Opioid alternatives--maybe for me

According to a randomized study, reported in the Journal of the American Medical Association, a combination of Tylenol and Advil worked just as well as opioids for pain relief in the emergency room. I’m sure such studies are looking for alternatives to opioids as a way to combat the epidemic of opioid addiction. But what about me?

Before reading about this, I never considered taking Tylenol plus Advil for my joint and muscle pain. I take two Advil fairly often, usually before golf or Jazzercise. But I’m going to give the combination a try. It makes sense, as the two drugs work in different ways. Advil (ibuprofen) is a nonsteroidal anti-inflammatory drug (NSAID). It works by inhibiting the synthesis of a group of compounds called prostaglandins that cause inflammation. (Aspirin and Aleve work in a similar way). Experts aren’t sure exactly how Tylenol (aceaminohen) relieves pain. It doesn’t suppress inflammation, but blocks pain in the brain.

As to dosage, Consumer Reports says to take the combination only occasionally and to stick to one pill of each per day: 325 mg of Tylenol and 200 mg of Advil. (The FDA set the maximum 24-hour dose of acetaminophen at 3,000 mg; the maximum dose for Advil is 1200 mg.) From what I understand, higher doses can give you more pain relief, but side effects of overdosing can be dangerous. Tylenol can be toxic to the liver, especially if you drink heavily. In fact, acetaminophen is the most common cause of acute liver failure in the United States. One-fifth of all patients who need a liver transplant sustained their injury using Tylenol. Advil is hard on your stomach and intestines. Plus, I’ve learned from experience, heavy doses suppress your immune system.

OK. I gave the combination of Advil plus Tylenol a try, one time before golf and another time before house cleaning followed by yoga. Meh. I think for me two Advils work better.

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