Acetaminophen Toxicity Questions

[discerned]

Hi, so here's my situation.

Two evenings ago I ingested 8 500 mg Hydrocodone/Acetaminophen tablets, 6 of which were insuffolated and 2 of which were (poorly) CWE'd. This started about 6pm and went til 11pm. The next day I took 5 tablets in the early afternoon and 6 more starting at 7pm til 10pm. So disregarding the CWE the math works out to three doses totaling 19 tablets or 9500mg over a 28 hour or so period. I don't have any signs of Acetaminophen overdose this morning, yet I know that they are latent in the beginning. So, would vomiting be occurring by now? For a liver that doesn't take this type of abuse normally, is 9500mg spread out over a 28 hours period likely to not cause serious problems? What should my course of action be?

Thank you.

 

[Johnsonville]

Just because you don't show outward overdose signs, does not mean that the liver was not taxed potentially to the point of damage. I have done this without too much trouble but I would certainly recommend doubling-up on your water intake today just to keep your bases covered.

Slightly off-topic: Insuffiating hydrocodone / APAP pills is really rather pointless. For the damage caused to your nose, the slightly stronger buzz is not worth it; not to mention the mountain of powder that would have to be sucked up would be hard enough.

 

[discerned]

Just took some milk thistle. Still no symptoms, I feel like I should have had some vomiting by now, so hopefully damage was done but failure didn't happen.

 

[discerned]

Yeah I realize that the signs of a toxic level might not present themselves. What is a good dose of milk thistle?

 

[NeighborhoodThreat]

Just because you don't show outward overdose signs, does not mean that the liver was not taxed potentially to the point of damage. I have done this without too much trouble but I would certainly recommend doubling-up on your water intake today just to keep your bases covered.

Slightly off-topic: Insuffiating hydrocodone / APAP pills is really rather pointless. For the damage caused to your nose, the slightly stronger buzz is not worth it; not to mention the mountain of powder that would have to be sucked up would be hard enough.

What he said. That is a lot of APAP, more than double the recommended maximum of 4000mg a day, even though it was over a 28 hour period, not a 24 hour period. While your liver is probably okay, I recommend monitoring yourself closely for the next few bits, sometimes APAP toxicity can take a while to manifest itself.

Do not take any more APAP or drink alcohol for the next few days. I also agree with Johnsonville, snorting pills containing APAP is worthless.

Do a CWE if you need to consume that much hydrocodone, if there are issues with your CWE, I don't recommend ignoring them and consuming that large amount of APAP anyway.

You may want to read into milk thistle, which has been shown to have liver-protective properties, although some research results have been inconclusive.

 

[discerned]

Thank you for the encouraging reply. So far I have stopped my APAP intake, taken 280mg of milk thistle, and 1000mg of Vitamin C. I don't drink so hopefully my liver was relatively strong before this. I don't have any tenderness in my upper right abdomin, which I've read is a sign that is almost always present, and early too. Like you said I'm just going to be monitoring myself for a week or so.

 

[NeighborhoodThreat]

^It sounds like you're going to be alright, and good idea on taking the milk thistle.

If you do notice any adverse reactions that could be symptoms of APAP overdose (such as tenderness, loss of appetite, etc), I recommend that you consult with a medical professional.

 

[discerned]

Just got back from the ER, my roommate convinced me to go instead of worrying about it all night. Got blood and urine tests and my liver enzyme and APAP level were completely fine. I'm going to seek some help for my opiate problem now. It's kind of weird that the catalyst for seeking help was concern over an OD from a non-opiate. Thanks again for the responses.