In this video the surgeons discuss the use of Tylenol, also known as acetaminophen, and Advil, also known as ibuprofen. ALWAYS CHECK WITH YOUR DOCTOR OR HEALTH CARE PROVIDER BEFORE TAKING ANY NEW MEDICATIONS. The surgeons discuss the fact that acetaminophen is metabolized by the liver. Ibuprofen, which is a non steroidal anti inflammatory or NSAID is metabolized by the kidney. So if you are healthy enough to take either of the medications, most of the time it is ok to use both medications at the same time as part of a multimodal pain treatment plan.
Wow hi welcome to another episode of talking with docs i’m dr brad weaning and i’m dr paul zalzel today’s episode paul very interesting question from some viewers in our comment section the question is can i take ibuprofen and acetaminophen or tylenol and advil together good question so often two pain relievers that are used very often especially in our line
Of work we see a lot of people in discomfort secondary to arthritis or other musculoskeletal conditions and they need something to take that can help them with their pain and often in our videos i find we we don’t necessarily directly answer the question we say hey maybe this is i think the answer here is is yes but yes yeah thanks for watching okay so i guess
It’s uh it’s the butt so what are we talking about by mixing are you talking about like crushing these pills mixing together and taking it are you talking about taking them at the same time or are you talking about staggering it for a half hour so theoretically you could crush them and mix them if you had like a swallowing disorder of some sort which sometimes
Happens um but i think generally you mean like say in the average day or maybe over a prolonged period of time and that could be either literally in the same handful or alternating essentially concurrently all right so yeah you can take these two different types of painkillers at the same time for the same condition um and why why is that why can we do that
Uh so a couple reasons the main reason is because the way that they’re broken down by our body so anything that we ingest or take or expose to can cause us problems and the problem is really based on how we how our bodies deal with it whether they can deal with it effectively or not effectively so acetaminophen-based products are processed by our liver well as
Anti-inflammatories are processed by our kidneys right so a lot of times when you see a medication the certain types of medications that you can’t mix together or shouldn’t take together it’s because they’re processed or excreted the same way kidneys if you take too much of those same medicines that the kidneys have to work at to get rid of you’re going to
Damage your kidneys right or the liver but in this case as dr weaning said acetaminophen is treated by the liver and the anti-inflammatories are treated by the kidneys so two separate systems in your body so it’s safe to take them at the same time other important question is is it important is it worth it taking like wow why do you have to take both why can’t
You just take one right so anytime you do any sort of treatment recommendation uh as physicians we always look at the risk benefit ratio right so a ratio is just a comparison of two numbers so we look at the risks and the benefits and compare them we want to make sure that the benefits way outweigh the risks right so whenever you’re choosing not even in this
Case for mixing the two together when you’re choosing any uh treatment option whether it’s medication or surgery you always want to look at the risk benefit ratio right yep absolutely so is there a population of people we’ll start with acetaminophen is there a population of people that should avoid acetaminophen right people who have liver dysfunction yes will
Have higher risk taking acetaminophen uh so probably shouldn’t because that’ll tip the scale in the risk favor as opposed to benefit paper so things like liver failure cirrhosis hepatitis those kinds of things yeah okay liver problems and then on the other hand ibuprofen yeah or any other antiques of course yes processed by the kidney so people that have kidney
Issues so people that have are on dialysis or people that have borderline kidney function or people that have really high blood pressure which a lot of times is related to your kidneys they should probably either proceed with caution or maybe not take it all and again all of this stuff should be discussed with your family doctor or your healthcare practitioner
Yeah if you’re taking a medication a new medication you really want to bounce that off your family physician or your primary health care provider because they know your whole history and they can tell you it’s safe but definitely things that affect your kidneys or problems with your kidneys you want to avoid anti-inflammatories and and a lot of people say avoid
Long-term use of anti-inflammatory life is a risk benefit ratio isn’t it really haven’t we learned that yeah like anything you do in life you always look at the risk versus the benefit and then decide if you want to do that go on a plane ride you’re on vacation right there’s a small risk going on a plane but the benefit is find it to a nice beach or a sunny a
Location right so paul why can’t i just take a whole bunch of acetaminophen and now you scared me about anti-inflammatories why don’t i just take a whole bunch of acetaminophen well a lot of people do take a lot of acetaminophen on a regular basis but for a few reasons one if if you take too much acetaminophen it will damage your liver right that’s why there’s
Guidelines on the bottle depending on the strength of the pill you’re taking certain guidelines that say this is how much you should take per day typically in the three to four gram range but that’s weight dependent as well as other medical issue dependent read the bottle right um because that can eventually damage it over a period of time and certainly long-term
Use of any medication can cause damage to that system that is involved in excreting that medication yep i think the other thing is that they work differently so sometimes like we’ve talked about in the past multimodal pain control if we have a different pathway that acetaminophen’s on and the anti-inflammatories on a different pathway sometimes the cumulative
Benefit of both of them is greater than either on their own well absolutely yeah so multi-modal approach we we talked about that a lot like i said and i’ll often use a topical anti-inflammatory too right over the area that’s hurting add some ice ice i felt physiotherapy yeah maybe a brace yeah one thing we don’t suggest using a lot for chronic type pain before
Surgery or anything like that is a narcotic we often say don’t use a narcotic because it i don’t think it’s a good solution for a problem that that is long-standing chronic um we see that in our population we use narcotics in our patients after surgery for sure yep but generally i don’t recommend it before but tylenol or acetaminophen and anti-inflammatory
We suggest a lot absolutely just one other thing about the anti-inflammatories it’s not just the kidneys you have to be careful of um certainly has issues with people’s stomachs so some people can get stomach pain and people that have had heart attacks or strokes often that’s a contraindication or a relative contraindication so again clear it with your family
Doctor or specialist before you take any of these kinds of yes yes if you’re taking an anti-inflammatory you’ve got to be careful for your uh definitely for your stomach because it can cause ulcers and uh also the blood thinning properties of anti-inflammatories if you’re on a blood thinner for something else then you have to be very cautious if you’re going
To be taking uh anti-inflammatories yeah any other blood thinners yeah so back to actually taking them so do we take them together like do you take the bottles and yeah like a big bowl like smarties kind of thing and grab a handful not treat them like a big bowl of smarties or m m’s um but i i mean not that long ago they used to it was said to take it about
A half hour apart right but i think nowadays uh it’s people are you can take it together at basically the same time um the and i think there are some pre-mixed preparations right available where both acetaminophen and anti-inflammatory are mixed in the same pill when you take that and a little bit of this trial and error sometimes you might want the space to
Maximize your pain control sometimes you can get some stomach discomfort if you take a whole bunch of pills so you probably have to figure out a little bit you always talk to your pharmacist another great resource as far as stuff like this right but in general kind of the take-home message is that yes you can take them together proceed with caution make sure
You kind of do your due diligence find out what you’re allowed to take what you’re not allowed to take and right yeah from there clear it with your health care provider for sure but yeah if you’re wondering if you’re googling hey can i take aspirin town all together the answer generally is yes unless you have a contraindication to one or the other so i think
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Transcribed from video
Can I Take Tylenol and Advil Together? By Talking With Docs
