France warns against use of anti-inflammatory drugs to tackle coronavirus

[Native]

Source: Reuters

PARIS, March 14 (Reuters) - France's health minister on Saturday said people should not use anti-inflammatory drugs if they have coronavirus-like symptoms because it could worsen their condition.

"Taking anti-inflammatory drugs (ibuprofen, cortisone ...) could be an aggravating factor for the infection. If you have a fever, take paracetamol," Oliver Veran said on Twitter.

President Emmanuel Macron announced on Thursday school closures and urged people to avoid close contact for fear of propagating the virus that has killed 79 people in France and infected more than 3,600. (Reporting by John Irish; Editing by Catherine Evans)

Our Standards: The Thomson Reuters Trust Principles.

Read more: https://news.trust.org/item/20200314135010-a6ijh/

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Paracetamol is another name for Acetaminophen

[Squinch]

1. I have seen other sources say alternate tylenol and advil - so alternate acetominophen

and NSAIDs to keep fever down.

Now I am confused! DU doctors: which is it?

[deurbano]

4. Yes, I saw the alternating thing, too.

[Native]

6. this is a new virus - the info will continue to change as updates filter through to us

everything I've seen thus far from credible sources outside of the U.S. has come to be accepted in the U.S. several days after the fact. That doesn't mean that France has it right and we have it wrong, but we've consistently been wrong on just about everything so far, so a rational person might want to consider that when deciding what they should do.

[Squinch]

8. This is true. I don't usually use Tylenol. Glad I bought a bottle before this all

started. Thanks for the info.

[Maxheader]

50. Wouldn't do the advil...

They are finding problems with it...kidneys..

[csziggy]

59. The doctor who took my left kidney out advised Advil - ibuprofen

And told me to not take acetaminophen or naproxen. He said ibuprofen was easier on the kidney I have left.

[BlueIdaho]

2. Acetaminophen AKA Tylenol

Generic vs Brand Name. Just FYI.

[Cirque du So-What]

3. Is paracetamol not an anti-inflammatory drug?

It’s little things like that.

[Native]

5. No, it is not.

[Cirque du So-What]

7. OK. Good to know.

I have been laboring under a misconception for many years.

[left-of-center2012]

43. "laboring under a misconception"

Wishing you a speedy delivery.

[Cirque du So-What]

48. I labored mightily

and brought forth a mouse.

[uppityperson]

10. No, it is antipyretic (lowers temp) and analgesic (pain relief)

[ancianita]

24. Is it over the counter? or prescription? I've never seen it.

[SansACause]

27. It's Tylenol

The French must use a different name for it.

[ancianita]

29. Ah. Thank you. Got it.

[luvtheGWN]

32. Paracetemol is the UK version of aspirin.

[Duppers]

38. Nope. It's acetaminophen.

Which differs from aspirin.

[Rebl2]

45. Aspirin

reduces inflammation whereas acetaminophen does not. I know because I have had rheumatoid arthritis for 50 plus years and it was drilled into my head many years ago.

[Duppers]

46. I've had RA for the last 2yrs.

It's important that folks know the big difference in pain relief and anti-inflammatory meds.

My dog also has arthritis. I take my nightly dose of daily aspirin with her sans the weiner.

[Layzeebeaver]

39. No

Paracetamol is Tylenol

[Aristus]

61. No. Paracetemol, or acetaminophen (Tylenol) as classified as an anti-pyritic. (Anti-fever).

It doesn't have the anti-inflammatory property of ibuprofen, naproxen, etc.

[hlthe2b]

9. Acetaminophen in overly repeated/high doses can be extremely liver toxic.

so just a little bit of caution here. Despite their decades-long advertising campaign designed to suggest otherwise, Tylenol (acetaminophen) is not without risk and should be used with similar caution to other OTC pain medications.

I'm not sure this advice is without controversy nor based as of yet, on firm evidence. Granted we are learning as we go. In some patients, there is evidence of cytokine storm, a sign of a "hyper-immune" systemic reaction (in the most seriously affected patients with pneumonia and rapid downward spiral--suggesting they may actually be indications for steroids to DIMINISH the body's immune and inflammatory response).

Still, I think it wise to be cautious with both NSAIDs (Ibuprofen, Naproxen, aspirin--even more caution due to Reye Syndrome for Children) and tylenol (acetaminophen). Moderation. More is not better.

[AnotherMother4Peace]

11. Thank you for this precautionary info. I do not have Tylenol in my house, BUT I just ordered some.

I have a high risk household, & am making every effort to take precautions. We've always taken just plain aspirin, and it's always worked just fine: simple: take with food, every 4 hours. - Don't over do it because of the blood thinning qualities.

So just on this bit of info I've tacked Tylenol onto an order that will be arriving (hopefully) on Tuesday morning. My local Vons usually delivers next day, but now it's about a week.

