Alternate Tylenol/Codeine and Ibuprofen for pain?

Discussion in 'Dental Archive' started by PRW, Sep 24, 2008.

  1. PRW

    PRW Guest

    I've posted a few threads here under a different name (I'm away from
    home, posting through Google instead of via Outlook Express on my own
    computer) about my phobias as far as dental procedures that stem from
    what has been a problem in getting my mouth dead enough, especially
    when there's drilling involved. My dentist, who I've been seeing for
    30+ years, and I are doing a lot better along those lines, the last
    few times I've been have been a breeze. He's taking a few more pains
    with his injections and is making sure to really pour on the water
    when doing fillings. (We have determined that the biggest factor
    that's giving me problems with the drilling is heat.)

    Anyway, I have to go there in the morning, probably to have an
    extraction done, and I'm counting down the minutes looking forward to
    sitting in that chair, because this time I really don't care what he
    does to me, anything is preferable to this pain.

    Although I'm paying for not taking his advice and getting this tooth
    pulled as a proactive measure, because he told me a year ago that this
    tooth needed to come out. It's a wisdom tooth, I'm not sure exactly
    which one, but it's an upper one on my left. The problem is that it
    has been moving slightly when I bite down. It's caused some issues
    with the teeth below it (had to have a filling repaired) and the
    biggest issue is that food, etc., kept getting constantly impacted
    around it, I was having to floss seemingly all the time.

    My dentist said because of the tooth moving and some other factors, he
    would recommend an extraction instead of trying to salvage the tooth
    with a root canal.

    However, it was not giving me any pain or anything, so I wasn't
    exactly in a hurry to have a tooth extracted although I had pretty
    much committed to do it before year's end (before my deductible kicked
    in again on my insurance).

    Big mistake ... it started getting a bit tender on Monday ( I recall
    biting down on something over the weekend and it feeling really weird
    and funny, that probably triggered it). It was more tender on Tuesday,
    so I called my dentist and canceled the cleaning appointment I had for
    Wednesday and made an appointment for next Tuesday to get the tooth
    taken care of. I thought I could tough it out if the pain didn't get
    any worse, but it got horribly worse Tuesday night, I woke up in agony
    two hours after taking two Ibuprofen (200 mg each, total 400 mg). The
    pain was radiating up into my jawbone and almost to my ear, and
    actually down into my lower jaw even though I'm sure the problem is
    that upper tooth.

    I called the dentist back today and he's going to work me in tomorrow
    a.m., plus he called me in some Tylenol/Codeine and some Erythromycin.

    And I'm sorry for the long lead-in but I'm getting around to my
    point ... the Tylenol/Codeine is not really taking the pain away any
    better than the Ibuprofen. I have heard that if you alternate the two,
    at two-hour intervals, you can get better results. Is that the case,
    or should I just stick to one or the other? Thanks in advance for any
    PRW, Sep 24, 2008
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  2. PRW wrote:

    I've recommended alternating 400-600 mg ibuprofen with 600 mg
    acetaminophen (no codeine) every 3 hrs.; IOW ibuprofen now,
    acetaminophen in 3 hrs, ibuprofen in 6 hrs, etc.
    The codeine will increase the chance of nausea (and constipation). I
    also wouldn't take the ibuprofen more than every 6 hrs.
    My stomach will not hold up to regular ibuprofen for over 2-3 days, but
    your stomach may be stronger. Also, the usual admonition to avoid
    alcohol when taking acetaminophen. (Alcohol also increases stomach acid
    secretion, and alcohol and acetaminophen together isn't good for the liver).


    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    Mark & Steven Bornfeld, Sep 25, 2008
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  3. PRW

    PRW Guest

    I actually do have gastric issues which would concern me about taking
    Ibuprofen long term. I do take Mobic regularly for arthritis pain. My
    gastroenterologist recommended not mixing the two. So I only take
    Ibuprofen if I need it, because usually it's been the best pain
    reliever (and fever reducer) for me, and when I do take Ibuprofen I
    discontinue the Mobic.

    I know Erythromycin is also supposed to be hard on your stomach, but
    I've never, ever had any problem with it.

    I'm just looking for something to do tonight to get through this
    evening at work (I work second shift and am having trouble focusing
    because of the pain) and tonight in bed until I can get this seen
    about in the a.m. And I'll learn to listen to my dentist. :)

    On Sep 24, 6:48 pm, Mark & Steven Bornfeld
    <> wrote:
    PRW, Sep 25, 2008
  4. Greg Bailey wrote:

    Thanks for the update.

    Good luck,
    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    Mark & Steven Bornfeld, Sep 25, 2008
  5. Greg Bailey wrote:

    If there weren't a lot of pick axes and chisels going in there, it's
    likely you will get relatively rapid relief.


    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    Mark & Steven Bornfeld, Sep 25, 2008
  6. PRW

    Dartos Guest

    PRW wrote:

    I think Steve B. mentioned cardiac (heart) issues are now the concern.

    I also quit prescribing it.

    Dartos, Sep 25, 2008
  7. PRW

    Dartos Guest

    Great indication for a stabident injection.

    Give a regular block, and if the patient isn't numb enough,
    one stabident does the trick.


    Greg Bailey wrote:
    Dartos, Sep 25, 2008
  8. Dartos wrote:

    The FDA alert system works in funny ways. I figure erythromycin must
    have been around since about 1950. For 50 years they found no serious
    problems. Then they found that taken in combination with the
    antihistamine Seldane (I think it was the first so-called "non-drowsy"
    antihistamine) cardiac arrhythmias could occur.
    So they took Seldane off the market. Whoops--they kept getting the
    cardiac arrhythmias with erythromycin alone.
    Funny how that works...or not.


    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    Mark & Steven Bornfeld, Sep 25, 2008
  9. Greg Bailey wrote:
    Generally, the antibiotic used now in dentistry for penicillin-allergic
    patients is clindomycin. It also carries a risk of gastrointestinal upset.


    Mark & Steven Bornfeld DDS
    Brooklyn, NY
    Mark & Steven Bornfeld, Sep 25, 2008
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