Opioids Rule of Thumb for Acetaminophen (tylenol/paracetamol/APAP)

[SpunkySkunk347]

I always find that there is a lot of misconception on this forum regarding acetaminophen; how much acetaminophen is safe, how much can be taken before getting into the range of overdosing, etc..

First of all, the best way to avoid problems with acetaminophen is just by doing a cold water extraction on whatever it is that you're taking in order to filter the APAP out.

But, I'm sure not everyone is going to do that, especially if they are out and about (for example, at a friends house or at a party) or if they don't have the time to (for daily users, I'm sure having to perform a CWE every time they dose becomes tedious - although chronic ingestion of APAP is dangerous).

Here is a standard rule of thumb for acetaminophen (this is only for single one-time doses, as any prolonged/recurring use of acetaminophen is bound to cause liver damage:
1-4g (1000 to 4000mg) - mild to moderate alterations in hepatic function
4g (4000mg) - Liver damage becomes possible
6g and above - Liver damage becomes likely
10g - Lethality becomes possible
20g - Lethality is likely to occur

If more than 10 grams have been accidentally taken, get to a hospital. Symptoms of acetaminophen overdose do not manifest immediately, and it can take days for death to occur.

 

[jamesBrown]

I think it should be mentioned that allthough the above post is probably correct for the most part about the toxicity of different amounts of APAP......taking doses of acetaminophen above 2-3 grams couod very easily cause severe liver damage in some people, even in a one time use. For the most part, people can handle much more than that with little to no problems, as long as they dont take that much APAP often.

For example, I used to take around 3500-5000 mg's of APAP at one time, about once every few weeks....and only once did I feel pain in my liver. Other than that, im fine...I even had my liver checked recently and its in tip top shape.....

So it is possible to take very high doses of APAP, its just something most people really shouldnt be playing around with and testing there limits.

I would say on average, the most APAP someone should ingest at a given time to be safe would be about 2500mg's. And this is only on rare occasions. I, of course, am speaking in the interest of harm reduction. I now that MANY MANY people take much more than that very often and sometiems have no ill effects...but its still dangerous, and the risk isnt really worth it in the end. Liver failure usually ends in death if not taken care of immediately. You would have to go to the hospital and end up with a whoppin medical bill all because you wanted to get a little extra high.

 

[BIGsherm7272]

btw the LD50 of acetaminophen in rats is 1944mg/kg, and is estimated to be 800mg/kg for humans.

 

[Cane2theLeft]

Maybe I'm oblivious but I read this forum pretty regularly and have for over 2 years and don't think misconceptions dominate the way APAP is treated.

The reason we so strongly advocate CWE and other harm reduction measures is not because its likely someone will kill themselves accidentally from a single APAP overdose but because chronic ingestion is damaging to the liver much like alcohol is. If someone is consuming 4-6+ grams of APAP daily this is going to have a cumulative effect and over time can pose significant risk.

 

[SpunkySkunk347]

btw the LD50 of acetaminophen in rats is 1944mg/kg, and is estimated to be 800mg/kg for humans.

I think its important for anyone reading to realize that the LD50 does not mean "Stay below this amount and you won't die".

A dose of 200mg/kg still has a very real potential of being lethal - and even if an individual were to survive such a dose, 200mg/kg would still do severe damage to the liver.

 

[SpunkySkunk347]

Maybe I'm oblivious but I read this forum pretty regularly and have for over 2 years and don't think misconceptions dominate the way APAP is treated.

The reason we so strongly advocate CWE and other harm reduction measures is not because its likely someone will kill themselves accidentally from a single APAP overdose but because chronic ingestion is damaging to the liver much like alcohol is. If someone is consuming 4-6+ grams of APAP daily this is going to have a cumulative effect and over time can pose significant risk.

Well, I remember reading a few posts where people had confused "Daily limit" with "Lethal amount", and were saying that 4 grams was a lethal dose.
4 grams is the recommended daily limit; it won't kill a person, and probably won't cause any sort of permanent damage - excluding incidents where someone has preexisting liver problems.