[Native]

12. Not to mention that the fever will likely not be high and some docs are recommending we let our body

temp do what it can and not take anything unless the fever gets high. But you know how people pop pills the minute they feel a twinge or their temp gets to 99 degrees. I'm glad they are at least warning people of complications that can arise based on their experience in treating this clever virus. Here in the U.S. we get charts that are scripted for 6-year-olds. The giant board chart from yesterday's Rose Garden debacle was completely inane. I'm still not over that.

[hlthe2b]

14. Yup... Easier said than done in practice though.

[AnotherMother4Peace]

18. Yes, you're correct: less is better. But if body temp is getting too high I want to have

the safest fever reducer for members of my household. That and other ways to reduce fever: cool towel, loosen clothing, etc.

[at140]

53. Cool washcloth on forehead beats any meds..much safer

[at140]

52. Fever is your friend unless it gets to 102 or higher

Fever is a natural response by the body in attempt to kill the infection.
It is like bringing summer weather inside body.
But excessive fever is dangerous. In any case keep well hydrated.

[Steelrolled]

15. I believe overuse of Ibuprofen is associated with kidney disease

So ideally you use drugs like this only when needed. Of course some people don't have a choice.

[hlthe2b]

16. Yes and can increase risk in both renal patients and those with heart disease.

Aspirin, of course, holds risks for gastric bleeding and for those on blood thinners.

On the other hand, moderate and occasional use of any of these for MOST people can be safe. All in moderation.

[at140]

62. So is alcohol, nicotine, saturated fats etc

when indulged in excess. Moderation is the key!

[AwakeAtLast]

64. And severe ulcers

Almost lost my Mom when one burst.

[at140]

51. ++++++++1000

[shanti]

13. Good to know

I bought some Tylenol by mistake last month. It doesn't really work for me on pain, so I usually use Motrin, which works great. Now I'll have the right med if I get sick.

[Warpy]

17. People on long term cortisone drugs can't just stop them.

NSAID drugs, including aspirin, are fever reducing drugs, Cortisone surpresses the immune system but NSAIDs don't, the mechanism is quite different.

The advice to alternate NSAIDs and Tylenol is prebably good, NSAIDs are extremely hard on the kidneys, Tylenol on the liver.

Be aware that every crank is going to be out there dispensing advice, much of it bad. Run everything by your doctor if you are ill.

[Joinfortmill]

19. Thank you. I passed this along.

[pnwmom]

20. And what about people with asthma who use daily inhalers with steroid?

[LiberalArkie]

25. I think that is a different steroid.

[Mendocino]

21. Acetaminophen and alcohol

Excessive drinking, 3+ drinks daily is very hard on the liver. Many doctors recommend no drinking at all if taking it.

[Duppers]

42. Very important info. Thanks for the reminder.

Any sick person should not be drinking anyway.

[Aquaria]

58. Which is ironic

Given that two of the primary ingredients in NyQuil are alcohol and acetaminophen. Not a good combination.

And ZzQuil, or whatever it's called is nothing more than liquid diphenydramine. Or Benadryl as it's more commonly known. You can buy a bottle of 500 diphenydramine pills for less than what Zzquil costs, and it does the same thing.

[Chemisse]

22. I've been planning on taking moderate doses of aspirin as an antiinflammatory.

as a strategy against the inflammation caused by an over-reactive immune system, if I should be one of those who becomes seriously ill.

Yes, I know aspirin is a blood thinner, but all the NSAIDS have significant risks. I still prefer aspirin over the alternatives.

I am curious about what scientific information supports this recommendation.

High doses of aspirin are thought to have contributed to the deaths of people in the 1918 influenza, as blood-filled lungs were detected in autopsies. In those days there were not recommendations for dosage and people took quite high amounts of it in the hopes that it would cure the disease.

[bobbieinok]

23. IIRC aspirin is anti-inflammatory. It is often the 1st OTCpicked

[SansACause]

30. Aspirin is the worst of the bunch

I'm surprised it's even being sold. It can cause stomach ulcers and stomach bleeding.

[bobbieinok]

44. iIRC daily aspirin was recommended vs heart attack. Supposedly saved colleague's husband

[at140]

55. Ditto with me...nt

[SansACause]

66. Yes, but at a lower dose

Low dose aspirin therapy has been around for a while, but it's being rethought due to stomach bleeding issues.

https://www.statnews.com/2019/07/22/study-millions-should-stop-using-aspirin-for-heart-health/

[rzemanfl]

26. My local Walgreen's had plenty of acetominophen. I told the clerk

it might become the next toilet paper when I bought some.

[moonscape]

28. I saw this yesterday, and shelved the

alternating ibuprofen/acetaminophen idea forthwith.

Also, it explains why those with hypertension might be showing higher vulnerability. Lisinopril, etc.

https://www.thelancet.com/pdfs/journals/lanres/PIIS2213-2600(20)30116-8.pdf

edit: can't figure out how to fix the link, will have to copy/paste

[moonscape]

37. btw - I didn't read the Lancet article to mean all

anti-inflammatory meds necessarily as it called out only ibuprofen specifically, but the science loses me.

