Medical Misconception: Is Tylenol better than plain old Paracetamol?

Counter-intuitive case

My patient came to me for a consult regarding a different case. He had no fever but he brought with him a Tylenol bottle. It was sold to him for 500 pesos by a balikbayan claiming that “it was better than Paracetamol.” He was selling it to me for the same price.

“It’s a nice offer but no,” I said with a smile. I told him that his balikbayan friend was lying. Acetaminophen, the generic name of Tylenol, is the same as Paracetamol.

He was confused. He told me that they were different names. They can’t be right.

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He was getting closer to realizing he had been duped.

Reality

Paracetamol is regarded by many Filipino doctors as the best remedy for Fever. Apparently in the US, Ibuprofen is the leading antipyretic. This isn’t a cultural difference. Asian livers react more to Paracetamol than Ibuprofen or Aspirin. This is a genetic difference.

In the Philippines, Ibuprofen is regarded as the best initial pain reliever followed by Mefenamic Acid and then Paracetamol. In the US, Acetaminophen (the US name for Paracetamol) is regarded as the best initial pain reliever. All medicines mentioned are over-the-counter. You can buy them even in online sites. However, certain conditions require frequent dosing and thus a consult with your local doctor is still best.

Balikbayans usually get generic medicines for free in the US and take them here. Some sell them, some just gave it away. A politician visited one of my health centers and gave me some of these generics. I examined each closely. The reason they were given away free is that most of them are near expiration. These products are surplus and regarded as pharmacy spoilage. They are still as good as brand new when you open them but if it nears the expiration date, they lose their potency and may actually be dangerous for your health.

The confusion of some balikbayans have created a misconception that Tylenol and Paracetamol aren’t different drugs. These happens too in drugs like Albuterol which is the same as Salbutamol. They are already happening too frequently that I hope it doesn’t turn into another medical myth. There are dangers to this misconceptions and it is best to consult your family doctors.

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by Zero Mella MD, Olongapo City, Philippines

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