Risk with chronic paracetamol (acetaminophen) use? Re hearing loss, tinnitus?

[Fertile]

So you were taking Neurofen as an anxiolytic?

Which is what i'm doing.

Paracetamol does have a mild effect on this also, but the combination with codeine is much better.

........

Pharmacists seem to think provided sufficient time for paracetamol clearance is given (6 hours between 1000 mg doses), liver damage should be minimal, even with long term use?

Not exactly - I was extracting the codeine from N+ and JUST taking the codeine. As I said - ibuprofen is profoundly insoluble in water.

 

[fastandbulbous]

A simple way of removing psracetamol is to put it in the fridge for a few hours. Solubility is 180mg/100ml at 4°C. Cant remember codeine phosphate's solubility, but dihydrocodeine tartrate is 1g in 4ml water (even if that's at 25°C, dhc tartrate is silly soluble, even at 4°C, so it's easy to seperate the two (also, paracetamol makes pretty crystals, if slowly cooled in the fridge!)

 

[Fertile]

But you have the problem that co-codamol also has a lot of binders and fillers.

Paracetamol solubility in water from the paper 'Solubility of Paracetamol in Pure Solvents'.

values given in grams of paracetamol/ per Kg of solvent.

7.21 0C
8.21 5C
9.44 10C
2.78 15C
14.90 20C

I have not come across the solubility of codeine phosphate or dihydrocodeine tartrate in water at a range of temperatures.

I played with this because Lifeline were considering providing HR workers with the data to check that clients were using the optimal method. But the conclusion was that super-metabolisers could theoretically work up to enormous doses of codeine and would not be protected from potentially toxic doses of paracetamol. So I offered them the fact that ibuprofen was profoundly insoluble, but they didn't use it.

I thought it a bit much but they were not forthcoming.

I think the conclusion was that since no study has taken place, we cannot use it.

 

[fastandbulbous]

Bimders and fillers aren't toxic (unless you're lactose intolerant!). Anyway, when I've had to resort to extraction, I administer via the rectal route (it tastes fucking hideous and it comes on faster). Any paracetamol dtill in suspension won't be absorned by the colon, if the water is absorbed quickly (wjich is what the colon is designed to do).
And anyway, I still eat some NAC (belt and braces).

 

[Fertile]

Oh, I know the binder/fillers are not toxic, but some of them are soluble so the figures I offer for paracetamol are 'best case'. You are always going to need more sovent.

Codeine freebase is soluble in dichloromethane at 20mg/mL & in chloroform to the extent of 2g/mL whereas paracetamol is insoluble. I know the people who produce 'homebake' heroin make use of these solvents.

The crazy Russians use gasoline to perform the same task. But let's face it, even pure desomorphine is a terrible thing to be addicted to. I talked to a team in Portugal who were looking for the toxins in desomorphine and it appears that an N-P bond is formed. So don't use P4 was my answer. H3PO2 works fine and even NaH2PO2 can be made to work.

But it's the thin end of the wedge. IVing a mixture of unknown (but toxic) drugs. How did they get there? Life must be awful for people to do such things,

 

[Ballz_Trippington]

Using it to treat exertion/stress headaches.

It's the mildest most effect remedy I've found.

I've over used tylenol and advil for migraines and a severe inflammation disorder....I've also suffered 5 concussions in my life (years apart).
But the specialist at the concussion clinic was very concerned about my acetaminophen and Nsaid use.
And basically said thst chronic use of tylenol WILL cause rebound headaches....also my over use of over the counter pain meds has severely affected my kidney function....which I'm still recovering from but almost back to normal....now they put me back prednisone and prescription diclofenac cream....
Please be careful with over using paracetamol.
My heart goes out to you....I know what it's like to live with chronic pain and it's something I wouldn't wish on anyone....I'm also experimenting with Tumeric capsules with black pepper to increase oral bioavailability but I just started this regiment so it's too early to tell if it's helping with my inflammation.

