July 20, 2007

Comparative Review: Liquid Vicodin vs. Childrenâs Tylenol

I am 95% recovered from my recent tonsillectomy, and can once again act as a productive member of society. No, no, silly, I havenât quit grad school and found a real job, but I have switched from my beloved liquid Vicodin to Childrenâs Tylenol to combat what remains of my sore throat during driving-around-shopping-and-going-to-the-beach hours. This is per my doctorâs instructions; Tylenol is the only over-the-counter painkiller that doesnât promote bleeding, and I canât swallow pills yet, so Iâm taking the liquid kind intended for small children. For those of you who may be surprised to hear that Iâve noted some differences between the two products, I have compiled a handy Comparative Review.

Liquid Vicodin

Form taken: Liquid (Hydrocodone-APAP solution)
Available flavors: Vomit
Taste: Initially awful, yet progressively numbing and welcoming
Mouthfeel: Syrupy, clingy.
Dosage: 5 to 15 ml (1 to 3 tsp)
Effects: Absence of pain, attention span, and motivation. Over the course of a day, interesting whole-body numbness can develop. Amuse yourself by pinching your arms and flicking yourself on the nose: fun for hours!
Pain relief: Highly effective on moderate to severe pain. However, this medication is apparently inactivated by the consumption of food or swallowing of any substance other than itself. If the tonsillectomy patient attempts to swallow, the rest of the body may remain numb but the throat will return to the state of agonizing pain.
Soporific qualities: Pleasantly drowsy.
Drawbacks: Not a good idea to drive, operate jackhammer, or do any task requiring attention for more than a minute or
Overdose risks: Difficulty breathing, coma, death.
Narcotic classification: Schedule II
Value for money: $$$$$. Pharmacy co-pay: $12.65. Approximate doses per enormous bottle: 40. Cost per dose: 32Â.
Other notes: Probably the third refill wasnât necessary, although this shit is still saving my life at night when Iâm trying to sleep and the residual swallowing pain is bugging the shit out of me.

Childrenâs Tylenol Oral Suspension

Form taken: Liquid (acetaminophen with multisyllabic additives, preservatives, corn syrup, flavorings and colorants)
Available flavors: Very Berry Strawberry, Bubblegum Yum, and others I havenât tried. (Note: these two taste almost identical.)
Taste: Cloying, so sugary it ceases to be sweet and actually burns the inside of your mouth.
Mouthfeel: Gritty like the icing roses on a cheap sheet cake. You can hear and feel the sugar crystals crunch between your teeth. Unbearable without immediate application of full dental hygiene regimen.
Dosage: Each 5 ml teaspoon contains 160 mg of acetaminophen, or 32% of a 500 mg Extra Strength Tylenol tablet. Standard dosage of 2 Extra Strength Tylenol tablets equals 6 and a quarter teaspoons of liquid, or approximately a quarter of the bottle at a time.
Effects: Irritation, compulsive tooth-brushing behavior, mild sugar high.
Pain relief: None recorded.
Soporific qualities: None initially, though after several hours the sugar crash leaves patient tired and with a headache.
Drawbacks: Feeling like a sucker; artificial bubblegum flavor impossible to eradicate.
Overdose risks: Diabetic shock. Also, if maximum daily dose of 4000 mg or 25 teaspoons exceeded, possible eventual onset of vaguely referenced liver problems.
Narcotic classification: None.
Value for money: Â. Drugstore price: 5 to 6 dollars. Approximate number of doses per bottle: 4. Cost per dose: $1.50.
Other notes: It has just been brought to my attention that, although I did not note this product at my drugstore, Tylenol makes a PM liquid in a flavor called âGolden Vanilla.â I am normally a sucker for such things, but this time it doesnât really help me because I already have a cost-effective nighttime pain reliever and sleep aid in trusty old Vomit flavor.

What have we learned today? Well, we've proved my long-held theory that Tylenol doesn't do shit. Let's look at the liquid Vicodin for a moment. It's hydrocodone (the generic name for Vicodin, Lortab, etc) in suspension with acetaminophen (Tylenol). On the foot-long warning sheet from the pharmacy, in the part where they "explain" how the painkiller works, the writers try to ascribe some effects to the Tylenol:

This medication is a combination of a narcotic (hydrocodone) and a non-narcotic (acetaminophen) used to relieve moderate to severe pain. Hydrocodone works by binding to opioid receptors in the brain and spinal cord, and acetaminophen decreases the formation of prostaglandins, therefore relieving pain.

If we take a moment to parse this explanation we'll see what I mean. Acetaminophen acts to decrease the formation of a kind of fatty acid named after the prostate gland. That's all very interesting, but I don't have a prostate gland, and for pain relief my money's on the thing that's binding to my opioid receptors. If you look even more closely you'll see that we're tipped off further in the language of the sentence itself, where the writers start off by asserting that "[h]ydrocodone works," but in the sentence's second clause they avoid the parallelism that would have sounded natural there because they couldn't bring themselves to claim that "acetaminophen works." Instead, "acetaminophen decreases." You see?

Furthermore, my controlled laboratory experiments (data scrupulously reported above) offer incontrovertible proof of my theory. By itself, the Tylenol does nothing, so why would we imagine that it's doing something when shaken up in a bottle with the much more powerful hydrocodone? Clearly, it's only there to dilute the opiate, or to "water it down," if you will. Ergo, the bottles of Children's Tylenol I've been buying are, in fact, sugar water. QED. This can only mean that the slight lessening of pain in my throat is due to the placebo effect, or else that my sore throat is being effectively overshadowed by the sugar headache and the slight twitch I've developed.

Posted by katie at July 20, 2007 03:56 PM | TrackBack