Comment by kazinator
11 hours ago
You don't want either of these; what you want is naproxen.
It works similarly, but stays a lot longer (half life is cited as being anywhere from 12 to 17 hours).
Acetaminophen and ibuprofen are just for temporary problems, like a headache that would go away on its own in a couple of hours.
They are uneconomic and inconvenient if you have something more persistent to keep at bay. Four ibuprofens or one naproxen? No brainer.
The main disadvantage of naproxen is that it's not approved for kids. So there is no naproxen syrup for infants or anything of the sort. Thus, you still need acetaminophen for that.
As pointed out in the article, naproxen is an NSAID like Ibuprofen, though slightly more COX1 selective. It likely has a somewhat lower risk of serious renal and cardiovascular events, but higher risk of GI bleeds. There are some studies that show little to no increase cardiovascular risk, but most do show some or even comparable to ibuprofen.
Convenience vs ibuprofen is a thing given the longer half life, but it still generally comes with similar risks. If you are taking anything for more than just an occasional headache, definitely discuss with a doctor, COX2 selectives like celecoxib may be a better risk profile and even more convenient.
(COX1 and COX2 selectivity loosely separate which systems get the brunt of the side effects)
I weirdly always found Naproxen much more effective than ibuprofen but also find Celebrex great which seems to further confuse the whole COX 1 vs 2 situation
Recently, I've had to take Celebrex (celecoxib) for a back injury and I've been taking it longer than is normally recommended—and that truly worries me (I've determined I have to come off it ASAP).
Where I am (Australia), most doctor's prescriptions that have to be taken long-term are issued as the first script plus five repeats. Not so with Celebrex, a script can only be dispensed three times (3 x pk of 30 200mg capsules — one per day, for 90 days max) and scripts can only be dispensed every 21 days. Reason: Celebrex is only recommended for short-term use because it's considered a dangerous drug with possible irreversible side effects if taken for too long.
This was not news to me even before taking Celebrex, way back in the 1990s I was prescribed its sister drug called Vioxx (rofecoxib) for back pain and it was much more effective than Celebrex (at least it was for me).
Anyway, sometime around 2000 I read an article in the journal Science about a significant statistical increase in deaths by heart attack, stroke etc. by those talking rofecoxib. At the time I said to myself it won't be long before Vioxx is banned. It took another three to four years for that to happen as Merck Pharmaceuticals fought the decision every inch of the way. It's worth reading the Wiki about this (when it's between a drug company and millions of dollars profit patients come off second best):
https://en.wikipedia.org/wiki/Rofecoxib
What's relevant here is that the related drug Celebrex survived because its side effects—whilst manifestly similar—aren't quite as bad as Vioxx. In short, Celebrex's COX-2 selectivity versus other less selective NSAIDs like aspirin (which target both COX-1 and COX-2) was deemed sufficiently beneficial despite its potential serious side effects.
Note: I'm not offering medical advice here and you should always take that from your medical practitioner. I mention this because only several days ago I had a discussion with two younger doctors who'd never heard of Vioxx let alone the Vioxx/Celebrex controversy.
You may be interested in this YouTube video on Vioxx. Unfortunately it's over hyped and designed to alarm but it's essentially factually correct: https://m.youtube.com/watch?v=K0GrFnOpJoU
The higher risk of GI bleeds is could be somewhat balanced by not having to take as many.
There are also slow release forms of naproxen. (Which make sense given its long action: lets people fade in the next one while the previous dose slowly fades out). That could also help make it easier on the GI tract.
> The higher risk of GI bleeds is somewhat balanced by not having to take as many!
Unless I am missing something, the data really doesn't back that up. naproxen is much more longer lasting and has a higher chance of causing ulcers. Hence why its not over the counter in the UK and is prescribed with omeprazole to reduce the risk of issues.
1 reply →