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    Old 06-01-2007, 04:51 AM   #1
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    How much acetaminophen?

    I've come to grips with the fact that I am addicted to prescription pain relievers. However, after a night of eye opening research, I'm left wondering how on earth I survived this long. I've been taking between 10g-15g per day of acetaminophen, through Darvocet lately, and sometimes for weeks at a time. I normally take 3g-6g a day for the last year or so.

    How much acetaminophen have some of you taken regularly through an addiction, or how much have you heard of addicts using a day? I'm extremely worried about my health now and just hope I haven't done damage that can't be repaired. I'm done with acetaminophen altogether now, I'm not going to take it ever again if I can help it.

    I live with chronic pain and need the relief, but I am now going to request to my pain management doctor that I am switched over to ibuprophen instead of the acetaminophen in the meds. I'm really, really worried now.

     
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    Old 06-01-2007, 06:02 AM   #2
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    Re: How much acetaminophen?

    Its a GOOD thing to be worried about this,really.it helps with the motivation factor and just reinforces the need to stop.there are quite a few different threads right on this addiction site here that i know i have posted on the nasty damage to your liver and the kidneys can get with abuse of tylenol in the meds that are taken that contain tylenol.

    the actual daily limit for an occasional use is actually 4000mgs,BUT if you are using any tylenol based product in an abusive/chronic or daily manner,that 4000 will drop down to only 3000mgs per 24 hour period.this is the 'safe' limit.once you go beyond that safe limit the liver just cannot metabolize anymore as the chemical needed to do this just gets too depleted and thats when cell damage begins.the one good thing about the liver tho is that at some level,without the continued abuse,it 'can" regenerate itself to a certain degree.but the abuse has to stop in order for this to actually occur.the kidneys also take a big hit with analgesics.espescially combined like ibuprofen,aspirin,tylenol,the usual suspects.you could just as easily succumb to kidney failure(analgesic nephropathy) as liver failure if this continues.everything gets filtered thru the kidneys before it actually exits the body,so even tho things like tylenol are heavily metabed in the liver,all of those toxins still have to pass thru the kidney tissue as well.and it can take its toll.

    if you are seeing an actual pain doc for pain management,there are many other med options that do not actually contain any tylenol.just discuss those concerns with your doc.my pain clinic will not under any circumstances actually Rx any med that contains tylenol,to anyone.they are just very much aware of the overall toll tylenol can take on a chronic pain patients body systems.i also have a kidney/liver disease so i wouldn't take them anyway or any other product that contains it.why take that crap if you really do not have to ya know?there are just much safer options availiable these days.darvocet just has to be one of the worst pain meds only because it contains such a huge whopping dose of tylenol.and you cannot get it in any other form than the 650mgs i believe.i would really sit down and discuss other options with your doc soon,there are so many others that are just soo much safer to have to take on a daily basis.good luck,marcia
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    Old 06-01-2007, 07:43 AM   #3
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    Re: How much acetaminophen?

    You Said that you were taking up to 15grams of tylenol through your darvocet use? With each Darvocet tablet containing 650mg, am I adding the math correctly that your daily intake of darvocets was as much as 23 tablets???? I am in no way judging you....trust me....I am in the throes of a detox myself off of darvocet and my daily "habit" had creeped up to about 10-12 pills a day, which I KNEW had to wreaking havoc with my liver (that translated to between 6,000 - 7,000 mg a day vs the "allowable" amount of 3,000 mg)
    I had been taking this amount of tylenol since a spinal surgery in Oct 2005 (all of it Legally prescribed by ONE doctor). You would think HE'D have been aware of the amount of tylenol within the narcotics that he was prescribing me on a monthly basis. I too began to do a little internet research and was horrified. That is one of the BIG reasons that ultimately led to me quitting narcotic pain meds entirely.
    I am still struggling with withdrawl 14 days after stopping CT, and ended up in the ER yesterday, feeling so bad. They ran some blood tests on my liver and miraculously there was NO damage...so, as "Feelbad" said, the liver is a remarkable organ that has amazing regenerative ability....up to a point.
    So, it is a very good decision on your part to change meds to something without tylenol.

