Posted on 03/01/2007 10:27:31 PM PST by neverdem
Vital Signs
People who take Tylenol and other medicines that contain acetaminophen are largely ignorant of the safe dosages, a new study has found, and unaware that an overdose can cause severe liver damage.
Of 104 consecutive patients at a Michigan clinic, almost 80 percent reported using acetaminophen in the previous six months, but about 63 percent were unsure whether they had been told about the dangers of high doses, and only 43 percent knew that the medicine could affect liver function. The survey results appear in the January/February issue of The Journal of the American Pharmacists Association.
The maximum daily dose of acetaminophen is four grams a day — 12 regular 325-milligram Tylenol tablets or 8 500-milligram extra-strength tablets. Recommended doses are lower for people with known risk factors, like heavy drinking or liver disease. Studies cited in the article report that overdoses of acetaminophen are the most common cause of acute liver failure in the United States. Although reactions vary widely, large overdoses can be fatal.
“Medical professionals have this information, but we’re not imparting it well,” said Janice L. Stumpf, the study’s lead author and an associate professor of pharmacy at the University of Michigan. “Be very careful about what you’re taking,” she added, “and be sure that you’re not taking more than one thing with acetaminophen in it. It’s very easy to do.”...
(Excerpt) Read more at nytimes.com ...
No sh*ttsky. I was taking handfulls of extra strenth Exederin for my chronic back and neck pain. I was also going through at least one 2 liter bottle of Diet Coke everyday. Guess what?......
You know..., you can take handfuls of Hydrocodone every day and what the doctor warns you about is not the opiate ingredient -- but rather -- the acetaminophen and not overdosing on that (max is supposed to be 4,000 mg per day). That seems kind of weird..., but I guess that's the case.
Regards,
Star Traveler
You said -- "No sh*ttsky. I was taking handfulls of extra strenth Exederin for my chronic back and neck pain."
A few Hydrocodone would have done you much better for that pain...
Regards,
Star Traveler
As an nurse, I never gave my babies Tylenol. My doctor showed me the medical journal article about it while I was waiting for my newborn son's circumcision in 1975. My kids were raised on Aspirin for the few times they needed anything like that. I am angry that doctors tell pregnant mothers and mothers with newborns that Tylenol is safe for their infants. Some give a lot, too! They think that because the doc said it is okay that it cannot do any harm!
Besides, there are other ways to reduce a fever than loading them up with drugs, and if done right away, the fever will drop to a safe level on its own. There are a few exceptions, of course, but fevers ranging from 101-103 can safely be reduced by giving a tepid water bath, dressing in light-weight clothing, and drinking liquids...hot or cold.
The acetaminophen is more likely to land you in the hospital than the Vicodan if you take two Vicodans and a couple of extra strength tylenols.
There's some evidence of liver toxicity of acetaminophen even at normal doses.
There's an amino acid called N-Acetyl-L-Cysteine (NAC), widely availble. It's what they give you in the hospital for tylenol overdose (name different, same chemical). It's also a great daily supplement to take as it's a powerful liver antioxidant. I just take some NAC with all Tylenol doses.
You said -- "There's some evidence of liver toxicity of acetaminophen even at normal doses."
I keep warning this relative of mine about damage to her liver. She says, "I know..." but keeps exceeding those max amounts. The hydrocodone is necessary for the back condition that she has, and being able to get around and function at all, so that part is not very much of a problem. It's going past a certain amount of acetaminophen that's the problem. If people really knew (in the general public) about the dangers of Tylenol (acetaminophen), the sales might drop in half.
And you said -- "There's an amino acid called N-Acetyl-L-Cysteine (NAC), widely availble. It's what they give you in the hospital for tylenol overdose (name different, same chemical). It's also a great daily supplement to take as it's a powerful liver antioxidant. I just take some NAC with all Tylenol doses."
I'll look that up and see about getting some. I never get near even a quarter of that amount, in Tylenol and really rarely take it. But, that relative of mine sure does, and that's not good. So, this might be something to help.
I just did look this up while typing this. I found "N-Acetyl Cysteine" is this the same as you're talking about? Just wondering. It was in many places on the net, talking about this supplement.
Thanks for your help...
Regards,
Star Traveler
It's the same stuff. Good prices from lef.org or beyond-a-century.com. Also, you actually get what you order from them--not some watered down c$$p. I have no relation with either except as a customer.
