♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet ♪
- Hi folks, I'm Brad and a physical therapist.
- Hi, I'm Chris, the pharmacist.
- And I'm exactly one half of the Bob and Brad
physical therapy.
What are we?
A channel, anyway. - You're the dynamic duo.
- But today we have Chris here.
He's gonna talk about, this is an interesting subject to me.
He's gonna tell you about if you can combine, whoa
I just dropped my... - Whoa
you've got stuff everywhere.
- Ibuprofen and Tylenol. - Tylenol.
- Some people think you can combine them.
- You can actually, yeah.
As a matter of fact, Advil makes an Advil duo
which actually comes as a combo tablet.
- You mean you can buy it that way?
- You can buy it that way.
So it's a little bit different strength
than what you would buy in traditional
extra strength, Tylenol bottles
or like in your Advil bottle or ibuprofen.
So separately, a acetaminophen comes as a 325 milligram
or a 500 milligram tablet. - Yeah.
- And then ibuprofen always comes as a 200 milligram tablet.
When you use Advil duo
you have both the ibuprofen and acetaminophen in one tablet,
it's 250 milligrams of acetaminophen
and 125 milligrams of ibuprofen.
And the theory behind that
and the way that they market it that way
is that you're using lesser amounts of both
to still get good pain relief and keep it safe.
- So studies evidently show that it actually works better.
- As a matter of fact, there's a very prolific study
with advanced dental or very severe dental pain.
So two or three removal where they just go in
and pull her out that when you combine
ibuprofen with acetaminophen or Tylenol
you'll actually get better pain relief
than you would say taking a Percocet or a Vicodin
which is either hydrocodone with acetaminophen
or oxycodone with the acetaminophen.
Which are the narcotic pain relief.
- The big ones.
- So the things that you can get addicted to.
So it actually gives better analgesia or pain relief.
So yeah.
I mean these days,
most dentists will not give you pain medication
because you can just do that
and they cost four bucks a piece
and bottles are on the shelf of any pharmacy.
You don't need to buy brand name anything
and you can combine them too.
And we'll talk about the dosing.
- Okay, so it's okay?
You don't have to buy the manufactured combination?
- No, you don't have to. - You can do it at home?
- The manufactured combination Advil dual, very convenient.
So it kind of takes all the guesswork outta there for you.
- I see.
- So you can take two tablets every four to six hours apart.
And so they'll tell you
they don't want you to take any more than six tablets
in a day is what their manufacturer guidelines are.
- You mean per each one?
- Well, no, if you're on Advil duo
which is the combination of the Tylenol, the manufactured
the commercially available product.
Or if you're at home and you're like, well
I don't wanna run out to the store.
I feel horrible.
I just had some bad dental work.
I have ibuprofen on myself.
I have acetaminophen on my shelf.
Can I take the combo?
And the answer is yes.
And so basically you can take two of your ibuprofen
which is 400 milligrams.
And you can take
one or two tablets of your extra strength, Tylenol
which would be 500 or 1,000 milligrams.
And you can use that combination three times a day.
- Oh. - Safely.
And it will give you excellent, excellent pain relief.
So the only things that we really have to worry about really
if you're on blood thinners
so because the ibuprofen can thin your blood.
So if you're on things like warfarin, Eliquis,
Clopidogrel, Xarelto
these are prescription medications that are blood thinners.
- And if you're on 'em, those names should be familiar.
- Correct.
So your doctor would've warned you
your pharmacist would've warned you
your nurse would've warned you.
So it's just something to be cognizant of though.
We have to be aware of that.
You know, if you're coming in
and asking a pharmacist, we're gonna make sure.
That you don't have allergies of course, alcohol use.
I mean, you don't want have, if you're a heavy drinker
and what they classify that is three drinks per day.
Things with acetaminophen or Tylenol in it
could actually be problematic for your liver.
So, and again, with certain blood pressure medication
sometimes the ibuprofen can be rough on the kidneys
or create blood pressure issues.
So all things to be aware of
these are things that if there is any question
talk it over with your doctor,
talk it over with your pharmacist
to make sure that it's safe for you.
But with respect to the dosing
if you have severe pain and inflammation,
so you really blew out your ankle,
you had some rough dental work.
The combination of Tylenol and ibuprofen is fantastic.
And I'll also go a step further
it actually is a phenomenal fever reducer.
Both the drugs, acetaminophen and ibuprofen by themselves
are good fever reducers.
But if you've got a really sick child
or you're very sick yourself
the combination will be better.
It will allow you to feel more comfortable.
It's gonna control that fever, should allow you to rest
and let your body other natural processes
to try and take care of that, to get you some rest.
- And if you've got an infant
then you're probably not gonna use this.
- Yeah, well you can, but it would be in liquid form
with both and we would dose it appropriately
to the child's age.
- I mean
I wouldn't feel comfortable trying to dose it myself.
- No, I would strongly encourage you to talk to your doctor
or talk to your pharmacist
so we can get you a correct milligram per kilogram dosage
so that you can safely take care of your child.
- So is that like under two years old or?
- Well, yeah.
I mean, it's gonna be any kid, so yeah.
It's gonna be up on us.
We've had kids that have a severe ear infection.
They can be quite uncomfortable, high fever,
just because that's what bodies do.
- So we're talking five or six years old?
- Even babies, six months.
- Right but I mean, so any age from zero.
- Any child, zero to 12.
- Then it needs to be adjusted.
- Adjusted accordingly to body weight.
So we wanna be real careful with that.
So 12 on up, we kind of look at it more as an adult dose.
- I see.
- but we'll, make sure there's no interactions
no side effects.
- And should they take it, this combination
with food, empty stomach?
- If you can.
So, if there's no nausea.
Like let's say in the work of dental work.
So we would tell you probably something soft.
So like some pudding or some apple sauce, mashed potatoes
just something, soup
but have a little something in your stomach
more than just a little bit of water
because ibuprofen inherently for some people
can be damaging to the stomach lining.
So when you're using the combination
we still have to take those precautions.
So ideally, a piece of toast and crackers
would be ideal to protect your tummy.
But the reality of it is
is that a little something in there and stay well hydrated.
So those would be the big things too
'cause you want to take care of those kidneys.
- Yep. So, as far as price, I mean,
is it a better deal to get the pre-manufactured combination?
- Yeah. - Or buy it separately?
- It'll be cheaper to buy it separately in most cases.
But hopefully, if we have pretty advanced pain
where you need the combination.
This hopefully it's gonna be a short-lived thing.
So it comes down to convenience.
Or do you want to take four tablets of something
or do you wanna take two tablet something.
So it's kind of a personal choice at that point.
So some people are like, I don't wanna mess with
two ibuprofen, two Tylenol
now I've got a mouthful of this.
And let's say for dental work, mouths still numb
and you're trying to swallow, that's no small task.
So it might be easier to buy something like the Advil duo
where you can just take one tablet at a time
and get your second one down and you're good.
- Is there a duo that's generic form?
- Not yet.
It's a very recent product.
It was just released in the last 18 months or so.
So it's not quite at that level yet
for a generic price.
- Well, that's good to know. Anything else we didn't cover?
- Not really.
So as long as we're not taking the blood thinners
we don't have the allergies to any components.
We don't have renal disease. We're not heavy drinkers.
I mean, those are kind of the big things.
So you can always check with your doctor, your pharmacist
to ensure that it's safe and appropriate for you.
But the reality of it is, excellent, excellent combination
to relieve pain and inflammation.
- Okay, that's good to know because
we need to know if we're gonna...
- Yeah.
We're there to take care.
- All right, very good.
- Thanks guys. - Take care.
- Have a great day.