In most cases, osteoarthritis can be treated quite effectively with acetaminophen, which is sold as over-the-counter Tylenol.
Because of the advertising dollars spent on prescription drugs, many arthritis sufferers had come to assume that the drugs known as COX-2 inhibitors—including Celebrex and Vioxx— were best for easing the symptoms of osteoarthritis. The drugs were marketed as improved versions of other common pain relievers that reduce inflammation. Until studies released during 2004 indicated that COX-2 inhibitors were associated with health risks, both Celebrex and Vioxx were widely advertised and widely used. Vioxx was taken off the market and is no longer available to patients; Celebrex continues to be used.
But in most cases, osteoarthritis can be treated quite effectively with a much cheaper drug—acetaminophen, which is sold as over-the-counter Tylenol (and also in even less expensive generic drugstore brands). Inflammation plays only a minor role in osteoarthritis, so an anti-inflammatory effect from medication is not necessary. Acetaminophen provides pain relief and is less likely to cause side effects (such as stomach irritation) than anti-inflammatory drugs.
As is true with any drug for arthritis, you need to discuss taking acetaminophen with your doctor. The maximum daily dosage of acetaminophen is 4,000 mg, and it can cause dangerous side effects if you take it in excessive dosages or you have liver disease or drink large amounts of alcohol. Several years ago, a study linked heavy daily use of acetaminophen to a higher risk of end-stage kidney disease. But since end-stage kidney disease is rare (only 1 in 5,000 people develop the condition each year), even regular users of acetaminophen are unlikely to develop the disorder.
Even though acetaminophen is the drug with the lowest overall risk of side effects, if you use acetaminophen regularly, you should see your doctor periodically to be monitored for adverse effects.
Posted in Arthritis on May 19, 2006
Reviewed May 2007
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This is a great article. I think you should also link this one to your other article in the Healthy Living area, http://www.johnshopkinshealthalerts.com/alerts/healthy_living/JohnsHopkinsHealthyLivingHealthAlert_125-1.html on the fine line between safe and harmful dosages of acetaminophen. Many people think just because it is a non-prescription drug, there is nothing to worry about. It is very easy to think "more is better" or take the doses too close together, forget when you have taken them, or, take other products, like a cold remedy, for example, that might have the same ingredient. Thanks so much for the great info! And beautiful website. I will tell other people about this excellent new health resource.
Posted by: Jo | May 13, 2006
Isn't acetaminophen to be avoided if one has any liver problems ?
Thank you very much for your quick reply to my post. Although liver issues were mentioned in the "Arthritis" article, I neglected to refer to the article referenced in the post immediately preceding mine; which referred to the same article that you recommended. This is one over-sight I will not be guilty of again.
Posted by: ryh393 | May 23, 2006
Does Tylenol provide any relief from inflammation in cases of osteoarthritis?
Posted by: joneslena | July 12, 2006
I asked about Tylenol since its stated in your article as the first choice to treat arthritis pain. The reason I asked is my doctor (orthopedic surgeon) just started me on Celebrex samples which seem to have so many possible side effects. I was taking Arthrotec which also has many possible side effects.
Thank you in advance for any comments.
Posted by: joneslena | July 12, 2006
my MD recently did a glomular filtration test. The reading, in the measurements used in Canada, was 60. Having just come from a continuing education lecture by a nephrologist my doctor told me that the nephrologist had said that anyone with a reading of 60 or lower, should not take ANY anti-inflammatories, including ibuprofen. In the past I have on occasion taken ibuprofen 400mg at bedtime OR voltaren 75 mg, with or without misoprostyl. This is not an every day occurence but perhaps 2-3 times per week, usually at bedtime, and when the discomfort level makes sleep very difficult. Your comments on the glomular filtration test and potential for kidney damage, would be appreciated. Thank you John Speck
Posted by: johnspeck | September 18, 2006
My internest has recently suggested the daily use of celebrex for my sometimes intense hand pain. Because I have coronary artery disease (under control) I`ve limited my dosage to one or two times a week.Can you give me your thougths on this? Thanks.
Posted by: skipmonica | October 21, 2006
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