@SigMan (SigMan) posted a new topic, subject "One 800mg vs four 200mg Ibuprofen". It read:

   I told my friend that my doc gave me a script for 800mg Ibuprofen. I said that I can go get OTC 200mg Ibuprofen and take 4 to get 800mg.
    
    He said it doesn't work that way and I disagreed. Once dissolved in the body they're both 800mg dosage going in. He said the 200mg will go in as 200 mg at a time.
    
    I think he's nuts. Right?

After which, @bob_2 (bob++) added

    Are you not restricted in the number of Ibuprofen you can buy in one go? Paracetamol (and Ibuprofen) is restricted to no more than 32 tabs at a time in the UK. Of course, you can trawl all the local stores and pharmacies to build up a stock, but that's the rule.

@MichaelEmouse (MichaelEmouse) replied

    If made with roughly the same ingredients/proportions/shape, 4x200mg would have more surface area than 1x800mg and have quicker, stronger onset. That's the only difference I can think of.

Then @kanicbird (kanicbird) said

    I think it would be the same, however it is common to buy 400mg of Ibuprofen in a single tablet in Spain, even 600mg I've heard, but only saw the 400. My g/f felt a pleasant ‘high' from that which was absent from the US version.

Then @Amateur_Barbarian (Amateur Barbarian) said

    If it's a scrip, insurance will pay for it. That's about the only difference. I believe the tablets break down quickly enough in the stomach that minor issues of surface area are irrelevant.

After which, @BigT (BigT (he/him)) added

    My doctor has, at times, just flat out told my mom to take extra OTC ibuprofen, knowing full well it was cheaper since her insurance won't pay for the prescription. (I'm not sure if this is currently the case.)

So @Washoe (Washoe) replied

    Every MD I've ever asked has said they're equivalent. When I tore a muscle in my back about 20 years ago, the guy who patched me up told me to just buy the OTC ones and take six at a time.

@jnglmassiv (jnglmassiv) replied

    bob_2:
    
    > Are you not restricted in the number of Ibuprofen you can buy in one go? Paracetamol (and Ibuprofen) is restricted to no more than 32 tabs at a time in the UK. Of course, you can trawl all the local stores and pharmacies to build up a stock, but that's the rule.
    
    No such restriction on the free side of the pond. I get the generic ibuprofen a thousand at a time. I don't use paracetamol (aka Tylenol or acetaminophen) but it is also unrestricted.

@Keeve (Keeve) replied

    jnglmassiv:
    
    > No such restriction on the free side of the pond. I get the generic ibuprofen a thousand at a time. I don't use paracetamol (aka Tylenol or acetaminophen) but it is also unrestricted.
    
    Seconded. I just checked, and I have a container of 225 acetaminophens @ 500 mg each. I've seen it sold in 500 tab bottles, and maybe even a thousand.
    
    (OTOH, the warning notices got a bit scarier about a year ago, warning people that other meds can contain acetaminophen too, so read the bottles carefully to make sure you don't take too much too fast.)
    
    Yow. Only 32 tabs at a time in the UK? How much in each tab? (In the US, over-the-counter unrestricted acetaminophen is available in 325 mg and 500 mg strengths.)

@DSYoungEsq (DSYoungEsq) replied

    Acetaminophen has issues that ibuprofen does not have. There are potentially serious side-effects from too high a dosage.

@Amateur_Barbarian (Amateur Barbarian) replied

    DSYoungEsq:
    
    > Acetaminophen has issues that ibuprofen does not have. There are potentially serious side-effects from too high a dosage.
    
    Acetaminophen can be **toxic **in relatively small doses for some high-risk users, including pregnant women and some children. The entire “Reyes syndrome” shuck that drove parents from aspirin to Tylenol probably affected far more people than aspirin every would have.

To which @Atamasama (Mr. Atama) replied

    DSYoungEsq:
    
    > Acetaminophen has issues that ibuprofen does not have. There are potentially serious side-effects from too high a dosage.
    
    Liver failure with a high enough dosage.

