OT: Acetaminophen toxicity

Several months ago, in a thread that had wandered away
from discussing food, I mentioned that I favored banning
acetaminophen from the market due to its high toxicity and
low therapeutic index relative to other pain medicines.

It appears that, unusually in my experience, public policy in the
U.S. is actually moving in a direction that I had hoped. A US FDA
advisory panel has proposed banning or issuing warnings on some
(but confusingly, not all) acetaminophen-containing medications,
including Vicodin.

(This is all over the news so I will not post a link.)

The toxicity problems with acetaminophen have been known for 30
years, and it is the leading cause of acute liver failure in
U.S. /U.K. / Australia / New Zealand.

Anyway, I'm just posting this to reinforce the message that
the stuff is dangerous and there are (in most cases) safer
alternatives.


Steve

"Steve Pope" <spope33@speedymail.org> wrote in message
news:h2ggib$jpp$1@blue.rahul.net...
> Several months ago, in a thread that had wandered away
> from discussing food, I mentioned that I favored banning
> acetaminophen from the market due to its high toxicity and
> low therapeutic index relative to other pain medicines.
>
> It appears that, unusually in my experience, public policy in the
> U.S. is actually moving in a direction that I had hoped.

I have to say, I took acetaminophen for the first time early this month and
got instant relief from a crushing headache. It also gave me the sweats,
which I guess meant I had a fever. I read about the warnings later.

Steve Pope wrote:
> Several months ago, in a thread that had wandered away
> from discussing food, I mentioned that I favored banning
> acetaminophen from the market due to its high toxicity and
> low therapeutic index relative to other pain medicines.
>
> It appears that, unusually in my experience, public policy in the
> U.S. is actually moving in a direction that I had hoped. A US FDA
> advisory panel has proposed banning or issuing warnings on some
> (but confusingly, not all) acetaminophen-containing medications,
> including Vicodin.
>
> (This is all over the news so I will not post a link.)
>
> The toxicity problems with acetaminophen have been known for 30
> years, and it is the leading cause of acute liver failure in
> U.S. /U.K. / Australia / New Zealand.
>
> Anyway, I'm just posting this to reinforce the message that
> the stuff is dangerous and there are (in most cases) safer
> alternatives.

Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
ibuprofen for most aches. Hopefully that's kinder to livers but who knows?

>
>
> Steve

On Jul 1, 3:22*pm, spop...@speedymail.org (Steve Pope) wrote:
> Several months ago, in a thread that had wandered away
> from discussing food, I mentioned that I favored banning
> acetaminophen from the market due to its high toxicity and
> low therapeutic index relative to other pain medicines.
>
> It appears that, unusually in my experience, public policy in the
> U.S. *is actually moving in a direction that I had hoped. *A US FDA
> advisory panel has proposed banning or issuing warnings on some
> (but confusingly, not all) acetaminophen-containing medications,
> including Vicodin.
>
> (This is all over the news so I will not post a link.)
>
> The toxicity problems with acetaminophen have been known for 30
> years, and it is the leading cause of acute liver failure in
> U.S. /U.K. / Australia / New Zealand.
>
> Anyway, I'm just posting this to reinforce the message that
> the stuff is dangerous and there are (in most cases) safer
> alternatives.
>
> Steve

The therapeutic index (http://en.wikipedia.org/wiki/Therapeutic_index)
of APAP always made me nervous. And now we once again are hearing
about it. In hospitals on patient's med orders (I'm a nursing student)
they are now putting a warning not to exceed a certain amount of APAP
per day. This warning appears with the order for any drug containing
APAP.

APAP's (acetominophen's) liver toxicity is well known in medico
circles. I have a friend who's a RN in a transplant ward and she says
she sees a LOT of liver transplants that can be traced back to the
patient taking excessive amounts of APAP.

John Kuthe...

"dsi1" <dsi1@humuhumunukunukuapuapa.org> wrote
> Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
> ibuprofen for most aches. Hopefully that's kinder to livers but who knows?
>

Yeah, really. I have never taken any kind of pain relievers, otc or
otherwise, until recently. It's hard to know what to trust when drugs are
out for years and then suddenly they are not okay. Go, FDA.

