should I be worried about acetaminophen?

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New Member

Date Joined Nov 2007
Total Posts : 10
   Posted 11/17/2007 6:35 PM (GMT -6)   
Hello all!
I am new here, am 32 years old, and have chronic low back pain.  I have also been on Vicodin for 4 years and wonder what the effects on my liver are.  Does anyone think that I should be worried about this?  My doctor has never brought this up.  I currently take 6 tabs a day of the 5/500mg strength.
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Regular Member

Date Joined Jul 2006
Total Posts : 495
   Posted 11/17/2007 10:15 PM (GMT -6)   
I would definitely talk to your doctor about your concerns... I figured you were close to the top end of the suggested amount so I looked it up... here is what I found...

"For the average healthy adult, the recommended maximum dose of acetaminophen over a 24 hour period is four grams (4000 mg) or eight extra–strength pills. (Each extra–strength pill contains 500 mg and each regular strength pill contains 325 mg.) A person who drinks more than two alcoholic beverages per day, however, should not take more than two grams of acetaminophen over 24 hours, as discussed below. For children, the dose is based on their weight and age, and explicit instructions are given in the package insert. If these guidelines for adults and children are followed, acetaminophen is safe and carries essentially no risk of liver injury.

On the other hand, a single dose of 7 to 10 grams of acetaminophen (14 to 20 extra–strength tablets) can cause liver injury in the average healthy adult. Note that this amount is about twice the recommended maximum dose for a 24 hour period. In children, a single dose of 140 mg/kg (body weight) of acetaminophen can result in liver injury. Amounts of acetaminophen, however, as low as 3 to 4 grams in a single dose or 4 to 6 grams over 24 hours have been reported to cause severe liver injury in some people, sometimes even resulting in death. It seems that certain individuals, for example, those who regularly drink alcohol, are more prone than others to developing acetaminophen–induced liver damage. To understand this increased susceptibility in some people, it is useful to know how acetaminophen is processed (metabolized) in the liver and how the drug causes liver injury."

I got that by simply looking up acetaminophen and your liver on google.

there are medications out there where you can get the opiate part without the acetaminophen... and just a question... seeing as how you've been on it for so long has your doctor discussed a long acting pain medication rather than the vicodin which is a short acting? Most of those contain (I believe) little to no tylenol, and seem to lessen the amount of short acting meds that you would take. :)

good luck... :)
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New Member

Date Joined Nov 2007
Total Posts : 10
   Posted 11/17/2007 11:50 PM (GMT -6)   

Thanks for the info TD

My PCP has been hesitant to give me any other pain meds.  I think he would rather send me to a pain doctor, which he said he was going to do, but then he referred me to this neurologist who is against giving narcotic pain relievers as they would turn me into Rush Limbaugh.  She says that I need to be patient and it will take 4-6 weeks for me to find relief.  I felt like saying, "I wonder what you would say if you could feel the pain I am feeling!"  I am finally determined to take a more active role in my pain management and plan on asking my PCP to give me that pain doctor referall because I simply can't go on like this anymore.  I am experiencing pain every day at a level between 7-9 (on the famous scale of 0 to 10) which goes down to maybe 6-7 on Vicodin.  I need help and I finally am going to do something about it.

Veteran Member

Date Joined Jan 2005
Total Posts : 763
   Posted 11/18/2007 6:12 AM (GMT -6)   
My dr. draws blood every 3 months to check all my levels . wouldnt be a bad idea.

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Veteran Member

Date Joined Sep 2005
Total Posts : 535
   Posted 11/18/2007 10:17 AM (GMT -6)   
If you are going to be taking the acetaminophen long term then it might not be a bad idea to look into an amino acid called NAC or otherwise known as N-Acetyl-L-Cysteine.

NAC helps to boost production of Glutathione which helps to protect the liver from toxins.

NAC is also used as an antidote for acetaminophen overdose.

You can purchase it at any drug or health food store

New Member

Date Joined Nov 2007
Total Posts : 10
   Posted 11/18/2007 4:40 PM (GMT -6)   

Thanks for the info quahog.  I have never heard of that and will definitely look into it.

My PCP has put me on Neurontin and I am hoping this will help with the burning and shooting pains in my back, groin, and legs.  He also refilled my Vicodin, while letting me know that I won't ever be completely pain free and should not try.  I told him I am well aware that I won't be pain free, but since the medication does not work like it used to I needed to take more to find some relief.  I am hoping to get that pain doc referral because I know my PCP isn't comfortable giving me anything besides the old standby.  I do love the guy though because he is a good listener and was sympathetic when I told him about the neurologist I saw last week.  My MRI is tomorrow.  I want so badly for it to show me why I'm in pain.

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