When taken as directed, assuming your stomach can handle NSAIDs (Nonsteroidal Anti-Inflammatory Drugs), alternating between ibuprofen and acetaminophen when trying to manage pain is usually an acceptable method.
However, if one decides to take more than directed and for long periods, the results could be disastrous, even fatal. For instance, a patient who suffers from uncontrolled high blood pressure is experiencing chronic headaches and taking non-recommended high doses of both acetaminophen and NSAIDs but not managing their blood pressure with medication such as Hydrochlorothiazide, which could help eliminate the pain.
According to The Cleveland Clinic, “And while both acetaminophen and ibuprofen are typically safe, she (Dr. Horwitz) adds that if you have kidney, digestive, bleeding or liver problems, you need to be careful with taking these over-the-counter (OTC) medications. Acetaminophen is processed through your liver, while ibuprofen is processed through your kidneys.
You also want to be aware of the recommended max dose for each. For adults and children over the age of 12, you don’t want to go above 4,000 milligrams of acetaminophen or 1,200 milligrams of ibuprofen.
There can be some serious risks if you take more than the recommended dosages. If you take too much acetaminophen or drink alcohol while taking an acetaminophen, you may cause liver damage. And if you take too much ibuprofen, you may cause kidney damage,”.
Some side effects for both may include but are not limited to:
Acetaminophen:
- Headache
- Nausea
- Vomiting
- Loss of appetite
Ibuprofen:
- Upset stomach
- Nausea
- Diarrhea
- Vomiting
- Leg swelling
When NSAIDs are chronically used in high doses, the National Institute of Health suggests that, “Studies of older adults show that chronic NSAID use increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction,”.
Furthermore, when acetaminophen is used chronically in high doses, the U.S. FDA (Food and Drug Administration), shares, “But taking too much acetaminophen can lead to overdose and severe liver damage. Symptoms of acetaminophen overdose may include nausea, vomiting, abdominal pain, confusion and jaundice (yellow skin and eyes),”.
What happens if you take too much Advil and Tylenol together?
After successful cancer treatment, a patient experiences several side effects and pain from the treatments even though the cancer is no longer present. They take non-recommended high doses of both NSAIDs (Advil) and acetaminophen (Tylenol) and, at the same time, do not follow the directions and do so in a chronic way for more than two years on a daily basis.
For example, acetaminophen is metabolized by the liver, and excessive intake can lead to acute liver failure, which could be life-threatening. With excessive intake of NSAIDs could result in gastrointestinal issues with stomach ulcers, bleeding, or perforation, as well as kidney damage, cardiovascular concern with an increased risk of heart attack or stroke, and high blood pressure, fluid retention, and electrolyte imbalances.
To make matters worse, the patient is also experiencing the following side effects from uncontrolled high blood pressure:
- Blurry vision or other vision problems.
- Dizziness.
- Lightheadedness.
- Severe headaches.
- Nosebleed.
- Shortness of breath.
- Chest discomfort or pain.
- A feeling of anxiety or that something is not right
Even worse, they are not treating their diabetes either and have had the following symptoms:
- Feeling very thirsty
- Passing urine more often than usual, particularly at night
- Feeling very tired
- Slow to heal cuts or ulcers
- frequent vaginal or penile thrush
- blurred vision
Instead of responsibly treating their health issues, they are taking non-recommended, high doses of not only acetaminophen and NSAIDs but also ADHD medication, and obviously, they cannot sleep well. And, on top of it all, taking tranquilizers to sleep and experiencing the following adverse effects from it all:
Side effects of ADHD medications
- Insomnia
- Decreased appetite
- Constipation
- Dizziness
- Headaches
- Anxiety
- Diarrhea
- Palpitations
- Rapid breathing
- Xerostomia (persistent feeling of dry mouth)
- Hypertension
- Restlessness
- Mood swings
- Fever
- Chest pain
- Fatigue
- Psychosis
- Weaknesses
Side effects of tranquilizers
- Nausea
- diarrhea
- drowsiness
- dizziness
- tiredness
- blurred vision
- changes in weight
- headaches
- muscle ache/pain
- dry mouth
- bad taste in the mouth
- stuffy nose
- constipation
- change in sexual interest/ability may occur.
What are five reasons why patients do not follow medical advice?
For the patient we are speaking of, the five top reasons why they are not adequately caring for themselves and following medical advice are:
- Fear
- Too many medications
- Mistrust
- Worry
- Depression
This patient, in particular, is suffering with deep depression. More importantly, they are not treating their alcoholism, which can cause serious repercussions. The “Big Book” of Alcoholics Anonymous describes dry drunk syndrome as feeling “restless, irritable, and discontented.” People who are working strong programs in recovery suggest that if you’re sober but still unhappy, this might indicate untreated issues such as the dangerous return of negative attitudes that harm one’s quality of life.
Patients, particularly those managing depression, often struggle to follow medical advice for a variety of additional reasons. Depression can severely impact one’s motivation and ability to adhere to prescribed treatments. The overwhelming nature of the illness sometimes leads to a state of inertia where patients might find even simple tasks burdensome. They may also experience a lack of hope or belief that their situation can improve, making the effort to follow medical advice seem futile.
Cognitive impairments associated with depression, such as difficulties in concentrating or remembering information, can contribute to non-adherence. Patients might forget to take medications, miss appointments, or misunderstand the doctor’s instructions. Furthermore, the stigma associated with mental health issues may discourage individuals from openly discussing their struggles with healthcare providers, thereby preventing them from receiving the tailored support they need.
Additionally, economic factors can play a role. Financial strain exacerbated by depression might prevent patients from accessing necessary treatments or medications. When depression interferes with one’s ability to work, financial pressures can lead to prioritizing survival needs over health needs. Lastly, social isolation—a common symptom of depression—reduces the support system that could assist with reminders or encouragement to adhere to medical advice. These multi-faceted challenges highlight the need for a compassionate, comprehensive approach when supporting patients with depression in following medical advice.
Combining ibuprofen and acetaminophen for acute pain management
In conclusion, combining ibuprofen and acetaminophen can effectively manage acute pain when used responsibly. However, overuse or chronic use can lead to severe health risks, emphasizing the importance of adhering to recommended dosages and addressing underlying health issues with appropriate medical guidance.