Over the counter meds

I think it's almost irresponsible to package such a dangerous drug with an addictive one.

Paracetamol/acetaminophen(Tylenol) is a "helper drug".  It works with other drugs, in this case codeine, to allow it to work more efficiently. That's why they bundle them together. On a pharmacist's advice, I always take paracetamol when I take ibuprofen for just this reason.

As for your liver, it's comparable to alcohol. If you're popping them like candy, or a frequent/heavy drinker, you'll kill your liver. Moderate use, for most people, is fine just like the occasional drink, for most people, is fine.

Yes, ibuprofen can trigger asthma (codeine can too!) but if you're not sensitive to it I think ibuprofen is safer. Paracetamol just slightly over the maximum daily dose can kill people.

I found I could get something over the counter today that I thought was a bit surprising

You'd be really suprised to find what you can get over the counter in Spain... virtually anything that's not addictive or subject to abuse!

So narcotics, barbiturates and tranquilizers (valium, etc.) are out but just about anything else you can buy over the counter. This includes all common medications for heart disease, high blood pressure, diabetes, thyroid problems, liver and kidney disease, allergies, antibiotics, ED (viagra et al), depression or anxiety and on and on.

What's more, most medications are surprisingly cheap, almost always much cheaper than the 7.20 quid standard charge in the U.K.

So if you're planning a visit to Spain be sure to bring along all your scripts. Just show the box to a pharmacist in Spain and they'll get you the exact match.

As a matter of fact, if your medications are many and/or expensive it could even be worth a cheap flight to Spain to stock up.

So narcotics, barbiturates and tranquilizers (valium, etc.) are out but just about anything else you can buy over the counter. This includes all common medications for heart disease, high blood pressure, diabetes, thyroid problems, liver and kidney disease, allergies, antibiotics, ED (viagra et al), depression or anxiety and on and on.

What's more, most medications are surprisingly cheap, almost always much cheaper than the 7.20 quid standard charge in the U.K.

As a matter of fact, if your medications are many and/or expensive it could even be worth a cheap flight to Spain to stock up.

Many of those above meds end up being free for people in England, as many of those kind of meds are under the 'exemption' category. There's no script charges in Wales, Northern Ireland, or Scotland.  (Think there's a charge on the Isle of Man, not sure about the Channel Islands Don't quote me though).  So may not always be cost effective to go to Spain.   

Yes, ibuprofen can trigger asthma (codeine can too!) but if you're not sensitive to it I think ibuprofen is safer. Paracetamol just slightly over the maximum daily dose can kill people.

Yes.  The problem with Paracetamol is that it depletes an antioxidant in the liver and if you don't have enough there goes the liver.  Some people can't handle it at all, not in an allergic way but in an unable to process it way. 

The other issue is that you can have no symptoms for up to 24 hours and then bam liver shuts down.   

If you take too much ibuprofen you tend to notice because it causes stomach issues first, but it can cause irritation.   

Both in general, for a normal person, are safe at normal levels.  But I'd rather take a stomach issue than a liver transplant.

Paracetamol/acetaminophen(Tylenol) is a "helper drug".  It works with other drugs, in this case codeine, to allow it to work more efficiently. That's why they bundle them together.

I'm afraid you're mistaken, a "helper drug" would be more like pairing caffeine with aspirin/paracetamol.  It helps the analgesics work more effectively.  Excedrin (US) and Anadin Extra (UK) both contain these three compounds

In the case of Codeine+Paracetamol, Paracetamol is included in the formulation to help curb codeine addiction. You'll sooner go into liver failure because of an overdose of acetaminophen than become a codeine addict.

Yes.  The problem with Paracetamol is that it depletes an antioxidant in the liver and if you don't have enough there goes the liver.  Some people can't handle it at all, not in an allergic way but in an unable to process it way. 

Also in its metabolism, Paracetamol generates Reactive Oxygen Species (like hydrogen peroxide), which causes oxidative stress that antioxidants would normally help control...so it's sort of like a double whammy.

A triple whammy comes in when you take ethanol and paracetamol together, as the enzyme that is implicated in paracetamol's hepatotoxicity is induced by ethanol--generating more ROS's and depleting more antioxidants, which can lead to liver failure. This is why even in the worst hangover I won't take any Tylenol.

<Sorry if i'm being too science-nerdy...For several years my research focus was on drug metabolism, specifically the enzyme that metabolizes paracetamol...>

That reminds me, isn't codeine and paracetemol also available? how do you ask for it, what would you need it for?

It's a good remedy for migraine but make sure that you stop taking it after 2 or 3 days. If an attack lasts that long, see your GP. The generic name is co-codamol and the standard dose is 500mg paracetamol to 8mg codeine phosphate (the UK formulation is as a phosphate, the US formulation generally as a sulphate but the effects are the same). You can also buy ibuprofen with codeine. The main brands are Boots and Nurofen, which is very good for rheumatic pain that's keeping you awake at night but again should only be used for a day or two.

If you need a stronger form of co-codamol (500/10 or 500/30), you need a prescription. This is sometimes made with dihydrocodeine, which is stronger than codeine phosphate/sulphate.

That reminds me, isn't codeine and paracetemol also available? how do you ask for it, what would you need it for?

Yeah, don't think you can get just codeine by itself.. But yes a mix of paracetamol & codeine!