On Jul 1, 3:32*pm, dsi1 <d...@humuhumunukunukuapuapa.org> wrote:
> Steve Pope wrote:
> > Several months ago, in a thread that had wandered away
> > from discussing food, I mentioned that I favored banning
> > acetaminophen from the market due to its high toxicity and
> > low therapeutic index relative to other pain medicines.
>
> > It appears that, unusually in my experience, public policy in the
> > U.S. *is actually moving in a direction that I had hoped. *A US FDA
> > advisory panel has proposed banning or issuing warnings on some
> > (but confusingly, not all) acetaminophen-containing medications,
> > including Vicodin.
>
> > (This is all over the news so I will not post a link.)
>
> > The toxicity problems with acetaminophen have been known for 30
> > years, and it is the leading cause of acute liver failure in
> > U.S. /U.K. / Australia / New Zealand.
>
> > Anyway, I'm just posting this to reinforce the message that
> > the stuff is dangerous and there are (in most cases) safer
> > alternatives.
>
> Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
> ibuprofen for most aches. Hopefully that's kinder to livers but who knows?
>
>
>
> > Steve
>
>

I call ibuprofen "Vitamin I"! APAP does not work for me appreciably.
But Vitamin I does!

Ibuprofen's easier on the liver than APAP but rough on the kidneys in
high doses.

John Kuthe...

cybercat wrote:
> "dsi1" <dsi1@humuhumunukunukuapuapa.org> wrote
>> Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
>> ibuprofen for most aches. Hopefully that's kinder to livers but who knows?
>>
>
> Yeah, really. I have never taken any kind of pain relievers, otc or
> otherwise, until recently. It's hard to know what to trust when drugs are
> out for years and then suddenly they are not okay. Go, FDA.
>
>

I never was one to take anything when I was younger too but for most
folks over 50, the future seems to be one of drugs, pills and pain. If
the FDA does find problems with OTC NSAIDs, I hope it's with naproxen -
I don't take that. My assumption is that aspirin is okey-dokey. :-)

John Kuthe wrote:

> APAP's (acetominophen's) liver toxicity is well known in medico
> circles. I have a friend who's a RN in a transplant ward and she says
> she sees a LOT of liver transplants that can be traced back to the
> patient taking excessive amounts of APAP.

You know, I heard some crazy statistic years ago citing the huge
percentage of liver failures caused by Tylenol type pain killers.
I was shocked, and it seemed to me most people had no idea.

Then they started with those commercials about we here at Tylenol
would rather you didn't take it if you weren't going to follow directions.
Not a word about This stuff can kill your liver! If I didn't know what they
were referring to, I wouldn't have known what they were getting at.

Quit beating around the bush! Tell people! Some people won't care,
but a lot will sit up and take notice. I hope this latest news will get the
word out.

nancy

dsi1 wrote:
> Steve Pope wrote:
>> Several months ago, in a thread that had wandered away
>> from discussing food, I mentioned that I favored banning
>> acetaminophen from the market due to its high toxicity and low
>> therapeutic index relative to other pain medicines.
>>
>> It appears that, unusually in my experience, public policy in the
>> U.S. is actually moving in a direction that I had hoped. A US FDA
>> advisory panel has proposed banning or issuing warnings on some (but
>> confusingly, not all) acetaminophen-containing medications, including
>> Vicodin.
>>
>> (This is all over the news so I will not post a link.)
>>
>> The toxicity problems with acetaminophen have been known for 30 years,
>> and it is the leading cause of acute liver failure in
>> U.S. /U.K. / Australia / New Zealand.
>>
>> Anyway, I'm just posting this to reinforce the message that
>> the stuff is dangerous and there are (in most cases) safer alternatives.
>
> Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
> ibuprofen for most aches. Hopefully that's kinder to livers but who knows?
>
>>
>>
>> Steve
Can't take any more aspirin as I take Plavix, ibuprofen makes me act
crazy, naproxen makes me throw up. I've been taking 500 mg acetaminophen
with good success and the odd 1000 mg when my arthritis really hurts.
Guess I will learn to live with the pain again.