    Your post was a bit ambiguous....are you STILL taking the darvocet now? You mention you are never going to take any more tylenol at all. I ask, because at the levels of darvocet you have been maintaining on a daily basis, it is not going to be easy to "just stop"....speaking from PERSONAL experience here....just read a few of my threads to see how miserable a detox from darvocet can be. My Pain management doctor told me I would have "no trouble at all just quitting whenever I wanted" because darvocet is such a "weak" narcotic. Well, that statement of his along with the AMOUNT of this crap he prescribed for me makes me so angry and I have a compulsion to lash out and try to do something about it. To me, it could almost be a malpractice case....especially if I HAD shown liver damage in that test yesterday.

    One final question for you 72575, and you certainly don't have to answer. You mention in your post about having a Pain Management doctor. Did one physician prescribe the amount of darvocets that you say you were taking? I ask because I possibly see a sad trend here on this board that so many of us "addicts" became the way we are due to what I perceive as the MISMANAGEMENT of prescriptions by Pain Management doctors. It should NOT be up to the patient to know what the limits are. That is the doctor's job.

    I wish you the best in whatever decisions you ultimately make and look forward to hearing back from you.

    Lou

    Last edited by coder; 06-01-2007 at 07:44 AM.

     
    Old 06-01-2007, 01:06 PM   #4
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    Re: How much acetaminophen?

    Due to the Terms of Service here at this particular site, I can't get into where I may or may not get the Darvocet, as it would be a breach of the forum rules. Hope that clears that up without actually going into specifics.

    When my Percocet runs out I turn to the Darvocet in large quantities. Yes, on average 20 a day. 5 at a time, 4 times a day. Sometimes for up to an entire week in a row. I've heard of people dyig or needing a liver transplant after just one dose that high, and thinking back on how often I have done it I'm just worried that it may be too late for me now. I thought if anything bad was going to happen, I'd know right away and could quit taking so much, but the more I read, the more I understand that is not so, that it can take some time for the effects to show up.

     
    Old 06-01-2007, 05:51 PM   #5
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    Re: How much acetaminophen?

    chances are if your able to type this, your gona be fine, i would cut the dose to 4g or none at all, and get some tests done, let your doctor know,and baby your liver for a bit, maybe look into taking milk thistle

     
    Old 06-01-2007, 07:47 PM   #6
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    Re: How much acetaminophen?

    Hey 72575,

    Yes acetemenophen is extremely hard on the renal system (primarily kidney, liver). I have been known to take 20 thousand mgs of acetemenophen in a day for several days in a row. And 14 thousand on a regular basis. "Feelbad" is very accurate of her facts in her post.

    I have found, unfortunately from experience, that the kidneys are really hit the hardest from acetmphn overdose. The liver soon follows because it is trying to do the job of the kidneys as well as it's own job at once. I quit taking Lortab c/t a few months ago and went into horrindous w/d's. So I decided (foolishly) to take extra generic Tylenol to make up for what I was missing from my daily intake. I had been told part of the w/d's are the tylenol and I was hurting really bad so thought more was better. So I took about 2000mgs about every 3hrs for four days. I got to where I couldn't eat, was drinking everything in sight because I was dehydrated and could barely urinate. I finally got so bad off and felt so horrible (I was dizzy and could barely keep balance to walk) that I went to the ER.

    Well I had kidney failure. I ended up spending 9 days in the hospital before my kidneys began to work again. The docs actually thought I would end up on dialysis for sure. My liver was also on overload which in turn sent my blood pressure sky high. I ended up spending a total of 16 days in the hosp. They had to give me some kind of anti toxin drug i.v. for days. Not to mention four or five other iv drugs to rehydrate me. After my kidneys got better the lead doc told me I was within 24 hours of death. And honestly that's exactly how I felt. I knew, I mean KNEW I was dying or would soon if I didn't get to the hosp. They knew immediately that I had had an overdose of acetmnphn from the blood work they did. (I had not told them what was really going on when I got there-just that I felt really bad) They also asked (before I had told them anything) if I was taking generic. They said that generic is especially really bad on the system because they put so much crap in for mix. Either way, alot of actmnphn is horrible on the system in large doses especially for long periods of time. As you see, it only took 4 days for my whole system to shut down.

