I appreciate all the information you gave me. Thank you!! I have been on Pain Medications for so long, that I did know that the Vicodin, Percocet, Etc does have acetaminophen and can kill you. I know you have to take no more then 8-10 a day. Thanks Again!!!
I am strongly against the use of acetaminophen (aka Tylenol) as part of the treatment of long term chronic pain. Vicodin, Percocet, Tylenol #3, Tylenol #4 are OK for short term acute pain from surgeries etc. but using them long term everyday as a regimen for treatment of chronic pain is very damaging to the liver.
Opioids alone DO NOT damage internal organs. They are one of the safest medicines out there for pain. However, there are a few that have addictive personalities and become addicted and begin taking way too much recreationally for a high...this IS dangerous. However, the latest research shows that between 1-5% of chronic pain patients become addicted to their pain medications.
Percocet has a maximum pharmaceutical dosing of 12 tablets per day as each pill contains 325 mg of tylenol. The maximum dose of tylenol that can be consumed safely over a 24 hour period is 4,000 mg. However, newer lower limits are coming out that states only 2,000-2,600 mg of tylenol should be ingested when taken daily over the long term. Additionally, one should not take more than 1,000 mg of tylenol per dose within a 4 hour period. The new limits state that a person should instead wait 6 hours before the next dose.
Vicodin contains 500 mg of tylenol per tablet, and hence, only 8 tablets of Vicodin can be consumed daily.
The important take away is that everyone that is on a tylenol-opioid combo product needs to calculate how much they are ingesting and watch the clock to make sure they are not ingesting too much. Originally, opioid-tylenol combo products came out as a cruel product from pharmaceutical companies in a effort to curb drug addiction as getting high on these pills will cause an overdose on tylenol so the tylenol synthetically CAPS the amount that can be consumed safely. Most opioids don't have a ceiling meaning that one can be prescribed large amounts if needed to control their pain without adverse effects. The addition of tylenol in opioid containing products, puts an artificial ceiling on the max amount that can be consumed safely. This is a way for doctors, etc. to control the dose without having to instill trust that the patient is not taking more than prescribed.
If you are taking a tylenol opioid combo product, I recommend talking with your doctor about switching to a different medication that doesn't contain tylenol such as Oxycodone IR or another tylenol free opioid Immediate Release (IR) med. I was prescribed Vicodin for a little over a year and then Percocet for about 2 years. During those time periods, I had elevated liver enzymes and periodic liver pain, all of which dissapated after stopping the tylenol. And yes, I was taking them as prescribed and my total daily amount was around 2,600 mg...no where near the 4,000 mg limit. I have finally been switched to Oxycodone IR, which contains only the opioid that is present in Percocet without the tylenol. I never take more than I am supposed to and many times I take less but I now have the peace of mind that I am not doing harm to my liver.
Lastly, it is important to note that those with liver impairement should NOT be taking any Tylenol combination products. Diseases such as Hepatitis C fall into this category. Additionally, some opioids put more strain on the liver in those with liver impairment such that the opioids used should be chosen with great caution.
Finally, a rule of thumb is to NEVER take OTC products that contain Tylenol while taking Vicodin or Percocet as you are ADDING in more tylenol that needs to totaled and added to the amount consumed through the Vicodin or Percocet. It is important to read the labels on OTC cold and cough medicines to understand how much Acetaminophen (or Tylenol) is in the product.
If you are prescribed a tylenol opioid combo product, I believe it is advantageous to talk with your pharmacist to understand what the maximum dosing is to be certain you are staying within the safe limits.
or can kill your liver/kidneys....