Your card expires on .Update your payment information to continue being a member of elDiario.es.Your support is still needed.It seems that you had problems registering as a member in elDiario.es.Finish the process in just a few minutes.We need you more than ever.Your payment details are wrong or incomplete.Update your data to renew the fee and not cause cancellation as a member of elDiario.esHuman beings are beings of customs, regardless of whether these customs make sense or not.The pharmacy is not exactly an exception to this behavior.People resort to certain pharmacological treatments because “it has always been done that way”, without the absolute majority of the time they have the opportunity to know if there is a justified reason behind it.It is simply assumed, because times are already crazy enough to doubt every action we take.Not even many doctors and pharmacists are free from the curse of routine: the force of habit is powerful and inertia very comfortable.Ibuprofen (600 mg) and paracetamol (1 g) are the protagonists of this absurd story that tells us more about human nature than about pharmacology.The latest installment of this nonsense story originates and reaches the media spotlights due to the entry into force of the Spanish Medication Verification System (SEVeM) in February.This system supposes a reinforced control of the administration of medicines in the pharmacy, which forces, among other things, to stop turning a blind eye with the dispensing of drugs subject to medical prescription (that is, those that need a prescription).For a very long time, pharmacies have sold drugs that legally required a prescription without asking for them.In this sense, among the most popular drugs that were served outside the law were ibuprofen 600 mg and paracetamol 1 g.Now, with the verification system, pharmacies have no choice but to stand firm with the sale of these medicines without a prescription, as reported by El Confidencial.This measure, which gives pharmacists a little push to embrace the Law on Guarantees and Rational Use of Medications (2015) more strongly because they are now more closely watched, has opened the debate.On the one hand, some pharmacists allege that ethics prevails over the norm and that they can find patients who really need ibuprofen / paracetamol and who do not have the prescription due to various circumstances.On the other hand, people have appeared on various social networks who see the measure in a bad way because it represents a restriction on freedom and the right to resort to these medications if we need them, especially for pain.The point, really, is that there is no debate for acetaminophen and ibuprofen at prescription amounts with the pharmacology in hand.Despite the fact that they have been happily and self-assuredly prescribed and sold for mild and moderate pain, both 1g paracetamol and 600mg ibuprofen are totally inadvisable for the general population.As the Spanish Society of Community Pharmacy warned years ago, it is estimated that there are 8.5 million Spaniards who receive daily doses of ibuprofen higher than those recommended and that only 400 mg doses are dispensed for 4.8% of cases of mild-moderate pain.In fact, Spain is a rare case in this regard.In most European countries, the ibuprofen prescribed/dispensed is 400 mg.Also, in other countries, ibuprofen 600 mg directly does not exist.Because it has been known for many years that these amounts of these active ingredients increase the risk of adverse effects without at the same time implying an obvious improvement in their most demanded therapeutic effects (mainly analgesics for mild and moderate pain) compared to the presentations that they don't need a prescription.In other words, more dose doesn't have to mean better.In the case of ibuprofen 600 mg, the risk of adverse gastrointestinal and cardiovascular effects and infections is increased, without this necessarily implying an evident improvement in its effects against pain, fever and inflammation.In the case of paracetamol, the risk of liver toxicity is increased, especially when the dose of 4 grams per day is reached.In fact, the United States Food and Drug Administration (FDA) recognized 10 years ago that paracetamol hepatotoxicity was a public health problem and therefore recommended limiting the maximum dose per intake in adults to a maximum of 650mg.In Spain, the Spanish Medicines Agency opted in 2017 to put paracetamol of one gram under a prescription due to this risk.In addition, the consumption of paracetamol in doses of 1 g increases the risk of interaction with oral anticoagulants (such as Sintrom) and the risk of stomach and cardiovascular problems.All drugs have what is called a “therapeutic window”, which is the concentration range of the active ingredient that allows it to provide beneficial effects with little or no probability of causing toxic or lethal effects.In general, medications are usually presented in doses that allow the maximum therapeutic effect to be obtained with the minimum possible adverse effects.In this sense, both ibuprofen 400 mg and paracetamol 650 mg are the optimal doses for the general population, the safest presentations and the ones that are most likely to be useful.In addition, it is precisely these presentations of medicines that do not need a prescription and can continue to be requested at the pharmacy without any problem.In contrast, ibuprofen 600 mg and paracetamol 1 g require a prescription (except for certain brand-name drug presentations, with a limited number of doses) because they present more risks, since the intake of these doses is closer to the toxic doses.In addition, they should be prescribed and dispensed for certain patients suffering from specific diseases (rheumatoid arthritis, osteoarthritis, more intense pain...) and for whom a higher dose is indicated.Never for a mild and passing headache.Administering these drugs with higher risks to the general population for mild or moderate pain without requesting a prescription makes not only legal sense, but also pharmacological and ethical.That they continue to be used with joy in Spain reflects misinformation, both from the general population and from the health sector, and inertia when it comes to updating with medical content that has been known for more than a decade and that led many countries to take measures.Unfortunately, it is very difficult to know the consequences that these pharmacological customs have had for the health and lives of the Spanish population.What is clear is that this typical Spanish absurd story is not over yet.More articles by Esther Samper @shoraThe most read by membersSalobreña cancels the registration of Macarena Olona and jeopardizes her candidacy for the Andalusian electionsActor Chete Lera dies in a car accidentThe price at each gas station this Friday: check the cheapest gasoline in your areaThe head of the PP political brigade sentenced for trying to adulterate 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