Pharmaceutical Knowledge for the Masses

[Archmage144]

Tell your friends--don't be fooled by advertising and packaging when you're buying over-the-counter remedies, because you might be getting ripped off. I'm reminded of this because I just saw a Midol commerical on TV, and I've been doing a lot of study of OTC drugs and their active ingredients in order to assist people in not getting ripped off by marketing. I'm on a crusade against disinformation, evil corporations, and medical ignorance! It's also a crusade to promote the purchase of generic drugs, because generally speaking, buying brand is stupid in terms of your wallet.

I'm particularly angry because the commercial is taking advantage of the fact that (many) people are stupid and don't read the labels on medications.

"Relieve cramps, bloating, headache? Tylenol and Advil can't do all that!"

Actually, they can. Do you know what the main ingredient in original formula Midol is? 500 mg of Tylenol (acetaminophen) and 50 mg of caffeine. Tylenol. The stuff that they tell you can't relieve your menstrual symptoms. So an extra-strength Tylenol (or cheaper generic equivalent) and a cup of coffee or a Mountain Dew delivers the same active ingredients. For those of you wondering about the caffeine, it's because caffeine is a mild analgesic and occasionally relives headaches, but many of those headaches are a result of caffeine withdrawal in the first place.

If you're the type that has menstrual cramps severe enough to purchase that "12 hour long-acting Midol" nonsense, you're getting ripped even worse. The only ingredient in that formula is 220 mg of naproxen sodium. What's naproxen sodium? In a 220 mg dosage, you can buy it over the counter as Aleve or its generic equivalents.

So boycott Midol and their related products, ladies, because not only are they lying to your face when they tell you that other products can't solve your problems, but there's really nothing different about Midol from any other pain relievers.

This isn't the only instance in which drugs you could get cheaply generically are labelled with new brand names and touted to be the best remedy for more specific symptoms, but the Midol commerical I just saw on TV incensed me to the point where I just had to get the word out.

Keep in mind that more or less all over the counter drugs have generic equivalents:

Tylenol = acetaminophen. Sometimes labelled "non-aspirin pain reliever." Standard dose 325 mg per tab. "Extra strength" dose 500 mg per tab.
Advil and Motrin = ibuprofen. Standard dose 200 mg per tab.
Aleve = naproxen sodium. Standard dose 220 mg per tab.
Benadryl = diphenhydramine. Dosing varies--I think either 40 or 60 mg is standard for the pill form, but don't quote me on that.
Sudafed = pseudoephedrine hydrochloride (often HCl). Dosing varies, but is usually 10 mg/hour of effect, resulting in 60 or 120 mg tabs being common. Often packaged as "non-drowsy sinus" or in combination drugs for various symptoms.
Mucinex = guaifenesen. Standard dose 600 mg per tab.

Aspirin is an amusing oddball because its generic name is also "aspirin" as a result of a lost lawsuit against Bayer Pharmaceuticals a very long time ago. The result is that any acetylsalicylic acid pain-reliever/anticoagulant/anti-inflammatory can be called "aspirin" despite it technically being a brand name of Bayer.

Most people already know this and take advantage of it, but the vast majority of OTC generics are "AB" rated (which means that they're "bioequivalent," or have the same theraputic value). If you ever doubt the contents of a drug, read the label's active ingredients (which most people here, I assume, are smart enough to do). This is a good way to make sure you aren't wasting money on that tiny little box of strange combination headache medicine when you could get a 200 count bottle of acetaminophen and take it with a caffeinated beverage. There are a lot of other drugs I can think of where you save money by buying generic (Claratin = loratadine, Claratin-D = loratadine with pseudoephedrine HCl, etc.), but they're usually pretty obvious. Most drug stores stock the generic right next to the brand--and if you check the active ingredients, they're almost always identical. Gasp!

Apologies if this post is beating people over the head with things they already know. >.>: <p>

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[Capntastic]

Isn't there some OTC pain reliever/something similar that has an extra strength/long lasting version that is literally the same thing in a different box, and they got in legal trouble over it?

I mean, I'm sure there's more than one, but one in particular got in a big legal snafu over it not too long ago, if I recall. <p>

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[Idran1701]

What about the non-active ingredients, though? I mean, they have to serve some purpose or they wouldn't be included, right? One thing I've always wondered about for medication etc. <p>

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"Never let your morals get in the way of doing what is right" - Salvor Hardin
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[Besyanteo]

I was not aware of a good deal of this information, but it seems my parents were: Looking in my cabinents, I don't see many name brands whatever. Anecitophinamen, Ibuprofen, a few others like that. They do use those melt in your mouth Claritins though. I suppose there's something to be said for those, as they seem to work as advertised.

[The Great Nevareh]

Non-active ingredients are stuff like preservatives, solvents, coatings, and the like, I believe. They aren't the chemicals that do the actual chemisty-altering of your body to make you feel better, but they kind of help in the process. I'm likely wrong, though.

For instance: A lot of the active ingredients taste extremely foul and bitter because they're highly concentrated from their natural origins. You need to dilute them in something or people will have trouble swallowing them. Coatings also help prevent the stuff from rubbing off on the way down and assist in the swallowing. Some of the non-active ingredients might simply be there to give the pill extra mass: A gram is very, very little, and most pills don't contain gram-weight amounts, so these filler ingredients could contribute to the placebo effect that might not be there if you flick something that quite literally is just ten grams of highly unpalatable chemical compounds into your mouth. Some of the other non-active ingredients could help keep the chemicals from being consumed by bacteria and fungi in the air.