    And like Coder and feelbad both said, there are alot of other options out there without having to take acetmnphn....Ibuprophen is also not good in high doses. It is better than acet., but it's still not okay to take in the doses you are taking. There's plenty of things without either of them in it if you absolutely have to take something since you do have chronic pain.

    And if you drink at all, of course it's making things even worse. I also believe the max dosage of acet. per day is 4000mg. When I was released from the hosp, they alotted me no more than 6 Lorcet of 10mg hydro/650mg acetm....because I also have injuries which I must take pain meds for daily.

    I do take more than I am supposed to but am trying now to keep it to the prescribed dose. I was however taking between 6500mg and 15000mg a day for the last year. I am convinced if it was not pharmaceutical, I would be dead. That is not to say in the least that it's okay....it is not, it is very hard on the renal system. Also, propoxyphene (Darvocet) is extremely hard on the lining of the stomach. It is actually way more dangerous to "over do" on it than hydrocodone......Of course, too much of ANYTHING is bad when it comes to drugs of any kind. Once the kidneys fail, the liver, heart, and virtually all organs follow.

    It's good that you decided to research this before it is too late. I would definately "look" for something else. Darvocet is a fairly mild narcotic, perhaps if you were taking a stonger narcotic, you wouldn't need to take so much, if it did have acet., therefore you wouldn't be taking so much of the acet.

    Sounds like you definately need to give you poor system a break!
    Shay

     
    Old 06-02-2007, 03:14 AM   #7
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    Re: How much acetaminophen?

    I've taken large doses of acetaminophen in the past over extended periods of time. First it was the hydrocodone, 7.5/750. I started out taking 2 at a time every 4 hours or so and then as my tolerance increased I found myself taking 4-5 at a time every 6-8 hours, sometimes more than 20 a day.
    Of all the people I have read about in similar forums, that seems to be the maximum that is taken. You probably don't hear about anything more than that because they're dead.
    The problem is that recently, as I have become aware of the potential damage, I have been feeling sick. Perhaps it is more mental, in fact I'm sure it is to some degree. But, for the last year or so I have also had urination problems, needing to go up to 8 times a day and feeling an urgency to go even when there wasn't much to go. It is difficult to urinate, and now it's impossible for me to urinate in a public restroom. I used to have a mental block about that, but with the increased difficulty of even urinating anymore, added to the mental block, well... it just doesn't happen.
    I often stand in front of the toilet for a few minutes trying to go, a little at a time, off and on, very weak stream. Aside from urniation, "other" things have decreased in volume and strength/flow in the same area. This could be from my kidneys being damaged or an enlarged prostate, but the blood tests I had run last year didn't show any signs of prostate problems, and my doctor didn't seem to be too worried about the urination problem for whatever reason. I think he should have been, now that I've read up on it. He knew how much acetaminophen I had taken in the past, when I had a bout of addiction with the hydrocodone for a year or so before that and he weined me off of it thankfully. My liver tests come back regularly with high ATS and LFT's, if I'm getting the abreviations correct, probably not. I'm thinking the numbers were in the elevated levels of 200-400, if I'm not mistaken. He was concerned about it, but has never taken any measures to correct it. Perhaps there are none, or perhaps he is incompetant, I don't know for sure.

    But, from what I have read in many other forums, my acetaminophen intake is extrememly high and among the worst of them. Many people seem to have survived it, though, so that is somewhat comforting to me. Still, I can't help but feel that there is some serious damage from my most recent abuse of the darvocet, having taken 20 a day for a week at a time. I did that last week, and I did that 2 weeks before that. I've taken like 200 of them over 3 weeks time, with 75 percocet 7.5/325 inbetween there. I'm just really worried and hope everything is alright and it isn't too late.

     
    Old 06-02-2007, 04:03 AM   #8
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    Re: How much acetaminophen?

    Opiates cause water retention. If you come off of them, you will pee like a horse.

    Do a search on opiates AND water retention for more info.

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    Old 06-02-2007, 07:32 AM   #9
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    Re: How much acetaminophen?

    I found this while researching further. It leads me to believe that while your tolerance to acetaminophen won't go up, exposure to it, on a regular basis, will mean that is becomes less harmful due to your liver protecting itself.

