to let the medic know before they administer morphine, etc. when they arrive. It would be easy to forget in the chaos.

 

Also important to remember that narcotics are inappropriate in cases of head trauma because they depress the CNS and slow breathing, which will already be slowed from the brain injury.

[iain]

No kidding, narcotics are a prescription drug for a reason, not just to make things difficult. Many people justify carrying other peoples' old prescriptions for climbing by thinking the concept does not apply to them. Others who are responsible consult their physician and ask for a prescription up front, explaining the concepts of mountain accidents and what would be good to have with them on a remote climb.

 

That said I'd probably be downing them if I was in a bad situation for a long period of time, and knew the contraindications.

[Bogen]

Ibuprofen. always. I have consulted 2 doctors on this, both told me that ibuprofen does not bother the liver and kidneys, but that acetaminophen does, particularly in conjunction with alcohol. Both doctors told me that alcohol and ibuprofen are fine together. Vitamin I and whiskey!

[cj001f]

Ibuprofen. always. I have consulted 2 doctors on this, both told me that ibuprofen does not bother the liver and kidneys, but that acetaminophen does, particularly in conjunction with alcohol.

ummm. No. There have been several cases of Ibuprofen related renal failure. All of the drugs mentioned Acetimenophe, ibuprofen, naxopren can cause renal problems with long term use.

[chelle]

Before you give anything to your partner after an accident, make sure you know what they are allergic to. Some people are hypersensitive to ibuprofen, naproxen, and even asprin. Anaphlyaxis will ensure a quick and unfortunate ending to their pain.

 

My $0.02.

[Bogen]

Ibuprofen. always. I have consulted 2 doctors on this, both told me that ibuprofen does not bother the liver and kidneys, but that acetaminophen does, particularly in conjunction with alcohol.

ummm. No. There have been several cases of Ibuprofen related renal failure. All of the drugs mentioned Acetimenophe, ibuprofen, naxopren can cause renal problems with long term use.

 

come to think of it, they said liver, but didn't mention kidneys... I wonder what "long term use" constitutes in this case?

[Stephen_Ramsey]

Ibuprofen. always. I have consulted 2 doctors on this, both told me that ibuprofen does not bother the liver and kidneys, but that acetaminophen does, particularly in conjunction with alcohol.

ummm. No. There have been several cases of Ibuprofen related renal failure. All of the drugs mentioned Acetimenophe, ibuprofen, naxopren can cause renal problems with long term use.

 

come to think of it, they said liver, but didn't mention kidneys... I wonder what "long term use" constitutes in this case?

There have been cases of people going into acute renal failure after a single massive dose of ibuprofen, during extreme endurance competitions (try googling on "ultramarathon ibuprofen renal failure". I would be careful taking a huge dose of ibuprofen if you are on a long climb and are very dehydrated and might have a very elevated CPK level. I know it's cliche, but "talk to your doctor". There is a reason why sports med doctors often do blood tests for kidney function, on patients who are taking high doses of ibuprofen for prolonged periods.

 

Not that I'm trying to bash ibuprofen. It's a fantastic anti-inflammatory drug, widely prescribed for sports-type injuries. But I would personally avoid taking big doses of it while on a climb, unless it was an emergency situation. Just my $0.02.

 

Alcohol is also potentially a bad idea, when taking high doses of ibuprofen. This is because alcohol can make the stomach lining more susceptible to irritation from the ibuprofen.

 

And, I have to agree with Chestbeater... When things go horribily wrong and you need to (for example) ambulate on a fractured leg, you want opioid analgesics. [Obviously, you need to know the risks and contra-indications and make an informed decision about whether to take them.]

Edited December 7, 2004 by Stephen_Ramsey

[Dru]

Ibuprofen. always. I have consulted 2 doctors on this, both told me that ibuprofen does not bother the liver and kidneys, but that acetaminophen does, particularly in conjunction with alcohol. Both doctors told me that alcohol and ibuprofen are fine together. Vitamin I and whiskey!

 

Nyquil is alcohol plus acetaminophen. You can check the label. Of course they do say not to combine Nyquil and alcohol.

[Bogen]

mmmm Nyquil. In the original green-fucking-death flavor. Love that big fuckin Q!

[iain]

I liked Nyquil but you had to be literally leaning over your bed when you drank it.

[cj001f]

Nyquil is alcohol plus acetaminophen. You can check the label. Of course they do say not to combine Nyquil and alcohol.

And the amount of alcohol contained in a dosage of Nyquil is miniscule.

 

"Acetaminophen is the most commonly reported drug overdose in the United States"

"At the therapeutic dosages, acetaminophen can be toxic to the kidneys in patients who are glutathione depleted (chronic alcohol ingestion, starvation, or fasting)"

(the later 2 may be of concern for alpine climbers)

http://www.ncbi.nlm.nih.gov/entrez/query...p;dopt=Abstract

[Dru]

Ok I am saying goodbye to Cherry Nyquil and Jagermeister shooters then.

 

The amount may be minimal but the concentration of alcohol in Nyquil is like 40%

[Bogen]

(chronic alcohol ingestion, starvation, or fasting)"

(the later 2 may be of concern for alpine climbers)

http://www.ncbi.nlm.nih.gov/entrez/query...p;dopt=Abstract

 

just the latter 2 ??

[Gaper_Jeffy]

Neither. I just take ecstasy pills for joint pain, the higher MDMA concentration the better. I've heard it works great for relieving boredom at bivys too!

 

[catbirdseat]

My old boss, Dave D., was in the research group at UW that elucidated the mechanism of acetaminophen liver toxicity. A highly reactive benzoquinone species forms. It is very hard to observe because of the reactivity. It was trapped by reacting with another molecule and it's existence inferred.

 

Liver failure is a real bummer. Don't mess around with Tylenol and alcohol.

 

Regarding Aspirin versus Naproxen. I read somewhere that Aspirin is a 4000:1 COX-1/ COX-2 inhibitor, which explains why it is so harsh on the stomach. The prostaglandins that COX-1 produces are protective of the stomach lining. Naproxen is 1:1 COX-1/COX-2. This is the lowest ratio of all the over the counter NSAIDS.

[catbirdseat]

First Vioxx and now Celebrex . Merck and Pfizer are taking it on the chin.

[Norman_Clyde]

Vioxx and Celebrex are both way overrated, overmarketed and over-hyped. When the drug companies won the right to market directly to the public in 1997, they abandoned any public health mission they ever may have had, and since that time have been morally and ethically equivalent to Philip Morris. When you look at their pattern of behavior and the way the FDA and other government agencies have functioned as enablers, it starts to look like it was inevitable (though only because the companies have not been able to suppress all unfavorable study findings, not that they haven't tried). I'm glad there is at last an event to show the public how ill these companies have served us.

 

Yes, it's too bad for all of you who have been cashing in on drug company stock. You should have traded it for Philip Morris or Halliburton instead.

[fenderfour]

I remember an over-the-counter pain med that was available in Canada that had caffeine, acetaminophen, and codeine all in one pill. Is it still available?

 

Dru?