Misc Does taking a LARGE amount of pills delay onset of action?

[ChemicallyEnhanced]

As always the strugglebus is real in the last couple days before I get my opioids script so been using Paramol*. I don't need a lecture about CWE or a discussion about how/why I didn't/couldn't do it, but 7pm last night I took 20 of them. Normally, when I DO do a CWE or take a smaller number of pills (like 4-6) I usually get some relief from the withdrawal in 40-60mins...but after taking these twenty I didn't feel any better AT ALL until 3am when suddenly I felt MUCH better.

Could the large number of pills have caused such a significant delay?

*OTC pills that each contain 500mg Acetaminophen and 7.5mg Dihydrocodeine**

**equivalent ~15mg Codeine

 

[burn out]

I don't see how or why it would.

 

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

As always the strugglebus is real in the last couple days before I get my opioids script so been using Paramol*. I don't need a lecture about CWE or a discussion about how/why I didn't/couldn't do it, but 7pm last night I took 20 of them. Normally, when I DO do a CWE or take a smaller number of pills (like 4-6) I usually get some relief from the withdrawal in 40-60mins...but after taking these twenty I didn't feel any better AT ALL until 3am when suddenly I felt MUCH better.

Could the large number of pills have caused such a significant delay?

*OTC pills that each contain 500mg Acetaminophen and 7.5mg Dihydrocodeine**

**equivalent ~15mg Codeine

I can't answer your question specifically, but I've noticed a similar thing myself. Sometimes less is definitely more.

 

[Jabberwocky]

You took 10,000mg of acetaminophen the other night?

Theoretically that might tax your liver so much less of the codeine was metabolized. Just a guess.

 

[Jen X]

Be very careful with high doses of Tylenol.
To answer your question I don't know.

 

[ChemicallyEnhanced]

You took 10,000mg of acetaminophen the other night?

Theoretically that might tax your liver so much less of the codeine was metabolized. Just a guess.

I ended up taking a total of 18,000mg in just over 12 hours.
I'm totally fine, though *shrug*.
Not saying it was a GOOD choice, but anything is better than withdrawal.
Plus, the liver can heal itself, so I'll just make sure I stay away for acetaminophen for a good while.

 

[Jabberwocky]

I ended up taking a total of 18,000mg in just over 12 hours.
I'm totally fine, though *shrug*.
Not saying it was a GOOD choice, but anything is better than withdrawal.
Plus, the liver can heal itself, so I'll just make sure I stay away for acetaminophen for a good while.

That's enough to cause acute liver failure. People have suicided from less. I know you didn't want advice regarding that, but damn. I would highly advise taking some NAC if you have any, it's the antidote to acetaminophen toxicity.

The liver can't always heal itself from from acute toxicity. In most cases the damage is permanent.

And remember, the liver does not have any pain nerves. You can't feel the damage. Your first sign would be illness.

 

[ChemicallyEnhanced]

That's enough to cause acute liver failure. People have suicided from less. I know you didn't want advice regarding that, but damn. I would highly advise taking some NAC if you have any, it's the antidote to acetaminophen toxicity.

The liver can't always heal itself from from acute toxicity. In most cases the damage is permanent.

And remember, the liver does not have any pain nerves. You can't feel the damage. Your first sign would be illness.

I did check and based on my body weight (52kg) it would take 20,400mg to be a toxic dose (not an LD-50 dose, just enough to be a toxic dose), so I should be okay.

 

[Jabberwocky]

"In adults, an acute ingestion of more than 150 mg/kg or 12 g of acetaminophen is considered a toxic dose and poses a high risk of liver damage"

150x52 = 7800mg

The maximum dose in the US per 24 hours is 5000mg

Acetaminophen Toxicity: Practice Essentials, Background, Pathophysiology

Extensive medical use of acetaminophen began in 1947. Initially in the United States, acetaminophen was available by prescription only.

emedicine.medscape.com

 

[ChemicallyEnhanced]

"In adults, an acute ingestion of more than 150 mg/kg or 12 g of acetaminophen is considered a toxic dose and poses a high risk of liver damage"

150x52 = 7800mg

The maximum dose in the US per 24 hours is 5000mg

Acetaminophen Toxicity: Practice Essentials, Background, Pathophysiology

Extensive medical use of acetaminophen began in 1947. Initially in the United States, acetaminophen was available by prescription only.

emedicine.medscape.com

Whoopsie. For some reason I thought it was 200mg/kg.
5000mg/day is actually a lot. Here in the UK the maximum dose per 24 hours is 4000mg, although people have had liver damage and even died from just taking that 4000mg/day but for several months or years in a row (mostly the elderly), so I even heard they might start suggesting 3000mg/day as the maximum dose.

I don't actually think it should be used in adults period. For pain, anyway. It's pretty effective as an antipyretic, but I think it's completely ineffective for treating pain in adults. Most doctors I've spoken to agree. And in studies, acetaminophen is no better than a placebo.

It definitely needs to stop being shoved into MOST painkillers. I actually wonder how many people who are addicted to prescription opioids have died over the years directly due to liver damage from all the acetaminophen added to their Co-Codamol/Vicodin/Percocet/etc.