    I'm not a doctor, that's just my take on the study below:

    Autoprotection by acetaminophen, i.e. increased resistance to toxic effects caused by pretreatment, is a well-known phenomenon. The purpose of the present work was to identify mechanisms for increased acetaminophen tolerance induced by pretreatment of rats. One group of female Wistar rats (pretreated rats) received acetaminophen orally in increasing doses (1 to 4.3 g/kg) twice a week for 3 weeks, one group (na´ve rats) received the vehicle. At time zero pretreated rats received a toxic dose of 7.5 g/kg (100% lethal in na´ve rats), and na´ve rats received a toxic dose of 4.3 g/kg. Blood and liver tissue were collected before and 12, 24, 36, and 48 hr after the toxic dose and were analysed for hepatic glutathione and cysteine contents, hepatic glutathione-S-transferase and blood alanine aminotransferase activity, as well as acetaminophen concentration in plasma. Steady-state mRNA levels of proteins involved in acetaminophen detoxification, cell division and acute phase response were measured, liver tissue was examined for proliferating cell nuclear antigen and degree of hepatocyte necrosis. Six na´ve rats not receiving acetaminophen served as controls. The mortality was the same in pre-treated and na´ve rats (33 percent). Thus, pretreatment increased the tolerance twice. Before the toxic dose pretreated rats compared to control rats had higher activity of glutathione-S-transferase (liver) and alanine aminotransferase (serum), higher hepatic mRNA level of glutathione-S-transferase and γ-glutamylcysteine synthetase heavy and light chain subunits, and lower hepatic concentration of glutathione, cysteine and mRNA of CYP1A2 than control rats. After the toxic dose, the mRNA levels of glutathione-S-transferase, γ-glutamylcysteine synthetase heavy and light chain subunits, and CYP1A2 in na´ve rats rose, approaching those of pretreated rats. Proliferating cell nuclear antigen labelling was high in pretreated rats, while only slightly increased in a few of the na´ve rats. Necrotic hepatocytes were found at all time intervals in pretreated rats, and in na´ve rats they appeared after 12 hr, peaking after 36 hr. Pretreatment increased the tolerance to acetaminophen toxicity twice, as estimated by mortality. The data indicate that pretreatment may reduce the relative production of toxic metabolites, but it primarily enhances the protection against these metabolites by regenerating hepatocytes.

     
    Old 06-02-2007, 11:36 AM   #10
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    Re: How much acetaminophen?

    Let me ask you a serious question here....why did you just post this long involved scientific explanation about acetaminophin tolerance?
    To me, it almost seems like you are trying to justify in some way continuing your usage because now we don't need to woory about tylenol toxicity.

    Just my observation....not meant as a personal attack.

    Lou

     
    Old 06-02-2007, 12:24 PM   #11
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    Re: How much acetaminophen?

    Well, perhaps just to give someone hope that is as scared as I am and going through the same thing. Maybe just to make myself feel better. I don't know.

    The study didn't suggest that continued acetaminophen intake gets any healthier for you, or that it was healthy in the first place, but to me it suggested that your body can indeed build a form of resistance to it over time and exposure. This would explain how people like me who have abused medicine with acetaminophen over a long period of time can live through a 10-20g a day habit, while someone who does it for the first time would likely die if they took 20g, or at least wind up hospitalized.

    I'll admit that the article did give me a moment of hope and relief. I'm in no way under the impression that that much acetaminophen intake is acceptable or any less dangerous, though.

     
    Old 06-02-2007, 12:32 PM   #12
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    Re: How much acetaminophen?

    72575,

    Reach is very right, hydro and darvocet both cause water retention and dehydration.....do you notice yourself really thirsty and drinking alot?

    I am confused about what you are asking....There's no two ways about it....the amount of acet. you are ingesting is highly toxic and will catch up to you one day......are you wanting to know if it's okay, wanting to stop, wanting alternatives.......?

    Like Coder said, there's no way of justifying this....

    And I have known many people who have taken in excess of 20 pills a day (much more) and survived.....survived a pretty lousey life, but survived none the less. You can read all the scientific reports you want to and you will find no better experts than the ones who come to this board (the addicts). Nothing personal...don't take me wrong....but you will get blunt answers here. No need to sugar coat a serious matter, that isn't gonna help you at all....right?