Hypertension is also treated with ACE inhibitors and ARBs, which results in an upregulation of ACE2.5 ACE2 can also be increased by thiazolidinediones and ibuprofen.

It's a hypothesis, re risk of ACE2-increasing drugs as CV attaches to cells via the ACE2 enzyme.

[muriel_volestrangler]

31. Meanwhile, Harvard is still saying ibuprofen is OK

What treatments are available to treat coronavirus?

Currently there is no specific antiviral treatment for COVID-19. However, similar to treatment of any viral infection, these measures can help:

While you don't need to stay in bed, you should get plenty of rest.
Stay well hydrated.
Take acetaminophen, ibuprofen, or naproxen to reduce fever and ease aches and pains. Be sure to follow directions. If you are taking any combination cold or flu medicine, keep track of all the ingredients and the doses. For acetaminophen, the total daily dose from all products should not exceed 3,000 milligrams.

https://www.health.harvard.edu/diseases-and-conditions/coronavirus-resource-center

[Native]

33. If you've been tracking guidelines from the CDC, WHO, etc., things change almost daily.

A couple of days ago the EU's CDC (ECDC) specified that you could only get sick from someone showing symptoms. A day or so ago, Singapore and China said respectively that 2/3 and 3/4 of those infected became infected by people who were asymptomatic. Those numbers are being kicked around by a couple of other countries to help verify them, but even if those estimates are grossly inflated, that's a heck of a lot of people picking up the virus from people who aren't showing symptoms.

Bottom line - the info changes constantly as experts learn more. All we can do is sift through it all, ignore what Trump is saying, and rely on what appears to be sound information - information that hasn't been coming from the U.S.

[muriel_volestrangler]

35. But this is apparently based on a long-held viewpoint

Health officials point out that anti-inflammatory drugs are known to be a risk for those with infectious illnesses because they tend to diminish the response of the body’s immune system.

The health ministry added that patients should choose paracetamol because “it will reduce the fever without counterattacking the inflammation”.

French patients have been forced to consult pharmacies since mid-January if they want to buy popular painkillers, including ibuprofen, paracetamol and aspirin, to be reminded of the risks.

Jean-Louis Montastruc, the head of pharmacology at Toulouse hospital, told RTL radio: “Anti-inflammatory drugs increase the risk of complications when there is a fever or infection.”

https://www.theguardian.com/world/2020/mar/14/anti-inflammatory-drugs-may-aggravate-coronavirus-infection

But, more information from outside the USA:

Do
...
drink plenty of water and take everyday painkillers, such as paracetamol and ibuprofen, to help with your symptoms

https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/

[Native]

41. Saw some abstracts in U.S. journals - like AAI's Journal of Immunology that point to NSAIDs possibly

impairing antibody production to certain infections. Thanks for your post. Good info.

[cstanleytech]

34. I will probably stick with the off brand Excedrin as it has

both acetaminophen and aspirin together.

[muriel_volestrangler]

36. Aspirin is an anti-inflammatory

https://www.nhs.uk/medicines/aspirin-for-pain-relief/

[cstanleytech]

47. I know but its been the only thing that has worked for me in the past when I have had a cold or the

flu.

[at140]

56. Just watch stomach bleeding with aspirin

because it is a blood thinner. I take coated low dose aspirin weekly
but usually with food.

[cstanleytech]

57. I am diabetic so I tend to be extra careful when it comes to things that

can mess with the liver or stomach as I do not need anymore complications by adding more problems on top of it.

[Texin]

40. Caution with acetaminophen, i.e., Tylenol. It can quickly be toxic to the liver.

It is contraindicated for persons with any kind of liver complications/disease, and if a person drinks alcohol routinely.

I've seen alternating between acetaminophen and ibuprofen. And just a person tidbit, Aleve, i.e. Naproxin can wreak havoc with eyesight after a couple of days.

[Chainfire]

49. In elementary school

They taught us that Aspirin was the wonder drug. Maybe it's time has come again.....

(if you want to take medical advice from a plumber)

[Pachamama]

54. It is a wonder drug and has important uses

It is on the WHO list of essential drugs.

It is an important blood thinner and saves lives.
This thread is irritating me because people are not Doctors and making comments that just aren’t factual.

[at140]

60. BER aspirin stopped many chest pains for me

BER = not beer, it is Before Exercise Routine began in my life.

[ooky]

63. Thanks for sharing this.

I take an anti-inflammation drug to manage inflammation from osteo-arthritis. I may need to stop using it if I develop this virus. If I hadn't read it here I might have missed that important information.

That's one of the big things I really love about this site and the people that share so much helpful information here.

[roamer65]

65. NSAIDs have anti-coagulant properties.

Especially aspirin. Not the best choice when you have possible hemorrhagic viral pneumonia.

Aspirin was not a big help in the 1918-1920 epidemic.