 

[JohnBoy2000]

I've over used tylenol and advil for migraines and a severe inflammation disorder....I've also suffered 5 concussions in my life (years apart).
But the specialist at the concussion clinic was very concerned about my acetaminophen and Nsaid use.
And basically said thst chronic use of tylenol WILL cause rebound headaches....also my over use of over the counter pain meds has severely affected my kidney function....which I'm still recovering from but almost back to normal....now they put me back prednisone and prescription diclofenac cream....
Please be careful with over using paracetamol.
My heart goes out to you....I know what it's like to live with chronic pain and it's something I wouldn't wish on anyone....I'm also experimenting with Tumeric capsules with black pepper to increase oral bioavailability but I just started this regiment so it's too early to tell if it's helping with my inflammation.

Gonna try tumeric capsules also, provided they're all natural spice basically encapsulated, no pharmaco-actives included.

My limit is 2 twice a day. Would that have been the dosing frequency you used those tablets?

 

[Ballz_Trippington]

Gonna try tumeric capsules also, provided they're all natural spice basically encapsulated, no pharmaco-actives included.

My limit is 2 twice a day. Would that have been the dosing frequency you used those tablets?

Sorry....are you talking about tylenol or turmeric???
For Paracetamol I was taking 1000mg 3 times a day plus the max dose of Ibuprofen for many years.
The Tumeric capsules I git from a health food store and they are 1000mg of turmeric curcumin with black pepper nothing else in them....turmeric curcumin has almost no oral bioavailability but black pepper increases the oral bioavailability by something like 2000% (don't quote me on that buts sonething like 2000% I just can't remember at the moment).
It's also good for resisting alzheimer's disease.

 

[JohnBoy2000]

Sorry....are you talking about tylenol or turmeric???
For Paracetamol I was taking 1000mg 3 times a day plus the max dose of Ibuprofen for many years.
The Tumeric capsules I git from a health food store and they are 1000mg of turmeric curcumin with black pepper nothing else in them....turmeric curcumin has almost no oral bioavailability but black pepper increases the oral bioavailability by something like 2000% (don't quote me on that buts sonething like 2000% I just can't remember at the moment).
It's also good for resisting alzheimer's disease.

Paracetamol 3 grams, with a gram to three grams of ibuprofen.

For years.

Yeah that's a lot.

I'm hoping to limit my use to a few months.

I take 2 solpadeine twice a day = 2 grams paracetamol.

 

[Ballz_Trippington]

Paracetamol 3 grams, with a gram to three grams of ibuprofen.

For years.

Yeah that's a lot.

I'm hoping to limit my use to a few months.

I take 2 solpadeine twice a day = 2 grams paracetamol.

I'm no doctor whatsoever so I can't give formally educated medical advice to anyone but I do think the absolute maximum anyone should be taking is 1000mg paracetamol once every 2 days.
Once you start taking anything everyday you inevitably develop a pavlovian sort of response where your body expects it and the rebound effect suddenly not taking paracetamol or whatever ends up becoming the problem your trying to correct.
Finding safer alternatives is a good bet!

 

[JohnBoy2000]

I'm no doctor whatsoever so I can't give formally educated medical advice to anyone but I do think the absolute maximum anyone should be taking is 1000mg paracetamol once every 2 days.
Once you start taking anything everyday you inevitably develop a pavlovian sort of response where your body expects it and the rebound effect suddenly not taking paracetamol or whatever ends up becoming the problem your trying to correct.
Finding safer alternatives is a good bet!

Safer alternative?

Paracetamol was the mildest headache reliever I thought there was available?

.......

When I don't take it I get a craving for amphetamine, which is the only other thing that makes me feel better.

 

[MsDiz]

I've over used tylenol and advil for migraines and a severe inflammation disorder....I've also suffered 5 concussions in my life (years apart).
But the specialist at the concussion clinic was very concerned about my acetaminophen and Nsaid use.
And basically said thst chronic use of tylenol WILL cause rebound headaches....also my over use of over the counter pain meds has severely affected my kidney function....which I'm still recovering from but almost back to normal....now they put me back prednisone and prescription diclofenac cream....
Please be careful with over using paracetamol.
My heart goes out to you....I know what it's like to live with chronic pain and it's something I wouldn't wish on anyone....I'm also experimenting with Tumeric capsules with black pepper to increase oral bioavailability but I just started this regiment so it's too early to tell if it's helping with my inflammation.

Have you ever tried caffeine for your migraines? It’s something that’s given as part of a protocol in A&E, of course sometimes caffeine can trigger them but it also can stop them.