Then again, I'm just operating on guesses. <p>[---------------------------]
"There is great disorder under Heaven, and the situation is excellent."
-Mao Tse-Tung

"I eat the talking bees because I am George Washington Christ"
-From "Bob the Ball"</p>

[Capntastic]

As much as I know (Not a lot) Nev is right, and non-active ingredients are merely a delivery system. But I'd like to know more :Y <p>

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[Archmage144]

Nev's right. The amounts of active ingredients in question are too small or impossible to work with as a patient. The binders, fillers, and soluble mass that make up the majority of a pill serve both to contribute to its mass and to streamline the delivery process. A lot of coatings are formulated to be time-release mechanisms, controlling the rate at which medication is delivered, which is why you can't crush, chew, or break many swallowable pills. Some pills are scored specifically so you know where to split them if you're supposed to take half a pill or whatever.

Generally speaking, the inactive ingredients used are largely irrelevant--after all, they're not acting on your body in chemical manner. There are times, however, when people have demonstrated allergies to inactives used by certain manufacturers--but that's not an impossibility with brand names, so it's just a matter of chance.

It should be noted, while I'm on my pro-generic kick, that you can get most prescription drugs in generic forms as well (and pharmacies always dispense generic over brand unless you ask or the MD orders brand, because it saves you money). But not all generics are 100% bioequivalent. As far as I know, most pharmacies won't stock generics that aren't equivalent to the brand name, but it does happen. A particular case I can recall involved a generic version of Duragesic patches, which are attached to the skin and deliver a pain reliever compound, fentanyl, transdermally. A company called Mylan released a generic fentanyl patch, but their patch's delivery system was actually drastically different from the Duragesic patches (or the fentanyl generic manufactured by another company, Sandoz, who actually makes the brand-name patches). As a result, we stopped carrying them!

Plus, some drugs, once you get "stabilized" on the brand name and have been taking it for a while, switching over might have odd side effects that don't necessarily make sense. This is the reason that some people are reluctant to switch to generic from brand after they've been taking a drug for a while, and why in some cases, MDs are reluctant to allow patients to switch.

Also, Zero, I have no idea what you're referring to, but I believe it. <p>

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[Uncle Pervy]

Question.

Ibuprofen vs. Acetaminophen vs. Naproxen sodium vs. so on.

Explain the differences in them? I used to use Aceteminophen for my arthritus, but my doctor put me in Ibuprofen, which does the jaerb much better. <p>---------------------------

ReakoSomner: regardless, I was poor, and in need of diamonds</p>

[PriamNevhausten]

Isn't naproxen sodium better known as Aspirin? <p><span style="font-size:xx-small;">"It's in the air, in the headlines in the newspapers, in the blurry images on television. It is a secret you have yet to grasp, although the first syllable has been spoken in a dream you cannot quite recall." --Unknown Armies</span></p>

[Idran1701]

Unless it's just another chemical name for the same substance, aspirin = acetylsalicylic acid. <p>

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"Never let your morals get in the way of doing what is right" - Salvor Hardin
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[KingOfDoma]

Anyone who watched the Tick should know that. <p>--------------------
Remember, even God has a sense of humour. Just look at the platypus.

-Kevin Smith</p>

[PriamNevhausten]

I must have heard it numerous times elsewhere, then. <p><span style="font-size:xx-small;">"It's in the air, in the headlines in the newspapers, in the blurry images on television. It is a secret you have yet to grasp, although the first syllable has been spoken in a dream you cannot quite recall." --Unknown Armies</span></p>

[Archmage144]

Acetaminophen, or Tylenol, is an analgesic. It cuts off pain signals sent to your nerves.

Ibuprofen, or Advil, is in a class of drugs called "non-steroidal anti-inflammatory drugs," or NSAIDs. It reduces inflammation of joints and muscles, which is why it's better for arthritis pain than Tylenol is. Naproxen, or Aleve, is similar, but its effects are usually longer in duration. There's a whole big thing about COX-1 and COX-2 and prostaglandins and various other enzyme activity, but I honestly can't remember every detail about which drug inhibits what and that information is largely meaningless to the average person anyway. Other NSAIDs include celecoxib (Celebrex), rofecoxib (Vioxx, which was pulled from the market due to increased risk of heart attacks), baclofen, and diclofenac. Aspirin is also technically an NSAID, though it also functions as an analgesic and an anticoagulant (blood thinner).

Their contraindications, or "reasons you should not take this medication," are also different. People with stomach problems, primarily ulcers, should not use ibuprofen, and long term usage may exacerbate any existing stomach conditions. Long-term usage of naproxen (Aleve, again, not Aspirin as suggested by Priam) has been shown to increase the risk of cardiovascular problems, so it should not be taken for more than 10 days at a time, but it's safe if you have ulcers, as far as I remember. <p>

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[The Great Nevareh]

If I remember correctly, Acetaminophen can wreak royal havoc on your liver if you use it too often. <p>[---------------------------]
"There is great disorder under Heaven, and the situation is excellent."
-Mao Tse-Tung

"I eat the talking bees because I am George Washington Christ"
-From "Bob the Ball"</p>

[Archmage144]

What can't? <p>

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[PriamNevhausten]

Vitamin C. <p><span style="font-size:xx-small;">"It's in the air, in the headlines in the newspapers, in the blurry images on television. It is a secret you have yet to grasp, although the first syllable has been spoken in a dream you cannot quite recall." --Unknown Armies</span></p>

[Besyanteo]

Priam wins a kewpie doll!

[PriamNevhausten]

I'll take absolution of my stupid error earlier in this thread instead. <p><span style="font-size:xx-small;">"It's in the air, in the headlines in the newspapers, in the blurry images on television. It is a secret you have yet to grasp, although the first syllable has been spoken in a dream you cannot quite recall." --Unknown Armies</span></p>

[Besyanteo]

That works too.