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Anecdotal, but my subjective experience and that of my family, is that acetaminophen is worthless for pain management. Given that is poses an active risk to liver function, I can't justify its use at all. It's far too dangerous to be legal over the counter.

Interesting that it is included at high doses in prescription painkillers - no medical function, just a rather deadly deterrent to anyone seeking opiates.



And this is why anecdotal evidence aren't worth much.


So when making medical decisions you should... not consider empirical evidence? n=1 is good enough when n is the only subject in question.

My n=1 experience with "tylenol" is that, even carefully prescribed, the use of acetaminophen can cause very severe problems when combined with pre-existing conditions and other medications.

No one told me that shit until I was in the ER 4 times.

Knowing how toxic it is, how potentially harmful the drug interactions can be, and how little evidence exists for its efficacy as a generic painkiller, I have no qualms saying that acetaminophen should be a highly regulated drug - Available to anyone who needs it per a doctors order certainly, but removed from all "consumer" products.


It depends on the types and intensity of the pain. Annoying/sleep-interrupting pains: yes, severe pains: no. For moderately-severe pain, either use acetaminophen + ibuprofen + famotidine if you know the source for certain, or go to the ER. Actual, short-term severe pain requires a prescription medication such as an opiate.


It was interesting when I studied abroad that it is not OTC, at least in Germany. (In Germany it's known as paracetamol.)


Lower dosage paracetamol is OTC in pharmacies here in Germany (I think the limit is 10g per pack).




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