I find myself taking a lot of tylenol with codeine lately because I am trying to manage my pain on my own (I have no GP). They are OTC here but there is such a small amount of codeine in T1's that I have to take a LOT of acetominophen to get any of the benefits of the codeine. My question is how much tylenol is too much? I know it can do a lot of damage to your liver and that's what I'm worried about but I don't know what else to do. I have no alternative. I have a lot of neurontin here but even the 3200mg I was supposed to be taking doesn't work. Because I have no doctor I can only go to the walk-in clinic. They will not prescribe narcotics so I get prescriptions for things like Elavil, Neurontin, Celebrex, Flexeril etc. that don't work. I was also taking Ativan because I can't sleep at night but I couldn't get prescriptions for anymore so I had to stop. I'm back to sleepless, painful nights now....very,very frustrating! I tried taking combinations of ANYTHING to sleep like benadryl or gravol but that isn't even working now.
4000 mg is the recommended amount but I think that is pushing the limits just a bit. It definately can cause liver damage over time.
I am going to assume you don't have any medical insurance and that is the reason you are unable to get proper treatment?
medications like Celebrex need to really be taken for many weeks in order to obtain the full effects.
Candachick I am so sorry you are having so much trouble finding a family doctor in Canada. I am also in Canada. We are in Alberta now but a year ago we were in Saskatchewan and I haven't had a problem in either province. Do they not monitor T1's in Ontario? They do in AB and Sask both. You don't need a rx but they take your name and number and you can only get one bottle every 30 days here. I would recommend phoning your local clinics time and time again until you can find a gp. I'm sure you will eventually find a new one setting up practice and wanting patients. We have lots of doctors here that have come from other countries. My doctor now is from South Africa as was my doctor in Sask. They have both been great doctors to me. I sure hope you can find one as I feel bad for what you are going through.
I'm sorry you still have not gotten any relief. Like Kissa said, the daily limit on acetaminophen is 4000mg a day. However, you are not supposed to take this maximum amount for over ten days I think it is. So even though you may not be exceeding the recommended dosage on a daily basis, you really should not take the acetaminophen on a daily basis for over a certain amount of time. Please be careful with this. It will cause liver damage. My aunt died from liver damage caused by acetaminophen. She took it daily for years. She passed away 13 years ago and her doctors said they were pretty sure her liver damage was caused by the acetaminophen. She actually had cirrohsis (sp?) of the liver and she never drank a drop of alcohol in her life. In fact, she hated the stuff. Please be careful ok? I know it's hard when you are hurting so badly. I hope you can soon find a doc to help you.
I have done quite a bit of research on my own on that very question, and the consesus i have gotten from medical articles and multiple docs opinions is that 4000 mg (4 grams) of apap total is THE maximum that should be taken in any one day period. Like another poster said, you would be pushing it, but you would probably be OK taking that total dose (remeber to include all meds with acetominophen in them in the total) for up to 7 days for acute use (such as post-op pain). However if you are a chronic pain sufferer and you take meds on a regular basis with apap (lorcet, vicodin, percocet, or tylenol/w codeine among others, then you should limit your apap intake to NO MORE than 2200 mg a day. This is the number i have read on a number of reliable medical studies on that issue. This is so you maintain normal liver enzyme levels, which are a sign that the liver is not being damaged. However, if you have Hepatitis B, or Especially Hep C, than you should avoid tylenol period. The same holds true if you drink more than extremely sparingly (and lightly). If you do have either issue, and you take a script with apap, then you should ask to be switched to a prescription painkiller with NO apap, such as ultram, darvon, codeine phosphate tablets, oxy ir, morphine tabs, or dilaudid tabs, none of which cause adverse liver effects (to the best of my knowledge anyway, always check with your doc first though).
BTW, it is a fact that many tens of thousands of people die soley from acetominophen induced liver damage annually in the USA, just as the previous poster's aunt did. (many times more than ever died soley from oxycontin or any other prescription narcotic w/out apap), but guess which drugs always gets the bad press
It's not that I don't have medical insurance, I live in Ontario and everyone gets "free" healthcare here. Our health system is great: you pay nothing and you get nothing in return . That seems to be how it's been so far anyways. If I had the option I'd pay to be seen by a real doctor!
Tylenol with codeine (t1) is OTC here and no, you don't have a limit on how often or how many you buy. I just walk into the pharmacy and ask for some and that's it!
The limit is 4000mg a day? Lets see, the average day I take about 10 (sometimes more I admit). Each T1 has 325 mg of aceteminophen so I'm taking at least 3250 per day, every day. All of that for a measly 80 mg of codeine !!!
To keep it simple, you should never take more than the maximum dose at one time, or over a 24-hour period, as it is described on the bottle. I know that some of you may disgree with this theroy, but Tylenol is definitely linked to liver damage, if too much in taken and/or if it is used long-term, especially if you drink a significant amout of alcohol and/or have liver disease. I have been advised never to take more than 1000 mg per day, due to my underlying medical problems; however, most people could take it as labeled on the bottle. Also, pls be aware that many narcotic pain meds contain Tylenol, including Vicodin, Percocet, etc, as do other OTC meds that are not carried under the brand-name Tyenol. Pls remember that, even when taking OTC meds, you should not take more than the maximum allowed amount, unless your doc has authorized it.
I agree with what everyone is saying though I have taken Tylenol PM's and the like since I was nineteen about 16yrs or so. I usually take about 5-7 grams in a ten hour or so period and so far as far as i know am ok. I just wondered perhaps a little on the dingy side how would i know if I had pretty much destroyed the liver or not. I've only recently started looking into it and i don't drink though I take it with caffeine which i have read can cause the kidney to fail or something like that. I know i have o.d several times though i didn't know it then. I thought i was getting the flu with a fever and all that and only took more which caused some strange shaking stuff and twitches. Anyhow this has been my experience thus far. emerald
I am just a little confused(okay, alot confused) as to why you have not seen a Dr if you have free healthcare.Even under the worst cicumstances,if you actually 'have" ins, there must be some way that you can actually get an appt with some sort of medical professional.Are there no docs that are close by or is there a really really long wait?i am just wondering as it just seems wierd thats all.