dsi1 wrote:
> cybercat wrote:
>> "dsi1" <dsi1@humuhumunukunukuapuapa.org> wrote
>>> Those alternatives would be aspirin, ibuprofen and naproxen. I rely
>>> on ibuprofen for most aches. Hopefully that's kinder to livers but
>>> who knows?
>>>
>>
>> Yeah, really. I have never taken any kind of pain relievers, otc or
>> otherwise, until recently. It's hard to know what to trust when drugs
>> are out for years and then suddenly they are not okay. Go, FDA.
>>
>
> I never was one to take anything when I was younger too but for most
> folks over 50, the future seems to be one of drugs, pills and pain. If
> the FDA does find problems with OTC NSAIDs, I hope it's with naproxen -
> I don't take that. My assumption is that aspirin is okey-dokey. :-)
But don't take a bunch of aspirin in one day as it can cause stomach
bleeding. If you're on blood thinners for health reasons steer clear of
aspirin as it is a good blood thinner on its own.

Seems that all meds, OTC or script, can cause problems if misused. It's
learning the proper use that can confuse you.

John Kuthe wrote:

>
> I call ibuprofen "Vitamin I"! APAP does not work for me appreciably.
> But Vitamin I does!

It do work good, don't it? It's indispensable for the treatment of
tendinitis - in my weird body, at least.

>
> Ibuprofen's easier on the liver than APAP but rough on the kidneys in
> high doses.

I'll take at most, 400mg twice a day. What do you consider a high dose?

>
> John Kuthe...

George Shirley wrote:

> Can't take any more aspirin as I take Plavix, ibuprofen makes me act
> crazy, naproxen makes me throw up. I've been taking 500 mg acetaminophen
> with good success and the odd 1000 mg when my arthritis really hurts.
> Guess I will learn to live with the pain again.

Sorry to hear of your pain. Ibuprofen affecting your behavior, sounds
interesting. That would be a tough choice - going a little nuts or pain.
My guess is that you can still take the acetaminophen but you should
monitor your liver function carefully. Just my guess. Good luck.

Steve Pope wrote:
> Several months ago, in a thread that had wandered away
> from discussing food, I mentioned that I favored banning
> acetaminophen from the market due to its high toxicity and
> low therapeutic index relative to other pain medicines.
>
> It appears that, unusually in my experience, public policy in the
> U.S. is actually moving in a direction that I had hoped. A US FDA
> advisory panel has proposed banning or issuing warnings on some
> (but confusingly, not all) acetaminophen-containing medications,
> including Vicodin.
>
> (This is all over the news so I will not post a link.)
>
> The toxicity problems with acetaminophen have been known for 30
> years, and it is the leading cause of acute liver failure in
> U.S. /U.K. / Australia / New Zealand.
>
> Anyway, I'm just posting this to reinforce the message that
> the stuff is dangerous and there are (in most cases) safer
> alternatives.
>
>
> Steve


If I could get one small refill of APAP and one of amoxycillin on my own
per year, I'd probably never need to see a doctor.

One of the reasons they blend hydrocodone with acetaminophen is so it
can be scheduled as a class 3 narcotic instead of class 2. There are a
*lot* more restrictions on class 2 drugs.

Bob

Nancy Young wrote:
>
> You know, I heard some crazy statistic years ago citing the huge
> percentage of liver failures caused by Tylenol type pain killers.
> I was shocked, and it seemed to me most people had no idea.

I heard on the radio this morning -- I think I remember this
correctly -- that acetaminophen kills more people than all
other drugs combined. A huge part of that (30 or 40%, I think)
is in combination with narcotics, such as Vicodin which combines
acetaminophen with an opiate. People want pain relief, and as
they use more Vicodin because of the opiate they work up to
fatal dose of acetaminophen.

dsi1 <dsi1@humuhumunukunukuapuapa.org> wrote:

>John Kuthe wrote:

>> Ibuprofen's easier on the liver than APAP but rough on the kidneys in
>> high doses.

>I'll take at most, 400mg twice a day. What do you consider a high dose?

I would say that is not a high dose.

According to my doctors, that max dose of Ibuprofen for a
healthy adult is either 1800 or 2000 mg/day. If that is
not working the usual advice is to use Naproxen instead,
at a max dose of 1000 mg/day.