 

[Ballz_Trippington]

Have you ever tried caffeine for your migraines? It’s something that’s given as part of a protocol in A&E, of course sometimes caffeine can trigger them but it also can stop them.

In my youth I was prescribed Cafregot which is just caffeine and ergot and it worked miraculously but it was taken off the market I believe because it can made into LSD or something like that....caffeine is added to a lot of drugs to help them kick in faster....but for me caffeine on its own seems to be a trigger for my headaches.

 

[Ballz_Trippington]

Safer alternative?

Paracetamol was the mildest headache reliever I thought there was available?

.......

When I don't take it I get a craving for amphetamine, which is the only other thing that makes me feel better

Hmmmm have you considered thst you might have an addiction to amphetamines? And the headaches are caused by withdrawal....it's weird to me thst Amphetamines also seem to cure your headaches....but again, I'm no doctor.
What about tiger balm or Voltaren topical cream on the area of your head that hurts?
I was skeptical but it really does help with me.

 

[Fertile]

I was just considering the practicality of making LSD from Cafergot. Unlikely. I expect it's because the pill-makers would need a licence to hold a Schedule 1 precursor.

But ultimately ergotamine still has a lot of niche medical uses and since it's a natural product and the only way to remove it is to remove infected grains individually.

 

[Ballz_Trippington]

I was just considering the practicality of making LSD from Cafergot. Unlikely. I expect it's because the pill-makers would need a licence to hold a Schedule 1 precursor.

But ultimately ergotamine still has a lot of niche medical uses and since it's a natural product and the only way to remove it is to remove infected grains individually.

Yeah I heard about thst cafergot to LSD thing when I was a teenager I'm in my mid 40's now....not a reliable source lol

 

[F.U.B.A.R.]

Dis you know you can make LSD from Fosters beer?

Make L$D Fast

Some people even tried this before the "this is a joke" disclaimer was added.


Not me though, I'm not that stupid. I was too busy drying banana skins...

 

[Fertile]

Yeah - their are grain cleaners that will separate out ergot infected grains by colour, but those things are costly. I guess if you obtained ergot you could purposefully infect a whole field. But you only have a 5 day window to harvest. Last I heard submerged culture was used. It is NOT a cheap material.

It actually ends up with tiny mushrooms growing out of the grains. No idea if they contain ergot but it's a long process to obtain. I also assume you would have to use an area where no grains are grown as part of biosecurity.

 

[BK38]

I would have it checked out. Even within the 'safe' guidelines,, long term use can cause tinnitus. It COULD be a sign of toxicity. Paracetamol toxicity is due to the body running out of a specific amino acid. If you don't have enough in your diet or your body doesn't absorb it well, you may have an issue.

After all, wouldn't you go to the doctor if you got tinnitus after taking a prescription drug at the higher doses for a protracted period of time?

Better safe than sorry, in my opinion.

Precisely

 

[fastandbulbous]

But you have the problem that co-codamol also has a lot of binders and fillers.

Paracetamol solubility in water from the paper 'Solubility of Paracetamol in Pure Solvents'.

values given in grams of paracetamol/ per Kg of solvent.

7.21 0C
8.21 5C
9.44 10C
2.78 15C
14.90 20C

I have not come across the solubility of codeine phosphate or dihydrocodeine tartrate in water at a range of temperatures.

I played with this because Lifeline were considering providing HR workers with the data to check that clients were using the optimal method. But the conclusion was that super-metabolisers could theoretically work up to enormous doses of codeine and would not be protected from potentially toxic doses of paracetamol. So I offered them the fact that ibuprofen was profoundly insoluble, but they didn't use it.

I thought it a bit much but they were not forthcoming.

I think the conclusion was that since no study has taken place, we cannot use it.

From those figures, it gives 100ml of water at 5°C will dissolve 821mg. I obviously incorrectly remembered the figures from Martindales Extra Pharmacopea (it was almost 2 decades ago), but even so, 821mg is still well below a single standard dose and both codeine phosphate and dihydrocodeine tartrate are soo much more soluble. So, put however many tablets you require (obviously not 100s), add 100ml of boiling water (it disintergrates tablets really quickly), then put in fridge for say 6 hours, after decanting solution from undissolved material. After 6 hours, there will be a load of recrystallized paracetamol on bottom of container, the required substances being still in solution.
Using either methionine or NAC is a good idea, as well.