Opioids Possible tylenol overdose .. any thoughts?

So I have been using opiates for a couple of years now. I dont use too regularly .. maybe a few times a month to a few times a week (it all kind of depends). I know that too much APAP can be liver toxic, but at times I get a little wreckless and want to ask people who have experience with percocet or vicodin how many pills they have taken, snorted, plugged etc? Tonight i have probably ingested right around 4 grams of tylenol (along with the opiates of course). I know that the max dose is 4 grams over 24 hours. I have exceeded that over the past 5 hours. I dont feel sick or anything. The first signs of APAP toxicity are nausea/vomiting .. I am not experiencing either of those. This is a bit comforting, but I am definitley concerned about liver damage. I need to stop taking these things in all honesty. I have been using them becuase of some pretty awful depression surrounding some terrible life circumstances and tonight i was really down and able to get my hands on a bunch of percocet. Should I be concerned about liver damage? Should I go to the hospital? I really do feel fine ... just real tired from the opiates. Once again, I am not showing early signs of APAP toxicity (ie N/V). Any thoughts?? I have no health insurance so I really cant afford a trip to the ER and I dont want to go for nothing. Have any of you ever taken a ton of vicodin or percocet so as to exceed the maximum daily dose .. If so what was your experience? I am pretty sure that I have exceeded the max dose before with my abuse with no noticeable problems. That obviously doesnt mean I have not damaged my liver .. but I am a bit worried right now and wanted to see what you guys thought Thanks for any replies. I am going to be more careful from now on. Its not worth it to worry like this for a buzz. Ill stick to oxycodone from now on.

You'll be fine, don't make a habit out of it, CWE takes 5 minutes...

are you sure lol? Im sort of freakin out. I definitely wont make a habit out of it but it is a little concerning bc I am reading things saying that taking 4 grams in a dose can result in severe liver damage or be potentially fatal. I am getting a mild aching feeling in my liver. Definitely nervous. Thanks so much for the reply though. Have you ever done this before?

^ Calm down if your liver was failing it would be VERY apparent. CWE from now on out so you don't have to worry. You have to consume it chronicly at that dose for weeks or months on end for your liver to fail(unless you are really sensitive to it). If it gets worse go to a DR. I've had liver issues from apap, my comments go off of my personal experiance.

yeah, calm down you will be fine. But if you continue doing this the combined liver damage can mess you up. I don't think liver hurts anyways, you'd get other symptoms like jaundice, nausea, vomiting if there was a serious problem. You might have done a small amount of damage, not noticeable in the long run and if not repeated will cause you no issues. It's taking over around 4 grams daily for a while that leads to serious liver problems.

BTW if you plug the APAP doesn't absoprb, just the opiate. It's just that in case of something like vicodin absoprption will be slowed due to the APA getting in the way.

So CWE then plug or drink. The best option. You can still use vicodin as long as you get the APAP out.

OK. Thanks guys. I think youre probably right. The hypochondriac in me is def coming out though. I spent a lot of this past weekend drinking with friends .. so my glutathione stores may be a bit low at this point in time ... which is sort of compounding the worries that I have. I gotta just relax and get some sleep I suppose. I need to learn how to do CWE. I did try it once using coffee filters but the ones i have suck. Any suggestions on a good filter to use .. i really dont have much experience or knowledge of CWE.

I dont think i could ever plug anything haha .. so thats out. Ill deg stick to CWE and oral route in the future. You guys are great though. Thanks for easing my concerns.

Just to give you even more comfort, I've gone through WAY more APAP than that in a lesser time frame and had a liver function test to get my license back after a DUI straight after and it came back fine.

Where are you located? In Australia you can buy proper micron filters from pharmacies. Not sure if you can buy them from pharmacies or anywhere else in the US if you live there. Someone else will have to confirm. If not, they wouldn't be hard to find online.