I am not a pill-popper by any stretch of the imagination, but did manage to develop some sort of allergy to acetaminophen. Every few months I would break out in very painfull burns all over my body, which would take weeks to heal. I couldn't figure out what was causing it, but finally decided to never take Tylenol again. That was five years ago and it hasn't happened to me since.
Never take Tylenol when you are or have been drinking alcohol. Very Bad.
Hydrocodone is hard to get hold of, and the drug dealers want a fortune for the stuff. When we were moving my folks stuff out of their home(after mom passed away) the baby grand piano landed on my knee. I made those Vicodin last and last. I cut them in half....
Well the general opinion is that my liver is damaged. No pain meds for me. I just went through a SSDI hearing, earlier this week. Not just because of the pain, but I went through a vicious custody battle in 05, and had a mild stroke, as a result.
You said -- "Hydrocodone is hard to get hold of, and the drug dealers want a fortune for the stuff. When we were moving my folks stuff out of their home(after mom passed away) the baby grand piano landed on my knee. I made those Vicodin last and last. I cut them in half...."
It is, that's for sure. My dad, when he broke his hip, he needed quite a few. He had a prescription for about 180 a month (the 7.5 mg one). That was quite a bit. That continued on for a while for him, but the doctor said that he had to be careful because of the DEA. They look over this stuff closely with the doctors, even if you have legitimate reasons.
And, for my other relative that I was talking about, I've helped her find sources online that have worked out well. Of course the DEA is shutting various ones down, "left and right" -- and you have some outifts which are crooked. So, it's not like going to a doctor's office. But, it works.
It is difficult to get doctors to continue to prescribe for an on-going condition. Usually they will do okay for one or two times, but that's about it. It's the on-going conditions which cause people to hunt around for some other way.
Regards,
Star Traveler
You said -- "Well the general opinion is that my liver is damaged. No pain meds for me. I just went through a SSDI hearing, earlier this week. Not just because of the pain, but I went through a vicious custody battle in 05, and had a mild stroke, as a result."
I'm not sure how one tells about the condition of your liver. Is there some kind of test that the doctor does?
That's too bad about the stroke. I hope things are going bette now and that you've recovered well.
If you need any more of that medication (I presume you can take a couple or so, if needed), I can give you an online reference and a phone number from a reliable source -- and that *would* definitely require medical records backing up the condition requiring the medication. And you will talk to a doctor on the phone about it. They will examine the records that you send. And it will require that the records be up-to-date, at least within the last 12 months (actually less than 12 months). Once you get through all that, you'll receive them in the mail on a regular basis, and continually.
Regards,
Star Traveler
First of all, I have to say that I am angry that as a nurse you’ve proposed that Aspirin is a safer alternative to Tylenol for children...and that you used it for your own children. ASPIRIN is NOT SAFE to give to children!! Have you heard of Reye’s Syndrome? If not, I feel that as a nurse you should be more informed. Look it up.
Epidemiologic research has shown an association between the development of Reye’s Syndrome and the use of aspirin-type products for treating the symptoms of influenza-like illnesses and chicken pox.
The U.S. Surgeon General, the Food and Drug Administration, the Centers for Disease Control and Prevention, and the American Academy of Pediatrics recommend that aspirin and combination products containing aspirin NOT be given to children under 19 years of age during episodes of fever-causing illnesses.
Tylenol, when used in appropriate doses, is a safe medication (although there are always risks associated with ANY medication, no matter how benign it may seem).
As a Pediatrician, I always inform parents of the dangers associated with giving too much Tylenol. You’ve inferred that doctors are wrong by telling pregnant mothers and mothers with newborns that Tylenol is safe for their infants. That is not the case. Tylenol has been proven to be a safe medication when used appropriately. I do my best, as do most other physicians, to assure that my patient’s are given the appropriate doses of medications and that ANY medication is not over used.
Perhaps instead of giving advice that has absolutely no scientific basis of fact, you should instead educate yourself. The information regarding Reye’s Syndrome and Aspirin has been very well known since the 1970’s!
Fast forward two years and the FDA is back on the same issue, but this time they are issuing the strongest recomendations to date. They also happen to be the most Draconian to all who are pain management regimens that include the popular synthetic opiates like Vicodin (hydrocodone) and Percocet (oxycodone).
