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

[Genetic Freak]

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.

Our contraindications for prescribing Ibuprofen have recently changed due to increased data on potential pathology associated with its use, such as renal impairment, internal bleeding, and particularly issues with the gut microbiome..
Not something you should consider, especially not chronic use..

 

[Ballz_Trippington]

Our contraindications for prescribing Ibuprofen have recently changed due to increased data on potential pathology associated with its use, such as renal impairment, internal bleeding, and particularly issues with the gut microbiome..
Not something you should consider, especially not chronic use..

I think the OP was listing my previous medication regime that I was taking for years and in fact I did develop accute kidney injury very very likely from such a regime.....but what do you do when you have such severe chronic pain and inflammation???
I've since halted my ibuprofen tylenol use.....the downside is now I'm prescribed cortical steroids (prednisone) and diclofenac cream.....I have severe insomnia as well so the prednisone is helping inflammation but the side effects are nearly unbearable....I don't know which medication regime is worse tbh.
But what does one do when the condition is so severe and the medication options are so limited???
Not sleeping for a week or more is not great either due to the prednisone.
It should be noted thst I have Eosinophilic Fasciitis that I only recently got diagnosed with but was having extreme pain and inflammation for almost a decade before they finally figured out what going on with my hands,wrists and ankles.
Plus the 5 concussions I've suffered through my life made struggle with severe migraines since early childhood (first concussion was at like 5 years old....literally got hit in the head by a baseball pop fly while sitting in the stands watching the game lmao) so I've been taking tylenol and or advil for decades....I'm very lucky to still be here and not be mentally Impared except for dyslexia and very lucky to get my kidney function back to acceptably functional levels.

 

[Fertile]

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.

But just see how many co-codamol 8/500 you can get into 100mL. Like I said - those binders really mess things up. They absorb water and you end up with a kind of paste.

A pure compound is not what is being dissolved here,

I noted that DCM & chloroform dissolve codeine freebase readily, but one would want to do that on a few boxes at the same time to avoid mechanical losses.

Even the Russians who make Krokodil freebase the codeine and use gasoline (!) to extract the freebase codeine.

I am aware that paracetamol's solubility is influenced by pH. The sodium salt of paracetamol is used in soluble paracetamol tablets. I wonder if any of the salts are insoluble in water? The calcium salt, for example? But then one might freebase the codeine in any case.