safe combination?

July 24, 2007 11:32 AM

I just took two tylenol, two advil, and two little white blood-pressure reducing pills with a little z on them. Is this ok?

Felt a migrainne coming. sort of panicked. what might the blood pressure pills have been? they were really small. fyi i get aural migraines with vision impairment so forgive any spelling errors.

posted by Baby_Balrog to health & fitness (14 comments total)

White round blood pressure medication with a Z imprint is probably Atenolol. 2 pills is not a whacky level of dose if you need them, but I don't know what the effect might be if you don't. Call poison control.
posted by headspace at 11:36 AM on July 24, 2007

yeah looks like the 25 mg atenolol pills. took two so that's 50 mg, normal dosage for adults. don't see any negative interactions with the other drugs. god my head is pounding through my skull right now.
posted by Baby_Balrog at 11:40 AM on July 24, 2007

Advil and Tylenol together is no problem, just watch the dosage on the Tylenol and don't drink any alcohol. You can probably take another Advil or even two. (I am not a doctor but I know arthritis patients take up to 800mg doses.)
posted by kindall at 11:49 AM on July 24, 2007

Is the Atenolol prescribed to you? Did you mean to take it, or did you just grab it by accident when you were in the bathroom, looking for something else?
posted by Kadin2048 at 11:54 AM on July 24, 2007

can i take two or three more advil then drink some beers in a couple hours?
posted by Baby_Balrog at 11:56 AM on July 24, 2007

i was prescribed some verapamil but then i ran outta insurance. so my friend who's a nurse gave me six or seven of these little guys an told me to take one if i was having a migraine
posted by Baby_Balrog at 11:58 AM on July 24, 2007

oh for goodness' sake, please do not drink BEER with a migraine! owwww!

i don't know anything about the blood pressure meds, but i don't think mixing tylenol & advil is a bad thing - it seems similar to what excedrin has which is tylenol & aspirin (and caffeine.

if i were in your shoes i would most likely at this point have something with a shot of caffeine like a coke or a coffee (or an excedrin) and some benadryl and sleep until my head felt better.
posted by tastybrains at 12:03 PM on July 24, 2007

800mg of ibuprofen is pretty much the highest therapeutically effective dose (beyond that more doesn't really help). The same is true of 1000mg of acetaminophen.

Acetaminophen says not to take any if you have more than 3 drinks in a 24 hour period. However, the guidelines for ibuprofen are quite a bit more strict. You shouldn't take ibuprofen in combination with alcohol in any amount: you'll substantially increase your risk of gastrointestinal irritation or even bleeding.

The WebMD drug interaction calculator finds some interactions between Advil and Atenolol. It doesn't find any with Atenolol and Tylenol.

However, the interaction does not seem important in your case:

MONITOR: Chronic (longer than 1 week) nonsteroidal anti-inflammatory drug (NSAID) administration may attenuate the antihypertensive effects of beta blockers. The proposed mechanism is NSAID-induced inhibition of renal prostaglandin synthesis, which results in unopposed pressor activity producing hypertension.

MANAGEMENT: Patients who require concomitant therapy should be monitored for altered antihypertensive response whenever an NSAID is introduced or discontinued, or when its dosage is modified.

Practical upshot: chronic advil use interferes with the atenolol but honestly that's probably a good thing in this case.
posted by jedicus at 12:07 PM on July 24, 2007

I don't know about Atenolol, but I know my Verapamil is a preventative for migraines, not a "quick fix". Taking an extra one won't do me any good (believe me, i would if i thought i had a chance)

Sending the caffeine (only 1 coffee/coke tho) to get the tylenol and advil working faster, then lie down. Turn off the lights, close the shades, and stay where it's quiet. You can probably take a couple more advil and tylenol in 4 hours. And for god sakes, beer is only going to make it worse.

Typical disclaimers, IANAD, just a daily headache/migraine sufferer.
posted by cgg at 12:13 PM on July 24, 2007

Your nurse friend, if I may say so, is being pretty fucking stupid.

There are plenty of very inexpensive hypertension meds. Sporadic use of a beta blocker makes no sense and may be dangerous.
posted by docpops at 12:38 PM on July 24, 2007 [2 favorites has favorites]

Is it OK to take a medicine that you don't even know what it is?

I don't mean to be a dick, man - I've had migraines, I know how bad it is - but tomorrow when you're feeling better, please consider that you should advocate more strongly for your own health well-being.

Also, beta-blockers don't work as abortives. They're for long-term use as preventatives. The beneficial effect takes weeks to kick in. Your nurse friend is a bad person: well-intentioned, stupid, and dangerous. Did your "friend" even check whether you had asthma, heart disease or diabetes first? Giving a beta-blocker to an asthmatic can kill them.

Frankly I'm appalled.

FYI, in the rare cases when I've felt a MOAM (mother of all migraines) kicking in, I have taken 1200 mg of ibuprofen (that's 6 regular strength advils) with good effect. This is higher than the recommended single dose of 800 mg and so I have never recommended it to any person. However, the 800 mg single dose can be taken up to 3 times in a day. I only take ibuprofen once in a day, to abort a migraine, so I personally use the higher dose.

Of course I cannot make any recommendation about what you should do. See a doctor.
posted by ikkyu2 at 1:07 PM on July 24, 2007 [5 favorites has favorites]

Another reason, by the way, that I feel OK to take the higher dose is that I mass about 80 kg; this means that my volume of distribution is considerably higher than the 40 kg tiny adult person that the drug company uses to calculate the maximum safe adult dose.
posted by ikkyu2 at 1:09 PM on July 24, 2007

OK everyone. thanks for helpin me id those. yeah i don't think the bp med really helped at all. i won't do it again. also i won't drink tonight.

thank you metafilter. i'm going to go crawl under my bed now and eat icecream.
posted by Baby_Balrog at 2:30 PM on July 24, 2007

For future reference, alcohol has got a metric buttload of drug interactions. Your liver would rather metabolize alcohol than just about anything else it could be doing, which often means you get more of the other drug, and for longer, than you were meant to. Alcohol also changes the rates at which you produce different metabolic enzymes: In particular, it induces the one responsible for tylenol toxicity.

I tried to look up the half-life of paracetamol/acetaminophen/tylenol for you, to see whether a couple hours is a reasonable timeframe for having your beer, but it turns out there's a lot of variation in that from person to person. You might inactivate half of your dose in one hour, or it might take four. If that weren't complicated enough, there are several pathways by which it's metabolized, only one of them involves toxicity, and external factors (like your liver glutathione reserve) determine the load that each pathway takes on.

Morals of the story: Tylenol is crazy unpredictable, for such a common drug. And don't take alcohol with anything except antifreeze. (It competes for the enzyme that turns ethylene glycol into poison.)

On the upside, ice cream appears to have very few drug interactions indeed. I hope it helps.
posted by eritain at 12:52 AM on July 25, 2007