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  • BDD Moderators: Keif’ Richards | negrogesic

"Safe" amounts of APAP taken a few times a week?

D

doctorS

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Joined
Feb 6, 2018
Messages
15
Hey ya'll,

I'm trying to figure out the relative safety of taking 2000-3000 mg of APAP as a consequence of using Norcos and/or Perkies, something like 2-3 times a week. I know this is well below the maximum recommended dose but I'm wondering if anyone has experience or knows anyone who has experience with employing strict harm reduction practices when taking opiates containing tylenol but still experiencing liver damage or dysfunction?

Thanks so much ya'll!!

~ The Doctor's in
 
^ pretty sure every other country says 3g is the max dose, US is just lagging behind.

Why not do a cold water extraction? A little bit of work, but don't have to worry about the apap as much.
 
2-3k of APAP isn't well below the daily limit, it's anywhere from 50-100% of the daily limit depending on who you ask. You might want to consider a cold water extraction, they aren't hard to do and could save your liver.
 
bptubbs said:
^ pretty sure every other country says 3g is the max dose, US is just lagging behind.

Why not do a cold water extraction? A little bit of work, but don't have to worry about the apap as much.
Click to expand...

The U.S. increased it to 4 grams a few years ago simply because people weren't noticing how much Tylenol was in certain medications so it was just an extra precaution.

I would do a cold water extraction also if I wanted to take pain killers that had Tylenol in them, but back when I didn't consider that an option or know about it and had access to pain meds I just made sure to stay under 4 grams and was fine, but I only did it like 3 days a week for like 6 weeks or something like that, which I still think is too much, but never ran into trouble.

I have heard other moderators on this site say that in actual fact, the body can generally handle a lot more than 4,000mgs in 24 hours and still be fine, but I would never ever personally exceed about 3,800 grams in a day (STUPID to do that amount as well) and I wouldn't be exceeding 2 grams a day more than like twice a week, since really, 2--325mg Tylenols should be good for a dose.

I honestly don't think you enter ACTUALLY REALLY dangerous territory till you take like 6 grams or more in 24 hours, and i think probably the majority of true Tylenol overdoses are from people taking 6, 7, 8, 9 or 10 grams of Tylenol in 24 hours.

Obviously extreme caution with Tylenol is warranted, but whoever said that they think more than 2 grams in a day is really dangerous? Yeah, I would not agree with that. I don't think you enter overdose territory till you take 4, but if you do that often that will also be really bad for your liver I'm sure.
 
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I think it's worth mentioning that these recommended maximum daily doses are meant to be spread out over the course of the day; i.e. no more than a 1000mg 4 times a day at no less than 4 hourly intervals - NOT taken all at once as you would have to do in order to catch a codeine buzz. You might get away with it on the odd occasion, but not regularly and definitely not daily - especially as rising codeine tolerance would quickly require you to exceed that limit. It's certainly not worth the risk. My friend's wife died from abusing co-codamol 8/500 tablets, upto 12g per day. She died a long lingering death as her organs shut down one by one. CWE all the way...
 
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Ok, Wow

First off, no one said more than 2 grams was automatically dangerous; just that it’s a recommendation depending on the source, and, why 3-4 grams per day is upper limit per 24 hours, generally, taking more than ~ 2 grams at once is a bad idea

Second, love to talk to any moderator (on this forum?) giving the impression that a “lot more “ than 4 grams a day is safe - It’s not, although have a feeling they maybe were just talking about the average amount to OD or something - However, that’s not an idea of HR. Remember, the dangers of APAP Are truly proportionate to dose, it isn’t like you go from “safe “ to OD -If You take too much Apap, it saturates the primary metabolic pathways, and instead it begins getting converted into a Toxic metabolite
-


So any abuse can result in some degree of this methadone (I swear my spellcheck keeps trying to turn words to methadone, except methadone itself!) of Apoguba” production (I don’t remember how to spell it :) )

Hhow much is truly “toxic “ deoends upon the individual, and what you could call “safe “ in a blue moon, is a lot less safe Every week, and possibly lethal after consecutive days

Of course it’s true, that the average person isn’t going to be “fine “ on 1500ngs, and then jaundiced on 2’500. Still, going over about ~2000mgs in 8-12 hours results in some “toxicity, and, several grams in a day, even if you don’t end up in an ER, we are talking side effects, (cramps, puking, jaundice, etc. ) and eventual liver damage

I’m sort you cannot safety plan to take 2-3 grams several times per month - It’s silly, when CWE is relatively simple and (Normally?) painless procedure, that lets you safely triple your dose

I question the wisdom of this thread; in any case, if don’t, maybe someone will link “Cwe” to safe from anyone ever UTFSE (it isn’t always friendly though)

Seriously, CWE, or learn to clog your etabolic pathways (about as safe as drinking isopropyl alcohol to treat ethanol overdose). -Lorne
 
Just because it doesn't immediately kill you doesn't mean that the side-effects of intensive APAP ingestion are not going to cause severe damage to your hepatic system over the course of time. Think about drinking Alcohol. Do people generally drop dead after a night of heavy drinking? What about 20 nights? Hundreds of Nights? Well, what do you know, one day, the nice MD is trying to figure out the nicest way to tell you that your liver is now a fatty mass, incapable of filtering anything.

You need to do a Cold Water Extraction my friend. I'm sorry. There are no ifs, ands or buts my friend. The process is just far too facile to give someone any kind of other advice. The is an irresponsible way to treat your body. Learn how to do a CWE and do it every single time unless "in a pinch" of some kind. I'm not trying to be a dick either. I want you to live dude and live healthily at that.
 
