First some medical terms for those not into this sort of stuff. Aspirin is an NSAID (pronounced IN- said). It is a member of the Salicylates (pronounced SA-li-sill-ates) family of drugs. They come from the bark of the willow tree. A chemical synonym for aspirin is acetophenetidine.
A chemical synonym for acetaminophen (pronounced a-seat-a-MIN-oh-fen) is 4-hydroxyacetanilide.
Both of these are CNS (Central Nervous System) agents since they both provide an anesthetic action. A pain reducer is an anesthetic. An inflammation reducer is an analgesic. A fever reducer is an antipyretic.
Is NSAID a bad word or does it just sound bad? In reality it just sound bad. NSAID is an acronym for Non-Steroidal Anti-Inflammatory Drug. In other words, its a medicine which is not a steroid and it reduces inflammation. No harm in that, actually sounds kind of innocent and helpful. But by using the acronym NSAID in commercials to people who are not told what the acronym stands for, it makes the word and the competition's NSAID products sound really harmful. Now that doesn't mean that acetaminophen is a steroid, however since it is not an NSAID, it does put in a category of drugs which do nothing to alleviate inflammation.
The next time you are having any form of muscle or joint pain, ask yourself whether or not the area in question is red, puffy, or swollen. If it is any of these, then it is inflammed, which is associated with a fluid build up in the affected area. To alleviate your symptoms, you need to reduce the pain and reduce the inflammation. What you need is a medicine which has an anesthetic action (pain killer) as well as an analgesic action (reduces inflammation). NSAIDs, like aspirin, are included in that category. They kill pain and reduce inflammation. Acetaminophen, while it does kill pain, it does not reduce inflammation.
If you have arthritis, you be the judge. The latest acetaminophen commercial says that arthritis pain is not caused by inflammation. I guess if the acetaminophen commercial were not telling the truth about arthritis pain, then the good folks at the Arthritis Foundation would step in with the truth, but they haven't, so the commecial must be telling the truth, right. Oh, by the way, did you know that the makers of Tylenol (acetaminophen) have given heafty amounts of funding (about one million dollars in one year) to the Arthritis Foundation for research. What was that one about not biting the hand that feeds you.
Ignore the commercial spokesperson and the brand names, look for the types of medicines you need to alleviate your symptoms. Anethestic for pain. Analgesic for inflammation. Antipyretic for fever.
Now lets compare side effects to see which is worse, NSAIDs or acetaminophen. NSAIDs can cause stomach upset is some individuals and therefore should not be taken by those who have stomach ulcers or who have hyperacidic stomachs. It should also not be taken by those who have an allergic reaction to aspirin. Aspirin, in particular, should not be used for fever reduction with children as this can lead to a complication known as Rye's syndrome which can lead to hearing loss or other more threatening complications. End result is that a certain set of individuals and a certain range of ages of children should not use aspirin. For the rest of us, NSAIDs are the best thing going. In fact, it has been proven that low dosage aspirin therapy is helpful in the prevention of secondary heart attacks. What this comes down to is that NSAIDs are helpful when used wisely. This can be said for just about any medicine.
Now to our other friend, acetaminophen. Turns out that about 95% of acetaminophen is passed through the body and out the urine, which is very good, but what, you might ask, about that other 5%? Turns out that for most people that other 5% attaches itself to features in your liver and reduces the liver's ability to function properly. Most people have no difficulty recovering from this effect. Five percent you might say is no big deal, but consider the following, are there classes of individuals for which this could be a bad thing? Yes indeed. Those individuals whose liver is not up to normal performance levels, such as those who like to consume alcohol at more than a couple of drinks per week, or those who already have a liver problem, such as those with hepatitus or other liver disease. For these individuals, acetaminophen can cause a temporary or a permanent shutdown of liver function. This can lead to hepatitus or even death. The next time you read the label on a bottle of acetaminophen and the dosage is two every four hours, you might think twice before popping four or more in less than four hours. Complete and permanent liver shutdown can occur in some individuals who overdose on acetaminophen and do not receive prompt specific treatment.
Seems as though there is another issue with acetaminophen which doesn't get a level of press coverage equal to its seriousness. Since we shouldn't be giving aspirin to a young child with a fever we have been giving them a liquid formulation of acetaminophen. All well and good, but did you know that this liquid formulation is concentrated and is usually about three time stronger than your acetaminophen pills or capsules, and it is sold over the counter. When the dosage says drops, it means drops, not droppers full. Children have suffered serious liver damage and death from liver failure due to their parent's overdosing them on acetaminophen. Just because its for infants and its in liquid form doesn't mean that it should not be taken seriously when giving it to children.
The conclusion is that all medicines should be taken seriously. They should be accepted for their shortcomings as well as their benefits. There is no perfect pill. NSAIDs aren't as bad as they would have you believe and acetaminophen isn't as innocent as they would have you believe. Unfortunately, you have to do your homework, get some knowledge, and be your own judge. Don't leave the fate of your health up to the medicine company executives who tell the commercial spokesperson what to say to convince you to buy their product instead of the other guy's.
The following are a few of the links I used to uncover the above information, just to let you know that I am not completely unfounded in my statements.
You can go to the home pages of these organizations and use their search engines to look for key words like, acetaminophen, liver, aspirin, etc.
USP (US Pharmacopeia)
Official American Medical Association (AMA) Home Page
National Institutes of Health (NIH)
American College of Rheumatology Home Page
Arthritis Foundation
Or you can use these direct links to articles to save some time, but they may move or delete these pages as their sites are updated over time.
AA-35 - acetaminophen, alcoholism, and liver damage
ACETAMINOPHEN (4-HYDROXYACETANILIDE)
NIA Age Page - Arthritis Advice
ACETAMINOPHEN ORAL SUSPENSION USP
USP Quality Review - Unintentional Acetaminophen Overdosing
ACETAMINOPHEN ORAL SOLUTION USP
ACETAMINOPHEN TABLETS USP
Acetaminophen, Alcohol: Deadly Mix (Reuters 10/15)
Patient Information - Osteoarthritis
Hotline (PATIENT INFORMATION) - RISK OF RENAL FAILURE WITH ANALGESIC USE
http://www.arthritis.org/research/rga/grant_cs.pdf
Arthritis Foundation - New Agreement With Mcneil Consumer Products Company
Arthritis Foundation - Living Well With Osteoarthritis
Arthritis Foundation - Product News from Our Sponsors
Arthritis Foundation - Rheumatoid Arthritis Fact Sheet
Arthritis Foundation - Osteoarthritis Fact Sheet
Arthritis Foundation - Unproven Remedies Fact Sheet
These are MSNBC links related to the NBC Today Show article shown on 20 Oct 1997.
MSNBC - Doctors give acetaminophen warning
MSNBC - Tylenol to issue warnings for kids
I'm not a doctor. I'm not even in the medical professional industry. Read the information. You be the judge.
Monroe Wyatt Pattillo, Jr. (MWP)
monroe.pattillo@monroepattillo.com
Site installed: 09 Jan 97 by MWP
Site updated: Sunday, 12-Jun-2005 09:40:16 EDT by MWP