Because each pill of these narcotics is paired with 500mg of acetaminophen, and many of the acetaminophen overdoses occur in populations who overuse these medicines, the FDA came up with a brilliant solution: take the drugs off the market.
Yep, that's right. Rather than require drug companies to reformulate their compounds with half the acetaminophen they use, the FDA wants to toss the baby out with the bath water by pulling these helpful drugs off the market.
Just exactly are the tens of millions of chronic pain sufferers going to take now? They offer no recommendation.
A Food and Drug Administration panel on Tuesday voted 20-17 that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.
The FDA has assembled a group of experts to vote on ways to reduce liver damage associated with acetaminophen, one of the most widely used drugs in the U.S.
Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., according to the FDA.
Panelists cited FDA data indicating 60% of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.
"We're here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact," said Dr. Judith Kramer of Duke University Medical Center.
But many panelists opposed a sweeping withdraw of products that are so widely used to control severe, chronic pain.
"To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake," said Dr. Robert Kerns of Yale University.
In a separate vote, the panel voted overwhelmingly, 36-1, that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.
So, they are telling us that we my have to carry around our Schedule II drugs in "black boxes" that will be make them readily spotted by every junkie and crack whore in the store with you. Good luck jetting them home in one piece
Fast forward two years and the FDA is back on the same issue, but this time they are issuing the strongest recommendations to date. They also happen to be the most Draconian to all who are pain management regimens that include the popular synthetic opiates like Vicodin (hydrocodone) and Percocet (oxycodone).
Because each pill of these narcotics is paired with 500mg of acetaminophen, and many of the acetaminophen overdoses occur in populations who overuse these medicines, the FDA came up with a brilliant solution: take the drugs off the market.
Yep, that's right. Rather than require drug companies to reformulate their compounds with half the acetaminophen they use, the FDA wants to toss the baby out with the bath water by pulling these helpful drugs off the market.
Just exactly are the tens of millions of chronic pain sufferers going to take now? They offer no recommendation.
A Food and Drug Administration panel on Tuesday voted 20-17 that prescription drugs that combine acetaminophen with other painkilling ingredients should be pulled off the market.
The FDA has assembled a group of experts to vote on ways to reduce liver damage associated with acetaminophen, one of the most widely used drugs in the U.S.
Despite years of educational campaigns and other federal actions, acetaminophen remains the leading cause of liver failure in the U.S., according to the FDA.
Panelists cited FDA data indicating 60% of acetaminophen-related deaths are related to prescription products. Acetaminophen is also found in popular over-the-counter medications like Tylenol and Excedrin.
"We're here because there are inadvertent overdoses with this drug that are fatal and this is the one opportunity we have to do something that will have a big impact," said Dr. Judith Kramer of Duke University Medical Center.
But many panelists opposed a sweeping withdraw of products that are so widely used to control severe, chronic pain.
"To make this shift without very clear understanding of the implications on the management of pain would be a huge mistake," said Dr. Robert Kerns of Yale University.
Kerns got it right. Glad to see that not all of them have their butts up their tailpipes.
In a separate vote, the panel voted overwhelmingly, 36-1, that if the drugs stay on the market they should carry a black box warning, the most serious safety label available.
Many of you still remember the Great Nationwide Oxycodone shortage of 2009? For the first time and over a period of four months, America had a very "painful" Oxycodone shortage that ended last month.
Millions of people paniced as they scramled for other products that were sitable substitutes for oxycodone, such as hydromorphone, Dilaudid, and Vicodin and Percocet.
The obly reason why drug companies like to combine Tylenol/acetomoniphen to an opiate like Vicodin (hydrocodone) and Percocet (oxycodone) There is only one reason why drug companies combine acetomoniphen: LESS OPIATE + MORE ACETOMINOPHEN = BIGGER PROFITS. From a Cost-Buying perspective, drug companies should be making oxycodone and Hydrocodone available by itself. If people who are being prescribed Pre So, they are telling us that we my have to carry around our Schedule II drugs in "black boxes" that will be make them readily spotted by every junkie and crack whore in the store with you. Good luck getting them and yourself home in one piece
I have a family member with severe chronic pain and three terminal diagnoses. Nothing touched his pain, Oxycodone, + Fentanyl patches- nothing. He was finally prescribed something that completely took away his pain and did not make him loopy or sedated. Methadone. I don't know how safe it is compared to other drugs, but it works for my relative like nothing else did and he no longer acts "all doped up".
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