Why would some think excessive Tylenol would be preferable over narcotic pain meds
How much Tylenol would a person have to consume over a two month period to permanently damage their liver
This is bizarre.
Tylenol is surprisingly easy to overdose on and is well known to cause liver damage. This is especially true if you take extra strength tylenol. It is recommended to stay below 3,000 mg of tylenol within 24 hours, which is only 6 extra strength pills. If you take a bit extra and get over 4,000 mg per day for multiple days, you can get major issues. There just is not much margin for error with tylenol.
I think people often get confused because you can typically take a bunch of ibuprofen pills for pain and there are rarely serious side effects. But ibuprofen and tylenol are much different in this regard, despite the fact that both relieve pain and both can be easily bought in a drug store.
> This is especially true if you take extra strength tylenol. It is recommended to stay below 3,000 mg of tylenol within 24 hours, which is only 6 extra strength pills. If you take a bit extra and get over 4,000 mg per day for multiple days, you can get major issues. There just is not much margin for error with tylenol.
Huh? To actually think that taking 6 extra strength pills in 24 hours isn't enough margin of error? I mean maybe if the person is completely clueless and doesn't read the medicine instructions.
Honestly, if you're in that much pain that you're gobbling up 6-8 extra strength pills per day, every day, you should be in the hospital with an IV hooked up, or addressing the chronic pain issue that's causing it. Or have the doc prescribe you something way stronger.
I don't know about other people, but for me paracetamol does very little, so if I had even moderate pain I could see why I would be tempted to take too much.
On the other hand, UK has OTC ibuprofen+codeine which can fix essentially anything.
OTC painkillers are usually not meant for moderate+ pain, at least the stuff available in USA.
They're meant for taking you from 3/10 to 1/10. I know most people don't think about it in-depth, but surely we can expect at least some basic logic from them?
Like don't swallow pill #6 if the first 5 extra strength pills did nothing.
-take 2 caplets every 6 hours while symptoms last.
-do not take more than 6 caplets in 24 hours, unless directed by a doctor.
It's not too crazy that someone in pain or feverish could think "maybe if I just take an extra pill or two I'll feel better and it will be totally safe..."
> How much Tylenol would a person have to consume over a two month period to permanently damage their liver
Liver damage can occur after a single incident. People have died from single time overdoses of paracetamol. There is a quick fix in an ER of giving NAC which can help eliminate most of the damage, but there is a small window(a day or two) where it is effective.
I have a load of NAC on hand. Would it be a good idea to take it whenever I take Tylenol? I can't imagine a pharma pathway that would result in it attenuating the painkiller effect. Just mop up the oxidative damage.
Not a doctor and I wouldn't listen to medical advice from HN, but you can find a lot on this:
>Therefore, it may be beneficial to administer APAP(Tylenol) in combination with NAC routinely to reduce rates of liver failure and death. Because NAC's main role is to reduce the accumulation of APAP's toxic metabolites, the concomitant administration of NAC should have no impact on the efficacy of APAP as an antipyretic and analgesic.
It's quite common. At least in Europe, available sizes of Paracetamol were severely limited not too long ago because it was the leading cause of overdose deaths.
Individual risk isn't exactly high, but OTC painkillers are ubiquitous.
Both accidents and suicide attempts are/were frequent. It's a rather terrible way to die, IIRC, with excruciating pain and entirely too much time to regret the decision/accident.
I know someone who ended up hospitalized from accidentally taking two over-the-counter meds that both contained Tylenol. It just doesn't take that much to cause damage.
In my case I went to the doctor only after trying to bear it for as long as I can - they did an x-ray and said there's nothing wrong with your foot and you'll just have to ride it for some days. Heck the doctor asked me to eat Turmeric pills - not even kidding. He made sure I wasn't getting a narcotic - and I wasn't looking for it because I am really afraid of side effects. (My wife is the same way - brave woman went without touching the narcotic meds after tooth removal.)
That pretty much leaves you with OTC pain meds - I know in these cases probably narcotics of the right kind in restricted doses sound much better but I am just truly afraid of side effects because of what we saw earlier in life.
Tylenol is over-the-counter, while you need a doctor to prescribe narcotics.
As such, Tylenol overdose is more common. The labels are very clear about how much to take, but when you're in chronic pain, you may not be thinking much about the warning stickers or labels.
Many stronger drugs have acetaminophen in them. I've tried oxycontin and had very little benefit. People should know for themselves what works for their pain but never underestimate the damage drugs can do, even if they're over the counter.
Honestly, this one does surprise me. American doctors give out opioids like nobody's business. They give you narcotic painkillers for post-tooth-extraction pain! That's ridiculous! The problem, I think, is that many people are foolish enough to "return their unused prescription". I never do that. I make sure to retain unused drugs to their true expiry.
It must have been really quite painful. Still, I'd strongly recommend keeping drugs of all manner handy if you've got good self-control around them. They have high utility.
Mine gave me high strength ibuprofen and percocet after wisdom tooth removal. I didn't take either because it didn't hurt, but they called me up after to make me take the ibuprofen - apparently the anti-inflammatory effect is needed for healing or something.
The DEA has cracked down tremendously on healthcare providers that over-prescribe opioids, though. Granted I'm sure there are many who still prescribe them like crazy, but it seems like active measures are being taken to curb it.
That's unfortunate. I've always wanted backup in case I really need it. Pity that we policy society by its least capable but I understand why it's necessary.
I've seen probably a dozen people in my high school class die from their narcotic pain meds originally prescribed to them. I only took a quarter of what was prescribed after surgery from shattering my leg, and yet weening off was worse than the pain from the injury.
I don't blame him for the choices he made, having been there.
Depends on what "die from their narcotic pain meds" means, and how big the high school class is, how long they've been out of school, and where their school is located.
So your class had a 1% death rate due to prescription opioids. Why do you suppose it was so far out of proportion to the general population? drugabuse.gov says prescription opioids accounted for around 15,000 deaths in 2017 [1], so 12 in a single high school graduating class is either a massive unexplained spike in the data, or something you made up.
I'm not who you're replying to, but don't you think that given we know pill mills exist, it's likely the data is actually highly location specific? I.E., a city with one is more likely to have lots of ODs compared to the national average? Have you taken a statistic course? At this point I'm not sure what you're objecting to anymore.
You're referencing media I don't know, I don't understand why you don't think the scope of the opioid crisis that has claimed thousands could involve the deaths of 12 people with 1 thing in common. Pill mill pharmacies are a thing, and some of those pharmacists have been charged with crimes.
Just consuming more than 4g on one day may be enough to start the liver failure, especially if using alcohol or other drugs.
Protip: have some N acetyl cysteine handy. It's freely available on amazon, and it protects your liver from acetaminophen abuse (and helps rebound faster the next day after a night of heavy drinking, but the FDA absolutely hates when people mention that :-)
EDIT: replying here as HN things I'm "posting too fast"
Whenever in doubt, by default, you take it due to its extremely good tolerance.
There are no bad side effects at usual doses, even after 50+ years on the market (well, at very large doses, vomiting, which I think is good in case of acetaminophen or alcohol poisoning)
