Acetaminophen has a narrow therapeutic index and can cause severe and irreversible liver injury in doses around 10 g. A single tablet usually contains 500 mg, but because it's a component of so many other "combo" cold meds, including some syrups, it's easy for people to overdose while mixing OTC products to get over a flu.
Aspirin has a lower standard dose (325 mg), higher LD50 (probably around 20-25 g), and is generally safer. It has fallen out of favor because it's known to cause an exceedingly rare but deadly syndrome in a tiny percentage of children, and because it can have gastroenterological side effects.
Ibuprofen is probably the safest option? I'm sure it can be overdosed, but it almost never happens, whereas acetaminophen results in tons of hospitalizations every year.
Are you kidding? Ibuprofen like most NSAIDS is terrible on the GI tract and the kidneys. People with healthy kidneys are usually fine with short courses, but even people with relatively mild chronic kidney disease should avoid NSAIDs.
People in their 20s that overuse NSAIDs end up needing kidney transplants. it's not that uncommon.
The most common cause of peptic ulcer disease of this demographic (affluent westerners) after H pylori is NSAID use.
> It has fallen out of favor because it's known to cause an exceedingly rare but deadly syndrome in a tiny percentage of children
This has really nothing to do why aspirin has less common use among adults. Aspirin has poor analgesic effects relative to the doses and the risks of GI complications.
> acetaminophen results in tons of hospitalizations every year.
The impact of NSAID related complications is far greater in terms of kidney transplants and upper endoscopy interventions, and related ICU stays.
Ibuprofen can also be liver toxic, but I believe the LD50 is significantly higher than the other options. I have not been able to find an exact number online.
As has been mentioned by others in this discussion, ibuprofen can also cause stomach upset (my wife has this problem, even when she takes it with food).
I've heard it can damage the stomach lining if taken at the wrong time relative to eating. But yeah probably still the least-bad first-resort painkiller.
I didn't know about this and got a nasty ulcer after taking ibuprofen for 6 days in a row while dealing with a disease. I'm not touching this anymore and stick with a max of 2g of acetaminophen per day if I need painkillers
This is misleading. Tylenol in therapeutic dosages does not seem to have much ill effect on the liver, it is not like alcohols or other direct liver toxins. Even people with advanced stage liver disease can receive acetaminophen. When it becomes toxic at supratherapeutic doses it is very toxic.
Aspirin and Ibuprofen will tear up your stomach and intestinal linings. Think internal bleeding. Alas I had to push back an epidural I desperately needed for back pain a few years ago by a week or two because I was taking too much Ibuprofen. I had blood in my urine as a result.
Aspirin has a lower standard dose (325 mg), higher LD50 (probably around 20-25 g), and is generally safer. It has fallen out of favor because it's known to cause an exceedingly rare but deadly syndrome in a tiny percentage of children, and because it can have gastroenterological side effects.
Ibuprofen is probably the safest option? I'm sure it can be overdosed, but it almost never happens, whereas acetaminophen results in tons of hospitalizations every year.