Continuing to self treat with the small amount of codeine and the large amount of tylenol that you are currently taking in could come back to haunt you at some point.Do you know just what exactly is causing your pain to occur?have you ever at any time had this pain adressed by any sort of Dr so you know what it is your really dealing with?Without getting some sort of treatment or intervention by a Dr, this cycle could very well end up continuing until you are forced to seek emergency help at some point.You really do need to get a handle on this whole situation before things really hit the fan.I hope you can work out what ever the barriers are that have kept you from actually seeing a good Dr in the past.You deserve much better care than this.Good luck,and PLEASE watch that tylenol.Marcia
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.
I am also VERY confused. What is causing your pain? Why do you not go the ER so that they can refer you the folllowing day for immediate treatment of such severe pain? I am just wondering because I cannot imagine why you would endanger your liver to such a degree if you had a legitimate pain concern. If nothing else, you should get to a Dr. and have your liver tested right away. Especially if you have been taking these for quite a while. Don't take offense, please. I would not wish liver failure on any of you fine people.
Last edited by Karebear71; 07-06-2005 at 08:20 PM.
I didn't have time to read all replies, so disregard this if it's been covered. Here's what I did: I was taking T3's, too, and worried about the same thing, so my doc gave me straight codeine tabs- NO acet. The acet. wasn't working anyways, never has in my whole life for anything. And the codeine tabs, they said I can take even 10 at a time if need be. The label says take 2-4, I think, but they said even like, 10 would be safe.
I hope that emeraldeyes114 sees this reply - maybe i will reply to her/him and point her/him to this because it is really important.
I live in Canada and it has easy access to OTC acetaminophen/codeine and it is a possible reason for the high kidney disease in this country.
Acetaminophen is a greater problem for kidneys then for livers. It has been known (rare) to cause total kidney failure with just one dose.
One way an another i have been on acetaminophen for many years. I was finally put onto oxycontin because i actually developed the disease of pain (maldynia) due to years of undertreated pain. Before that i had been taking the max 4 gm dose and for a number of years i was also put onto 600 mgs 4 - 5 times a day of ibuprofen along with the acetaminophen.
My kidney problem was only discovered by random chance and since then my kidneys have consistantly deteriorated to the point that i am now very close to being placed on dialysis.
Once kidney problems begin it is very hard to stop further deterioration and trust me you don't want to start losing any kidney function.
Anyone out there that has been on this drug for more than 6 months needs to have their kidneys checked.
I had no idea my kidneys were deteriorating - this is a silent killer. Once you begin you lose kidney function it leads to all kinds of metabolic disorders and other diseases - which also happened to me.
My kidney specialist told my doctor to remove all my meds for pain and to put me onto oxycontin and codeine for breakthru. What he didn't tell her was not to give me oxycontin with acetaminophen and for 5 years that is what i took. I had no idea i was still actually taking the same amount of acetaminophen as before and my kidney function dropped in that 5 years from 42 to 20.
So worry about your liver, but worry more about your kidneys
Here are the 2 types of kidney problems that occur with acetaminophen and other types of non-steriodal anti-inflammatory pain meds.
This condition is kidney failure which results from taking large amounts of over-the-counter medicines such as aspirin, acetominophen or ibuprofen, for a prolonged period of time. Every medication we take, whether prescription or over-the-counter, passes through the kidneys. Analgesic nephropathy usually results from people self-medicating, perhaps to relieve chronic pain from arthritis or back pain. These medicines should never be taken on a regular basis without checking with your doctor. Thousands of Americans have destroyed their kidneys by using excessive amounts of painkillers.
This is a kidney disorder caused by inflammation of the tubules and spaces between the tubules and glomeruli. The inflammation causes lesions that may be temporary (resulting from an allergic reaction or side effect to a medication), or chronic. Medications commonly associated with this disorder are antibiotics such as penicillin or ampicillin, and nonsteroidal anti-inflammatory drugs. The disorder causes a reduction in kidney function that can range from mild to severe. About half of the people with interstitial nephritis experience a decrease in urine output.
I hope you have finally found a doctor who can identify and properly treat your pain. The World Health Organization says that pain that does not resolve after 2 weeks of drugs like acetaminophen and ibuprofen needs to be treated with narcotics. The disease of pain maldynia is mainly caused from undertreated pain. There is no known cure for maldynia.
Don't forget one of the greatest contributors to "Pain" is pain itself.
I brand new here, and i came to your reply to canadachik and i thought you might be interested in the reply i just sent to her. I am really worried about the amount of acetaminophen you are having to take. I also took way too much of this drug when i couldn't get help from doctors for my pain, and now i am just a step away from going onto dialysis.
What type of pain are you having? Have you seen any doctors? Are you like me and have been tossed around the medical playground regarding your pain? It took me nearly 20 years to get to the root of the problem.
I was also wondering why you are taking tylenol PM with caffeine? As i understand it tylenol PM is just a combination of acetaminophen for pain and benadryl to help with sleep. Doesn't taking the caffeine with it sort of defeat the purpose? I know caffeine can enhance the pain reduction of acetaminophen.
You probably know that benadryl is a very strong anti-histamine that can really throw your body chem out of wack when taken everyday. Yes, it does promote sleep. Anyone who has had to take this drug will tell you they sleep all the time when on it.
Im sorry if it seems like i am butting in here, but i am concerned for your kidneys.