Question: What is the difference between taking one 800 mg regular Tylenol that requires a prescription and taking four 200 mg regular Tylenols bought over the counter? The prescription costs twice as much.

        Answer: First off, the effectiveness of one 800 mg Tylenol is equal to that of four 200 mg Tylenols. Otherwise, says Dr. Rama Kasturi in the University of Cincinnati Medical Center pharmacology department, two things are at work here: cost and compliance.

        • Compliance: That would be patient compliance, meaning how well the patient complies with the doctor's instructions. Studies show patients are more likely to take medicine that's prescribed in fewer doses.. That's why doctors prefer 800 mg pills over 200 mg pills.

        • Cost: It all depends on who's paying. If it's an insurance company, it will pay for prescriptions but not over-the-counter stuff. So a script is probably cheaper because it's only a co-payment.

        If the patient is paying, he needs to compare the cost for four bottles of 200 mg to one bottle of 800 mg. If the four bottles come out cheaper, he should discuss it with his doctor. But be prepared for a lecture on compliance.

        If you have a stupid question, send it to Ask a Stupid Question, Cincinnati Enquirer, 312 Elm St., Cincinnati OH 45202; fax: 768-8330.

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