More Knee Arthritis Relief with Tylenol and Motrin, but More Side Effects as Well

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motrin tylenol side effectsOur patients are seeking a knee surgery alternative and one of those options is obviously drugs. So a recent study showing that combining ibuprofen (Motrin) plus acetaminophen (Tylenol) provided better relief of chronic knee pain than Tylenol alone, may be real news. However, the study also reported that this benefit came at the cost of increased Motrin Tylenol side effects. This randomized study reported that after 10 days of use, patients taking a total daily dose of 1,200 mg of ibuprofen (equivalent to 6 over the counter 200 mg tablets) plus 3,000 mg of acetaminophen (equivalent to 6 extra-strength Tylenol tablets) reported better knee pain relief than patients taking only one drug. However, after 13 weeks of treatment, 6.9% of those taking the combination had a worrying drop in their blood hematocrit indicating blood loss-possibly a result of occult stomach bleeding — compared with only 0.9% of those receiving acetaminophen. The decreases in hemoglobin were particularly notable in older patients. During the course of the study there were 18 serious illness events, including a fatal ruptured aortic aneurysm, chest pain, and worsening of renal failure. Overall, patients in the combination groups experienced more diarrhea, while those on acetaminophen had more liver enzyme abnormalities. By the end of the study, 51% of patients in the higher dose combination group had experienced drug-related adverse events.  The fact that many patients had side effects from Motrin and Tylenol continues to cause concern that a better way to deal with chronic inflammation may be to take higher doses of fish oil. In addition, the study didn’t look at the marked increased risk of sudden cardiac death for patients taking NSAID drugs like Motrin. The upshot? While you may get better pain relief from Tylenol and Motrin combined, this cocktail also seems to have serious and concerning side effects, the most worrisome of which seems to be more stomach bleeding.

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