Note the above are considerably higher than the non-prescription
label maximum, so this is something you should only do
on a doctor's recommendation.

Steve

Mark Thorson wrote:
> Nancy Young wrote:
>>
>> You know, I heard some crazy statistic years ago citing the huge
>> percentage of liver failures caused by Tylenol type pain killers.
>> I was shocked, and it seemed to me most people had no idea.
>
> I heard on the radio this morning -- I think I remember this
> correctly -- that acetaminophen kills more people than all
> other drugs combined. A huge part of that (30 or 40%, I think)
> is in combination with narcotics, such as Vicodin which combines
> acetaminophen with an opiate. People want pain relief, and as
> they use more Vicodin because of the opiate they work up to
> fatal dose of acetaminophen.

Yes, people don't realize how much they are getting when they
take some Tylenol with some Nyquil, etc etc. But I've heard plenty
of people say they pop a bunch of Tylenols for one reason or
another without regard for the dose. I don't think people will be
sitting there adding up their combined acetaminophen dose unless
they really get how dangerous it is.

nancy

On Wed, 1 Jul 2009 20:22:35 +0000 (UTC), spope33@speedymail.org (Steve
Pope) wrote:

>Anyway, I'm just posting this to reinforce the message that
>the stuff is dangerous and there are (in most cases) safer
>alternatives.

What are the safer alternatives now?

--
I love cooking with wine.
Sometimes I even put it in the food.

On Jul 1, 4:02*pm, dsi1 <d...@humuhumunukunukuapuapa.org> wrote:
> John Kuthe wrote:
>
> > I call ibuprofen "Vitamin I"! APAP does not work for me appreciably.
> > But Vitamin I does!
>
> It do work good, don't it? It's indispensable for the treatment of
> tendinitis - in my weird body, at least.
>
>
>
> > Ibuprofen's easier on the liver than APAP but rough on the kidneys in
> > high doses.
>
> I'll take at most, 400mg twice a day. What do you consider a high dose?
>
>
>
> > John Kuthe...
>
>

My med book says the max dosage is 400-800mg t.i.d to q.i.d (3 to 4
times a day) and not to exceed 3200mg a day.

I've seen prescription ibuprofen tablets of 1000mg too. I will
occasionally take up to 800mg for a bad migraine, but I don't take
ibuprofen regularly.

Make sure and drink plenty of water too.

John Kuthe...

dsi1 wrote:
>
> John Kuthe wrote:
>
> > I call ibuprofen "Vitamin I"! APAP does not work for me appreciably.
> > But Vitamin I does!
>
> It do work good, don't it? It's indispensable for the treatment of
> tendinitis - in my weird body, at least.

Great for gout, too. Or a sprained ankle.

Not much good for a pulled muscle, though.

On Jul 1, 3:32*pm, dsi1 <d...@humuhumunukunukuapuapa.org> wrote:
> Steve Pope wrote:
> > Several months ago, in a thread that had wandered away
> > from discussing food, I mentioned that I favored banning
> > acetaminophen from the market due to its high toxicity and
> > low therapeutic index relative to other pain medicines.
>
> > It appears that, unusually in my experience, public policy in the
> > U.S. *is actually moving in a direction that I had hoped. *A US FDA
> > advisory panel has proposed banning or issuing warnings on some
> > (but confusingly, not all) acetaminophen-containing medications,
> > including Vicodin.
>
> > (This is all over the news so I will not post a link.)
>
> > The toxicity problems with acetaminophen have been known for 30
> > years, and it is the leading cause of acute liver failure in
> > U.S. /U.K. / Australia / New Zealand.
>
> > Anyway, I'm just posting this to reinforce the message that
> > the stuff is dangerous and there are (in most cases) safer
> > alternatives.
>
> Those alternatives would be aspirin, ibuprofen and naproxen. I rely on
> ibuprofen for most aches. Hopefully that's kinder to livers but who knows?
>
>
>
>
>
> > Steve- Hide quoted text -
>
> - Show quoted text -- Hide quoted text -
>
> - Show quoted text -

Yes, kinder to livers, but unkind to kidneys. You have to be careful
not to OD on ibuprofen.

N.