Essentially how do otc painkillers work?

They have different mechanism. Advil and ibuprofen are the same thing. They are antiinflammatories. Tylenol has a different mechanism which I don’t know off hand.

Tylenol masks the pain, but does not lessen what ever is casing it. By masking it, the nervous system does not think it needs to generate fever to address the problem.

Ibuprofen is a NSAID – non steroidal anti inflammatory drug. It alleviates the inflammation that is causing the pain. So it treats whatever is inflamed.

So the first masks it (and does that well), the second treats it, (which is healthier in the long run).

The reason I asked is because when I have headache or migraine I tend to go with the Ibuprofen. Then I try and sleep it off. But when I wake, I feel more, “flowy” more “smooth” and feel better.

Essentially the liver makes some new substances from the contents of the pill. These substances vill make the nervous system “unaware” of the pain, witch often is a relief.

@_Whitetigress It’s probably the antiinflammatory properties of the ibuprofen that makes you feel better in general. Not just getting rid of your headache, but also affecting your whole body. Also, pain makes us feel bad in more than one way, it’s a trauma to the body, so relieving the pain stops other bad things that are happening

Ibuprofen is a Cox 1 inhibitor, which is an enzyme in the body. (It might also work on Cox 2 I am not sure? Drugs like prescription Vioxx were promoted as Cox 2 inhibitors, but had serious side effects and was removed from the market. Ibuprofen, although it can have serious side effects, they are fairly rare and the drug has been considered relatively safe for many years). Tylenol inhibits the nerve messages.

I’m not a doctor.

@jleslie ibuprofen is cox1 and cox2 inhibitor. It’s the inhibiton of cox2 bit that’s responsible for the anti-inflamatory and pain relief. The cox1 inhibition causes the antiplatlet properties of NSAIDs. Cox 1 inhibition also prevents the stomach lining from producing the chemicals that prevents stomach acid from damaging it. This is why NSAIDs can cause ulcers and gastric problems. The selective cox2 only inhibitors were an attempt to produce a drug that gave pain relief but didn’t cause GI bleeding. The downside was an increase in cardiac risks.

Paracetamol is a cox3 inhibitor. However cox3 doesn’t do much else in humans you don’t get as many side effects.

@Lightlyseared I remember that about cox 2 actually. I had a friend who was a pharm rep for Vioxx and he was telling me about it back in the day. What confused me was that Vioxx had so many problems, so I wasn’t clear in my mind if ibuprofen had that property, but I thout it did. I guess it is something else about the Vioxx that caused the problems? Interesting how it is hard to predict what the body will do.

All NSAIDs have an increased risk of cardiac problems with prolonged use to a greater or lesser extent. With vioxx the increased risk was so great that risks outweighed the benefits of taking it.

When I get a migraine or feel really miserable or achy from being sick, I combine acetaminophen (Tylenol, Paracetamol) and ibuprofen (Advil, Motrin) because they address the symptoms differently. I figure that taking a half-dose of each, rather than a full dose of either is also easier for my body to process, since acetaminophen is hard on the liver and ibuprofen is hard on the stomach – but I have no scientific backing of that supposition.

They work differently.

@hearkat I’m surprised that works well. If they work differently I would think you are not getting a therapeutic dose of either.

@JLeslie – I take one 500mg Extra-Strength Tylenol (the bottle recommends taking two) and one 200mg Advil (the bottle says to take one, then take a second if the first one isn’t enough). I will take another dose if I’m not noticing significant improvement within 30–45 minutes, but that’s usually not necessary.

@hearkat Interesting. Regular strength is 325, so I guess 500 is not too short of a regular dose of Tylenol. FYI, when I take ibuprofen the relief usually comes right at 50 minutes. I’m sure everyone is a little different. I just mention it because you might want to give it a few more minutes. I might try it with aspirin and Tylenol. I think the aspirin is good for my blood flow and I don’t think Tylenol intereferes with Aspirins blood thinning properties. I’m glad you mentioned this idea.