Is acetaminophen actually medically indicated for pain relief?

My aunt is a nurse and says pretty much the same thing. She says dehydration is a big cause of the headaches and a few glasses of water will help just as much.

Well, there is this:

“Acetaminophen belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever reducers).... Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before a person feels it.,,, If the pain is not due to inflammation, acetaminophen is as effective as aspirin. It is as effective as the non-steroidal antiinflammatory drug ibuprofen (Motrin) in relieving the pain of osteoarthritis of the knee.”

In other words, acetaminophen can relieve pain as well as fever, but it won’t relieve inflammation, which can be one of the causes of pain.

I think your friend is, as you put it, whackadoo.

I’m having trouble finding a research study that specifically compares acetaminophen to placebo, probably because that kind of study is so old that it’s not available online.

What I can offer you is about 28,000 studies that include the words acetaminophen and analgesia. Most of these would not make sense if acetaminophen did not provide pain relief and seem to be predicated on the understanding that it does.

Here’s the abstract of one study that does compare acetaminophen and placebo in the context of trying to decode the mechanism of analgesia:

The central nervous system effect of acetaminophen (paracetamol) and acetylsalicylic acid was investigated in healthy volunteers according to a crossover, double-blind, and placebo-controlled design. Ten subjects received, by intravenous route, a placebo, 1 gm acetaminophen, and 1 gm acetylsalicylic acid. Analgesia was assessed by measurement of the subjective pain threshold and the objective nociceptive flexion reflex threshold in response to selective transcutaneous electrical stimulations. A close correlation was observed between subjective and objective pain thresholds. Acetaminophen increased both thresholds for more than 4 hours (24% and 23% of baseline value at 120 minutes, respectively; p < 0.001, ANOVA). In contrast, acetylsalicylic acid had no noticeable effect on either threshold. These findings show that acetaminophen-induced analgesia is centrally mediated, in contrast to aspirin. The time delay between plasma concentration kinetics and acetaminophen analgesic effect is another argument in favor of its direct action on the central nervous system.

….I have to run, but there are an awful lot more that back this up.

I knew it!!! It never ever helped my headaches. (unless it had codeine in it.)

@Judi, well that takes me on further into whackadoo land, possibly.

You see, I also heard that acetaminophen is only added to codeine so that people won’t overdose on the codeine. That’s because – and somebody must’ve thought we all know this – too much acetaminophen causes liver damage.

Therefore, it you don’t want to burn out your liver, make sure you don’t take too much Tylenol 3.

It’s one of those things that doctors do for other doctors. But the general populace doesn’t necessarily know about (well, until recently).

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I feel like I’ve fallen down the rabbit hole, through the looking glass, and on the wrong side of the Matrix. I mean, it’s frickin’ Tylenol… the safest drug ever made.

You have listed all the reasons why I think the replacement of aspirin with acetaminophen for general use is just plain nuts.

Unless someone has an aspirin sensitivity or a specific susceptibility to Guillain Barre, it makes no sense to not take aspirin, which works better and is safer.

@Marina – I can’t take aspirin or acetaminophen because it upsets my kidneys. Tylenol is metabolized in the liver so I can take that, and so is codeine.

@Darwin Um, confused. The main ingredient in Tylenol is acetaminophen.

Sorry – I meant ibuprofen.

@Darwin Ah, got it.,

I think the confusion may stem from the fact that acetaminophen/Tylenol (unlike aspirin, ibuprofen, and other non-steroidal anti-inflammatory agents (NSAIDS)) is not an anti-inflammatory. This means that it won’t reduce swelling, redness, etc. It is an analgesic, though.

Tylenol does have certain advantages over NSAIDS: it can be taken during pregnancy while NSAIDS cannot, and it does not cause bleeding or gastric irritation, while NSAIDS do. However, the anti-clotting activity of aspirin, while dangerous in some cases, is also one of its major benefits in the right context.

Let’s try to clarify all this mess.
1. Acetaminophen is an analgesic medicine, albeit a weak one.
2. Acetaminophen has no antiinflammatory properties.
3. The combination meds (Tylenol #3, Percocet, Vicoden, etc.) are not designed to confuse patients. They are mixed together to allow a lower dose of the opioid drug, and to synergize in analgesia. Synergy means that the effects of each drug are no longer additive, but beyond that.

@shilolo Can you tell me if this is true? I took a pharmacy course, and my teacher told us that they’ve been trying to get acetaminophen off the market for years, but can’t find a viable alternative. That it’s really bad for our bodies, but we still use it. I don’t know. It seemed quite paranoid to me, but I do know it does liver damage. I stick to low doses of Advil, if really needed.

I don’t know about trying to take it off the market. Yes, it can cause liver damage (but usually at high doses). Moreover, its precise mechanism of action is unknown (i.e. it would never pass FDA approval today, unless of course it was sold as a homepathic or “natural” medicine (since they don’t require approval), but I digress). However, it does have benefits as a mild pain reliever and fever reducer. Advil (ibuprofen) has its own side effect profile (stomach and kidney damage), so there isn’t a perfect medicine.