More on Tylenol

[happyhbmom]

Tuckamore said in a post that 1000 mg tylenol (the dose in "extra strength" tylenol) is "usually not fatal" but is never a good idea.

I would love to see references for this.  I do know about the FDA's efforts to reduce the maximum dose, but my family members take extra strength tylenol and I would like to understand more about how dangerous that might be.  I was under the impression that 1000 mg is safe for use as directed for healthy people.  I personally have had more than my share of 1000 mg doses and my liver is still (amazingly considering how much other garbage I've put through it) working well (but an anecdote is not data- my own experience shouldn't color what others do).

Just thought a discussion might be useful, since it appears people are now very frightened by the information, and we all should be aware of how severe the danger is.  It does seem like the FDA is poised to lower the max dose, so I thought a discussion of the dangers of the currently available max dose would be useful to all.

[Ashelen]

Yeah my doctor allows me to take up to 1000 in a single dose...just not to exceed 4000mg in a single 24-hour period...for my lortabs I take 2 5/500's 3x a day to keep the limit well under "unsafe". Even when I hurt I try not to take more than 3x a day just to be safe...I've abused my liver over the years so I don't want to take a chance :).

If you're someone who needs to take any of the combined narcotic painkillers, look into the lower-APAP alternatives; for lortab/vicodin there is Norco...it's the same dosage of hydrocodone (5, 7.5, 10) but only 325 APAP...and they have similar replacements for oxycodone (Endocet, for instance, is 10oxy/325APAP).

advocate for your liver! :)

[happyhbmom]

I'll add the first reference- this is medline, which requires free registration, but is a GREAT resource for medical info.

http://emedicine.medscape.com/article/820200-overview

lists general toxicity (overdose) amounts in healthy humans in the 7-10 gram range, and states that if you are healthy (not malnourished, have a healthy liver, etc), not consuming alcohol,  and follow daily dosing limits of 4 grams per day, risks of liver damage are very small.

This is the reference I read when the FDA notice first came out, so I did not worry about my current practice of giving my (teenaged) kids or husband extra strength tylenol.

The FDA is actually more concerned with reducing the daily limit to 3,000 mg/day than reducing the individual dose, I believe.  They also want to remove tylenol from many combination drugs, because a lot of people go over the limit without being aware, because tylenol is in several different medications they are taking.

[peekawho]

I'd like to see that, too.  We routinely use acetaminophen in the hospital setting, and very routinely give 1000mg doses, up to a max of 4000mg a day, unless the patient has a liver impairment.  In that case, up to 2000mg a day may be given.

Of course, the idea of any medication is to use the least amount that is effective for treating pain, and to discontinue use as soon as is reasonably possible.  Most people *should* try to use regular strenght Tylenol first, and increase the dose according to effectiveness if needed.