@GIGObuster (GIGObuster) replied

    I would ask the pharmacist, IIUC it is true that four 200mg Ibuprofen will be the same, but one should follow the recommended times for intake.
    
    The warnings about possible overdose should not be ignored as others mention. In the case of the 800mg it seems that the capsule is usually of the delayed release kind, ask if that is the case. Those are mostly for situations were it would be inconvenient to take breaks to take the cheaper lower dose ones.
    
    Drugs.com
    
    ### BRUFEN RETARD 800 MG PROLONGED RELEASE TABLETS | Drugs.com
    
    Patient information for BRUFEN RETARD 800 MG PROLONGED RELEASE TABLETS Including dosage instructions and possible side effects.
    
    Aside: who came with idea of calling those 800mg tablets BRUFEN RETARD? Sure it is appropriate, but it really sounds to come from the same guys that gave us AYDS.

To which @usedtobe (usedtobe) replied

    I suspect this tale was created by “Big Pharma” to scare people away from the OTC versions as they came available, but I'll throw it out here anyway, on the chance it might have some truth:
    
    While both the Name Brand and generics both have the same active ingredients, the composition of the other stuff may cause different rates of absorption.
    
    The obvious are the ‘timed release' formulas - the binders, capsule composition, etc. may make a difference in how fast the drug gets into your blood.
    
    Again, I've never heard a word of this from either an MD or pharmacist.
    
    I can't see any difference in effectiveness because of number of pills.

Then @SigMan (SigMan) said

    They're both coated caplets so most likely they'll absorb at the same rate.
    
    https://s25.postimg.org/g0g7zlq8v/S5031008.jpgupload gambar

So @Some_Call_Me.Tim (Some Call Me... Tim) replied

    Hmm… if the link GIGObuster provided is the same stuff, the 800 pills are “Delayed Release”.
    
    If I were going to risk taking the smaller pills, I would take one 4x as often as the doctor recommended taking the 800 rather than all littlealexis@example.net. (e.g. one every 3 hours if the doc recommended an 800 every 12h.) Or two pills at a time twice as often as the 800 recommendation.
    
    Oh, and acetaminophen is a completely different beast, I value my liver and wouldn't mess with overdoses of those at all- it doesn't belong in this thread.

Then @SigMan (SigMan) said

    Two of the 200s are the usual dosage as directed.

Then @Some_Call_Me.Tim (Some Call Me... Tim) said

    Yeah, two twice as often as the 800 recommendation then.
    
    One thing that your doctor may not be mentioning is that people often don't follow the directions on when to take medicine. From the doctor's perspective, a patient is more likely to be successful in actually taking the proper dosage if less work by the patient is required to do so. By prescribing the 800 to all patients, the doctor may expect that a higher % of patients will actually complete the regimen than would have successfully completed a regimen of more pills more often.
    
    This could be true even if the effects would be identical if the patients could be trusted to follow the directions in either regimen.

To which @si_blakely (si_blakely) replied

    From Wikipedia
    
    > Limiting the availability of paracetamol tablets has been attempted in some countries. In the UK, sales of over-the-counter paracetamol are restricted to packs of 32 x 500 mg tablets in pharmacies, and 16 x 500 mg tablets in non-pharmacy outlets. Pharmacists may provide up to 100 tablets for those with chronic conditions at the pharmacist's discretion. In Ireland, the limits are 24 and 12 tablets, respectively. Subsequent study suggests that the reduced availability in large numbers had a significant effect in reducing poisoning deaths from paracetamol overdose.

After which, @filmore (Fil More) added

    SigMan:
    
    > I told my friend that my doc gave me a script for 800mg Ibuprofen. I said that I can go get OTC 200mg Ibuprofen and take 4 to get 800mg.
    
    I've heard in the past that the over the counter Ibuprofen has some ingredient in it that will make you sick if you take too much. If you take the normal dose, you won't notice it. But if you take a lot, that other ingredient will make you throw up. It's to stop people from overdosing on it. Does anyone know if that's true?

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