Oh yeah, I agree with everyone else that Tylenol is one of the most dangerous things out there for your liver, and there's not much that can be done if you really do overdose and it's one of the most painful ways to die I'm told.

I also know that it builds up and causes problems over time.

I think it was that one poster said that he'd be scared to take over 2 grams in 24 hours, and while that doesn't scare me maybe it should and it's just entirely unnecessary and unhealthy.

I've never actually done a cold water extraction but that's cause I don't do pills with Tylenol in them often.

If (or when) I get pills again that have Tylenol in them I'll do one, and even while doing one I would not ever go above 3 grams in a day.

It is true that I was once told by someone knowledgable here that you are not usually in immediate danger of liver failure if you take LESS THAN but close to 4 grams in a 24 hour period (not all at once though...that's different...probably not in excess of a gram in four hours...) but I believe it was relative to the context of my having been concerned at the time that I'd taken something like 3.5 grams in 24 hours one time.

Just because you can possibly survive doesn't mean it isn't stupid and Tylenol is extremely hepatoxic.

I agree with everyone: don't mess with large doses if you want your liver to last.
 
the most you can take in a 24 hour period, (i googled how much apap does it take for toxicity) is 4 grams apparently. This next part is off of https://livertox.nih.gov/Acetaminophen.htm The best known form of hepatoxicity from acetaminophen is an acute, serious hepatocellular injury as a result of intentional or unintentional overdose. The injury is due to a direct, toxic effect of the high doses of acetaminophen. Acetaminophen hepatotoxicity most commonly arises after a suicide attempt using more than 7.5 grams (generally more than 15 grams) as a single overdose (Case 2). Hepatic injury generally starts 24 to 72 hours after the ingestion with marked elevations in serum ALT and AST (often to above 2000 U/L), followed at 48 to 96 hours by clinical symptoms: jaundice, confusion, hepatic failure and in some instances death. Evidence of renal insufficiency is also common. Serum aminotransferase levels fall promptly and recovery is rapid if the injury is not too severe. Similar injury can occur with high therapeutic or supratherapeutic doses of acetaminophen given over several days for treatment of pain and not as a purposeful suicidal overdose (Case 3). This form of acetaminophen hepatotoxicity is referred to as accidental or unintentional overdose, and usually occurs in patients who have been fasting, or are critically ill with a concurrent illness, alcoholism or malnutrition, or have preexisting chronic liver disease. Some cases of unintentional overdose occur in patients taking acetaminophen in combinations with controlled substances (oxycodone, codeine), who take more than recommended amounts over several days in attempts to control pain or withdrawal symptoms. Instances of unintentional overdose in children are often due to errors in calculating the correct dosage or use of adult sized tablets instead of child or infant formulations. Because acetaminophen is present in many products, both by prescription and over-the-counter, another problem occurs when a patient ingests full or high doses of several products unaware that several contain acetaminophen. Hope your safe - The Dragon
 
Trust me, I know how to do a CWE. The problem is that the Tylenol actually potentiates the opiate, I'm not sure how experienced ya'll are with these but the high is much different when you do a CWE, it becomes more of a light cerebral buzz than a full body stone. If you're viewing harm reduction as basically just "do literally every single thing you can to eliminate every single risk variable" then yeah sure, removing all tylenol is great, but I mean come on - there's nothing so critically unsafe about taking less than 2000 mg of tylenol a day that it warrants doing a CWE every time you want to take a few Norcos. Nobody here actually answered my question - is there legitimate, scientifically backed evidence of the notion that taking a lower amount of APAP than the daily maximum a few times a week still results in gradual hepatic damage? If so, then yes, CWE all the way. If not, why does it matter? I'm not taking or planning on taking anything close to 3000 mg a day, the very most I take in a day is 6 norcos which adds up to 2000. Is 2000 actually dangerous or not? I'm not trying to be OCD level careful, I'm just trying to be real life careful, you know what I mean? 2000 is not a large dose. There are millions of people who take 2000 mg of tylenol every day just for aches and pains. We're talking harm reduction here, not harm elimination. If I wanted harm elimination I wouldn't do drugs at all. Lol!
 
CWE them, it's so fucking easy. Then this isn't a problem. Onwards to YouTube my friend.

I rather think that feeling the Paracetamol adds to the high is a massive placebo, perhaps liver damage feels good?
 
Yeah, take it from someone who knew nothing about the dangers of Tylenol and accidentally overdosed myself after suffering a head injury and other injuries from a car accident. Kept taking the Tylenol for pain and had Liver failure.

No pain can compare to this. No doctor knows how I survived. I should be dead.
It has taken been ten years of a special diet and major pain everyday. The doctors tell me liver tests are normal and the liver is the only organ in the human body that can regenerate itself. Still hurts and itches and burns. It has disabled me for life I'm pretty sure.

Please friends- NO AMOUNT of Tylenol is "safe"! It is the worst thing.
 
Angelicka said:
As long as you take under 4000 mg in 1 day you are safe.
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Please, in the future make sure that the advice you're giving is accurate. You are encouraging harmful behavior. You need to limit your APAP intake as much as possible. Don't refer to the acute poisonous dosages if you intend to take that much every day for consecutive days.
 
Keif' Richards said:
Please, in the future make sure that the advice you're giving is accurate. You are encouraging harmful behavior. You need to limit your APAP intake as much as possible. Don't refer to the acute poisonous dosages if you intend to take that much every day for consecutive days.
Click to expand...

Unfortunately, we are all guilty of feeding the troll...
 
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