Yesterday I had Mohs surgery to excise a basal cell carcinoma from my face. Afterwards the surgeon advised that I take a Tylenol and an ibuprofen tablet together to suppress pain after the lidocaine anesthetic faded.

I asked, “why not take two Tylenol tablets or two ibuprofen tablets instead?” He told me that studies had shown that Tylenol and ibuprofen taken together were as effective as opioids for suppressing pain. They complement each other.

I had both on hand, and followed his suggestion. It did indeed kill the pain. Not a particularly good test though, as the pain was minor. Ibuprofen has the additional benefit of reducing inflammation.

Over the decades I’ve had at least half a dozen Mohs surgeries. This was the first time that my surgeon reported “all clear” after the first excision. I was quite happy for that!

I learned of the ibuprofen & Tylenol trick a year or two ago.

I had a tooth root going bad. Naturally, this occurred on a Friday before a long weekend. I had some pain meds left over from a prior tooth thing and my dentist prescribed an antibiotic.

The pain med did essentially nothing.

When I called the dentist back she said to try alternating ibuprofen and Tylenol every three hours. Had both on-hand.

Damned if that didn't eliminate the pain entirely.

Back in the day, we took an aspirin and a Tylenol together. IIRC Goody's headache powders and Bufferin tablets were that combo.

^^^^^

The alternating meds work better than both at the same time.

This is something I’ve been telling my patients for years. Take two different analgesics (at lower doses) with entirely different mechanisms of actions not only help but also minimize the risk of adverse side effects.

The same course was recommended by my hernia surgeon.

quote:

Originally posted by MNSIG:
The alternating meds work better than both at the same time.

That depends on the severity of the pain, in my experience. Mild pain, yes, but moderate to severe pain, they typically need both at the same time.

I recently got the same advice from my dentist for pain.
Also, recently saw an ad for Advil Dual Action which contains acetaminophen and ibuprofen.

I guess that makes sense. I think a good number of medicines being marketed are combinations. And sometimes, the combination is not just a better treatment for the condition each is trying to address but the combination can even result in treating a totally different condition than either alone can treat.

Many years ago an osteopath I know suggested a similar combo - one Tylenol (acetaminophen) and one Aleve (naproxen sodium). Has worked for me since. I've also done the acetaminophen/ibuprofon combo

Sorry. Can someone explain again why this works with a little more detail?

Also, just to be very clear, whether taken separately (mild pain) or concurrently (intense pain), one should half the standard dose of both pain relievers? But what about frequency - ibuprofen indicated every 12 hours vs acetaminophen indicated every 4 hours?

600mg ibuprofen every 8 hrs and 1000mg of acetaminophen every 6 hours would be the maximum prescription strength dosing for pain. (800mg of ibuprofen does not improve pain control but does improve reduction of inflammation). Ibuprofen works at the site of pain to reduce inflammation, acetaminophen works in the central nervous system to reduce pain perception.

quote:

Originally posted by konata88:
Sorry. Can someone explain again why this works with a little more detail?

Also, just to be very clear, whether taken separately (mild pain) or concurrently (intense pain), one should half the standard dose of both pain relievers? But what about frequency - ibuprofen indicated every 12 hours vs acetaminophen indicated every 4 hours?

There is no one standard dose. There are ranges of doses that are considered "safe" for the average patient with no underlying diseases (for example, liver or kidney disease).

For an adult, for example, ibuprofen (brand Motrin or Advil) can be taken at 600mg - 800mg every 6 - 8 hours. In some patients, 400mg can also be effective, but that is considered low end dose.

Acetaminophen (brand Tylenol) is typically taken at 650mg - 1000mg every 6 - 8 hours.

As you can see, there are different ways to take these meds. Separate (alternating) or combo, low or high. The higher the dose of any one med, the higher the risk of adverse side effects. With ibuprofen, you need to consider its effect on the stomach and the kidney, if you have those diseases. With acetaminophen, you need to consider the liver.

quote:

Originally posted by 12131:
<snip>
For an adult, for example, ibuprofen (brand Motrin or Advil) can be taken at 600mg - 800mg every 6 - 8 hours. In some patients, 400mg can also be effective, but that is considered low end dose.

Acetaminophen (brand Tylenol) is typically taken at 650mg - 1000mg every 6 - 8 hours.
<snip>

I keep Regular Strength Tylenol (325mg/tablet) and generic ibuprofen (200mg/tablet) on hand. Until my Mohs surgeon suggested the Tylenol-ibuprofen pairing, I used a single tablet of one or the other for effective pain relief lasting several hours. I seldom needed either though.

^^^^ If lower doses work for you, great. No good reasons to go higher.

I can't do ibuprofen because of my kidney situation. Please be careful, it doesn't bode well with challenged kidneys.

quote:

Originally posted by rat2306:
Back in the day, we took an aspirin and a Tylenol together. IIRC Goody's headache powders and Bufferin tablets were that combo.

Excedrin brand pain reliever is the combination of acetaminophen (tylenol), aspirin, and caffeine and used to be my go-to for headaches when I was more open to meds (I do my best to refrain these days).

Dollar Tree has it available generically and labeled "Headache Relief"... something like that

^^Yep, you're right. It's Excedrin I was trying to remember. Haven't taken that in ages. BC and Goody's extra strength powders are aspirin and acetaminophen. Bufferin is aspirin with three antacids. Those brands used to be in the family medicine cabinet; now, I just have regular aspirin and Tylenol.