    Most likely your kidneys will go before your liver...and having problems peeing is one of the signs of kidney problems...and peeing little amounts...extreme thirst...dizziness...and slight haluciations or seeing little flashes of light....
    Your kidneys show up as krentitine (sp?) on bloodwork and should be in the range of (-1) to (+1)....(if I remember correctly)...

    The only way you are going to know if you have any physical damage is to see a doctor.....You can't really self diagnose something like this, and if you do have a problem, you are going to need medical attention.....once your kidneys are failing, there is nothing you can do from home to correct the problem.....and if you keep up on the pace you're on, you could very easily end up on dialysis.....which is quite miserable!

    I say you take the advice of the people here and either change your choice of meds, see a doctor, or quit altogether....

    Whatever you decide, we are all here for you and hope the best in your endeavors!
    Shay

     
    Old 06-02-2007, 01:22 PM   #13
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    Re: How much acetaminophen?

    72575,

    I think what the report is saying is that if the average joe blow took the amount of acet. that you take, they would o/d right away....

    ...or if you had taken the amount you do now 5 years ago, you too would have o/d'd also.....

    I'm not sure that it means we build a "resistance" but rather, a tolerance level....which also means it takes more to be effective on pain, which means you take more for the pain, which means you exceed your threshold for tolerance trying to kill the pain.....does that make sense? So you still can o/d, it takes a lot more.

    I don't really see why you feel hope and relief from that report....it's like the person who works in the sun and can take staying in the sun all day without getting burned, and the person who rarely gets out will burn and blister.....either one can still get cancer.

    It may take longer for you to show any damage from all the acet., but the damage you will have will be much worse, and you will have much more of it.
    The organs in your body are taking some very long, slow abuse resulting in some pretty brutal damage.

    But on a better note, if you can actually sit up and talk then you may not have much damage so far, because believe me, if you did have substantial kidney or liver damage, you could not do much of anything and you would be insisting on going to the ER! So, it's not too late to change your intake and prevent further problems!

    Again, Darvocet is one of the worst things you can abuse! Pharmacuetical wise anyway...

    Shay

     
    Old 06-02-2007, 02:10 PM   #14
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    Re: How much acetaminophen?

    Hello 72775

    I thank Shay very much for asking the questions asked. I couldn't figure out either exactly what the goal is for you. If you want to continue to take an opiate for whatever reason, that is certainly your choice. But unless you are concerned with all the ingredients in any particular med you are taking, then the research you are doing is kinda lopsided. It seems to me that you are trying to prove that you aren't gonna drop dead from acetaminophen... or it, in all honesty, actually seems that your research is an effort to justify why you want to change over to a straigght opiate (ie. oxycodene). Well, as you are still alive and kicking, too much Tylenol has not ben ingested yet. I don't meab to sound crude, but is that what you are wondering? if youe only concern is the Tylenol, then just don't take a med with Tylenol in it.

    Good wishes
    reach

     
    Old 06-02-2007, 04:12 PM   #15
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    Re: How much acetaminophen?

    Thanks for the replies, first of all. Most appreciated.

    Yes, I'm wanting to confirm that I haven't already killed myself, more or less. I'm very worried about the amounts of acetaminophen that I have already taken over time, and more so this past month with the darvocet. I've been taking 20 of the 100/625 a day, so that's 12.5g a day of acetaminophen, and that's not good at all, I've learned. I'm hoping that I haven't already done serious damage to myself. I am done with the opiates containing acetaminophen, though, and plan to switch over to ibuprophen and cut down my use to one or two doses a day at the most.

    Although, another problem presents itself, as my pain managment doctor did a 180 on me last time I was there and went from wanting to put me on multiple pain killers like Oxycontin and others combined, to telling me that I am too young for this (32) and she wants to take me off of everything within a month. The pain is too much for me to do that, which is why I went there in the first place. She doesn't know that I'm an addict or that I abuse the meds, so I don't know why she changed her tune so suddenly now. I know full well I have a problem with the medication and propenisty to abuse it, but ti is very problematic in that I actually truly need it and can't live comfortably without it for more than a day or so.

     
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