I am in the US and have no idea if we can buy filters at the pharmacy. My guess is no bc I have never heard of this before. I actually just did a CWE with coffee filters that I have at home and it worked out great. Wound up with a nearly clear solution .. did have a slight cloudy tinge to it but apparanty APAP has a solubility of 8 mg/ml and I used 15 ml of water so the amount of APAP that i had is pretty negligible. I am glad you could give me more reassurance though. It is scary to think about your liver failing and I was a little worked up over it for about an hour. I cant begin to express how helpful your reply and all the replies have been. I know i keep saying thanks .. but this has relieved all of my apprehension.

the filters i just used worked better than the other ones i had before ..

If your really concerned I would suggest going to the ER. A lot of people OD on Tylenol by accident because they take cold medicine or any number of other products that have tylenol in it that isn't obvious unless you read the active ingredients and know that acetaminophen is Tylenol.

Another suggestion (Not meant to replace the ER) is to go to the health food store and get some NAC (N -acetylcysteine) this is the antidote to Tylenol. I take it any time I have to take Tylenol. It doesn't prevent Tylenol from working it just keeps it from going to the 2nd path metabolism in the liver.

I had very high liver enzymes and was showing signs of liver failure because I needed to take Tylenol and Advil daily for about a year. I guess I'm just sensitive to it because I never exceeded the daily dose. So, now whenever I have to take it I take NAC with it.

NAC will NOT keep you from killing your liver if you OD on Tylenol over and over again. I'm saying this because I don't want to give the impression that it is a miracle cure.

I hope your ok. I know how terrifying it is to think you've OD'd. Please, go to the ER if for nothing else than peace of mind. And please, let us know if your ok. I worry!

But also, take a deep breath. And know that if you did take too much and your treated that the good news is that there is no long term damage to your liver. BUT you have to be treated.

And try the NAC as well as doing a CWE. If you do both of these things, you'll never have to be in the scary place you are now.

I'm sending you healing and calming thoughts out into the universe.

P.S.

It sometimes take a day or more for symptoms of tylenol OD to show up. The sooner your treated the better the outcome. If your not going to go to the ER then at least go to the health food store and get the NAC.
I don't recommend it as a replacement but truth be told, I have used this myself for a time when I took too much Tylenol. My liver enzymes were checked at my next MD appt. and they were back to normal.

You're fine. Don't do it again and avoid booze.

Do a CWE next time.

Also, I wouldn't start exclusively banging the oxy as I hear it is more addictive (aka: better, stronger) than hydrocodone (I've taken neither as I live in England and we don't seem to have these apparently wonderful opiates).

I'd advise to CWE your hydro's and take oxy as a rare treat to avoid a nasty habit.

Your liver is also able to regenerate itself over time. As long as you're not doing it constantly, 4 grams of Tylenol at once is not a huge deal. Milk Thistle is another liver protecting agent available at health food stores. Make sure you get standardized extract.

yea i didnt go to the ER. I have no problems at all today .. no nausea/vomiting/stomach pain. Everything seems to be fine. I probably put a lot of stress on my liver, but I didnt do any serious damage. There is no way that I did bc I feel fine ... if something were seriously wrong I would be developing or already have developed symptoms of toxicity. REgardless, I will never do that again. I am just going to play it safe from now on and do CWE.

You will be fine, I once took 6g of apap by accident and had no adverse reactions.

^6 g's could be fine for you and deadly for somone else. But I agree, dont freak out about it.

my thoughts are that for the majority of people without any significant liver problems .. overdoing it with tylenol on occasion is likely not going to have any significant adverse effect. Only if it is done consistently will you begin to develop problems. People probably OD on tylenol by taking too many vicodin or percocet all too frequently with no problem at all. This is definitely prob not the first time I have done this, but I will certainly be more careful bc i am now more knowledgable about it. I used to tihnk you had to take like a whole bottle of tylenol to do any damage, but it turns out the potential is there at lower doses and it may be easier to damage your liver than what I had previously thought. Regardless, let it be a lesson to everyone to not take advantage of your body and its capacity to handle substances. Instead take care of yourself, do your research and think before you do anything that could be potentially harmful.