I hear it’s possibly related to some of the same issues that drive my nasal polyp issue. Not sure if valid, though.
8 Likes
I am really cautious when taking any kind of pill, even standard stuff like ibuprofen. But when my migraines get bad enough the thing that works best for me is to take two ibuprofen and one Excedrin. If it doesn’t get better i still make myself wait a few hours before i take a second Excedrin, but that’s my limit on how much I’m willing to take 
And i am also aware the ibuprofen isn’t great either so i try avoid taking it unless I’m sure i need it.
Wish i had better alternatives but thankfully i don’t really on them for pain relief on the reg, so my paranoia about taking them isn’t too bad
5 Likes
In the hospital where I work we see hundreds on teenagers every year with paracetamol as the drug of choice for deliberate overdose. The stuff is everywhere and really easy to take a life changing dose. I should emphasize the vast majority of cases are impulsive overdoses and very shortly after regretted. I shudder when I see stacks of the boxes at self service checkouts alongside candy or whatever.
5 Likes
I’m no pharmacologist, but I’ve read that there is a genuinely synergistic effect to be had with that combination, which puts it above the ‘eh, we’ll just add some methanol to the alcohol that isn’t authorized for drinking’ school of indirectly lethal enforcement; but it also wouldn’t surprise me if “should we really sell a combination of a drug surprisingly dangerous not too far above the recommended dose and a drug unsurprisingly popular above to well above the recommended dose over the counter?” got a “yes” in part because junkies getting liver damage may not get assigned quite the same moral weight as people getting liver damage; even if medical ethicists would deny it when asked point blank.
2 Likes
In the U.S., codeine with acetaminophen is a prescription-only medication. Many other prescription painkillers combine acetaminophen with other opioids. Vicodin and Norco are hydrocodone with acetaminophen. The latter has more more acetaminophen per dose. Percocet is oxycodone with acetaminophen.
4 Likes
Are they unaware of how the stuff is dangerous, lacking in better alternatives, or really not thinking it through?
Even for an overdose that you’ve carefully considered and continue to stand by; ‘unlikely to kill you in the immediate term; pretty high risk of inducing liver failure that will painfully kill you in the short to medium term’ seems close to a worst-case scenario.
1 Like
Dunno, just had some pretty major surgery (bilateral hip replacement) and I have to say I am a satisfied Percocet customer (for the first 2-3 weeks until they wisely cut me off in favor of the OTC stuff). So, sometimes acetaminophen (and the oxy) are a good thing?
2 Likes
https://www.regulations.gov/document/FDA-2011-N-0021-0001
The Food and Drug Administration (FDA) is taking steps to reduce the maximum dosage unit strength of acetaminophen in prescription drug products. This change will provide an increased margin of safety to help prevent liver damage due to acetaminophen overdosing, a serious public health problem. This notice explains the reasons for the reduction in dosage unit strength and describes how FDA is implementing it for approved prescription drug products that exceed the new maximum tablet or capsule strength. FDA is also requiring safety labeling changes, including a new boxed warning, for acetaminophen-containing prescription drug products to address new safety information about the risk of liver damage.
Hepatotoxicity
Despite wide scale use for many decades, oxycodone has not been convincingly linked to instances of clinically apparent acute liver injury. However, oxycodone and other opioid-acetaminophen combinations have become a common cause of acute liver injury, which is usually the result of excessive use of the medication for the opioid effect, which leads secondarily and unintentionally to an overdose of acetaminophen. In 2014, the FDA warned against the use of opioid combinations in which the dose of acetaminophen is greater than 325 mg per tablet or unit dose. Because of their potential for hepatotoxicity, opioid combinations in which the dose of acetaminophen is greater than 325 mg per tablet or capsule were discontinued.
Oxycodone, like other opiates, is metabolized in the liver by the P450 microsomal oxidizing enzyme system, and levels can be significantly affected by either inhibitors of CYP 3A4 (which increase levels and can lead to toxicity) or inducers of the enzyme (which decrease levels and reduce efficacy).
Likelihood score: E (unlikely cause of drug-induced liver injury).
may count as lies your government tells you, but there are footnotes…
Critical mass has yet to be reached.
7 Likes
oh god no. not this again.
5 Likes
Weird. I’m a night owl but I generally see white/gold, though the white is very bluish.
3 Likes
I don’t know how things are in the US, but here in Europe ibuprofen is considered a major no-no for anyone with GI issues, especially any kind of inflammatory bowel disease.
1 Like
Yeah they’re teenagers. They aren’t really thinking it through. Often they just yeet whatever is in the meds box down their throat. Could be iron tablets or their dads epilepsy medication. But acetaminophen is something that is in everyone’s cupboard
I’m pretty sure they stopped making 'ludes decades ago. I used to call them SuperDrunk pills. Never had quail.
1 Like
Didn’t know until yesterday that you could cook lean meat with lean. Thanks FDA!
1 Like
1 Like
“I love my albums…”
Also, “I got E. I got E. The old standby…” has a whole different meaning these days.
2 Likes
