American here: I know paracetamol is acetaminophen, but how much is a packet?
paracetamol packet
It looks like it's a sheet of 6-8 pills
https://www.nps.org.au/news/paracetamol-ibuprofen-combinations-for-acute-pain
according to the acetaminophen i've got at home, dangerous dosage is >4g per day. that means that if 4 packets was 20x that, each packet would be 20g, which, if they're normal 500mg pills, would be 40 pills per packet.
Various countries limit painkillers to small packet sizes (e.g. 20 pills here in Germany) and pharmacies only hand them out one at a time, so you can't overdose as easily/spontaneously, either like the person in the post did due to pain, or for suicidal purposes.
It's not perfect protection, as you can just go to multiple pharmacies to buy multiple packets, but yeah, you will have to actually go do that and will get told at the pharmacy that you shouldn't take more, if you're not aware.
Yikes! The use of the term "packet" was initially confusing to me. Here in the States it's not uncommon to see small packets of a single dose of over the counter medicines in gas stations and convenience stores for when you're not at home and something comes up. The directions for extra strength Tylenol are 2 every 6hrs (1000mg dose) not exceeding 3 doses per day.
I was thinking "4 packets over 3 days, what's the big deal?"
Worth noting as well that the OP said four packs a day for three days.
Well, generally you're only supposed to take ~2 tablets at a time, so 10? 40 pills a day is 13,000mg of acetaminophen, or 20,000mg if they're extra strength.
That's, uh, bad. You're recommended to take under 4000mg per day, so that'd be a bit over a packet? Makes sense to me.
For the record, mixing two painkillers without consulting a doctor is also usually a bad idea but way fucking less of a bad idea than taking 13000mg of tylenol in a day. Afaik, acetaminophen with other stuff is probably fine but napoxen, ibuprofen, and aspirin all work roughly the same way and shouldn't be mixed.
For the record, mixing two painkillers without consulting a doctor is also usually a bad idea but way fucking less of a bad idea than taking 13000mg of tylenol in a day.
Basically, if something hurts so much that you might take enough paracetamol/acetaminophen to fuck with your liver then you yes, you should be under a doctor's care. That said, between my wife and me, we've had three or four doctors over the years all be very chill with the idea of alternating Tylenol and Ibuprofen after surgery or the like. I guess they work on such different chemical pathways that they don't have much interaction potential, and keeping under the daily dose of Tylenol in particular is incredibly important, as we've seen in this thread.
Not "even paracetamol". ESPECIALLY paracetamol.
Tylenol/acetaminophen/paracetamol is both weak ass painkiller and really dangerous because the overdose line is low. Here they put it in synthetic opioid drugs, it doesn't help with pain but does make them more dangerous.
PSA: stupidity is dangerous
Yeah, how long until this idiot cooks this liver too?
Honestly, getting a liver transplant in a week is the most unbelievable part of this story.
Happened to me. It was actually 6 days. Listed on a Friday, transplant was done the following Wednesday.
It's bizarre to me that someone can make it to adulthood without knowing that paracetamol specifically is no fucking joke.
People look up resources on them and see that the recommended max dose of ibuprofen is lower than paracetamol per day in weight of the active ingredient and stop reading.
They don't get to the part about how the effect per weight isn't the same. Or how damaging paracetamol can be for the liver if you take it regularly or go over the recommend limit. Heavy drinkers especially don't take into account the extra stress on their liver, which is a contributor to the 400-500 deaths it causes every year in the US alone.
Meanwhile ibuprofen makes you feel sick and want to vomit once you start to go over the recommended limit. And if you reach that stage, you basically just stay hydrated to keep your kidneys going and wait for it to pass. Since it usually takes another 2-3 times as much to for the severe effects to occur.
To quote Scrubs:
Dr. Cox: Did you just page me to ask me how much ibuprofen to give Mrs. Lenzner here?
Sunny: Well, I was worried it would exacerbate the patient's
Dr. Cox: It's ibuprofen! Here's what you do. When she wakes up, get her to open her mouth nice and wide, then get some of those ibuprofen pills in your hands and throw them at her. Whatever sticks in there, that's the correct dosage.
And in the pilot episode, it was J.D. and regular strength Tylenol.
I mean this is just dumb. Like I’m sorry but this would happen with basically every medicine or drug. They aren’t made to be taken at higher doses than advised.
(Imagine you took 8 liters of beer per day for 3 days, you’d be half dead too.)
Moderation people…
You haven't seen the ridiculous quantities that some alcoholics will consume
Tolerance is a different beast. But 8 liters of beer is ridiculous.
Humans drink 2-3 liters a day. Of water.
You know what else is stupid? Pain management in the US. I get that you need to be careful about addiction, but the idea that people should have to suffer pain because we're having a pain medication "reefer madness" spasm is idiocy.
The guy just kept taking them until his teeth stopped hurting. Why is the alternative that he just has to put up with being in pain?
The fact that the drug companies lied about the addictiveness of their product so doctors were handing them out like candy didn't help.
Yes it is. I have had, over my 40 years as migraineuse (they started in my teens) 5 intractable migraines. Meaning less than once every 5 years I get one that lasts days, I cannot eat or drink, just puke. I used to be able to go to my doctor and get shot up with opiates and Phenergan, so much of it, they would do one dose, come back later, another, another, another, until finally I would say "it still hurts but I don't care" and go home nodding like a junkie, sleep and wake up with no headache, and, importantly, NO desire for more drugs.
Now the opiates are not allowed because they didn't work. But nothing works on the status migraine. Now they give you a cold cocktail IV of some sort of Advil and nausea medicine and it doesn't work either, and costs $2,000 because it can only be done in the emergency room not the doctor office.
It's adding insult to injury. There has to be some way to make these available for acute situations at least.
Is this real? Who gets a liver donor in 4 days?
The liver damage is very believable but a liver transplant after 4 days is absurd.
I think what's extra dangerous about Tylenol is that it doesnt feel like it's doing anything. When it works, some minor pain goes away, or maybe your fever goes down. But there's no side effects that you really feel, so I bet people get a false sense of security with it. Like, oh it isn't giving me opioid euphoria, or knocking me out. And you can just buy as much as you want, no restrictions. It must be perfectly safe.
It's people like this who make other people think any amount of painkillers is bad, and seem to get a sense of superiority about them for never taking any.
Even a little acetaminophen makes my liver feel funny the next day. Ibuprofen actually works for pain relief for me (migraines mostly) but it can cause stomach ulcers. Painkillers are definitely not something you can just use without thinking, and daily use especially can fuck your body up, ibuprofen is also hard on your kidneys.
Take the minimum effective dose as infrequently as possible.
He's not the first one to 'kill his liver' with paracetamol/ acetominophen (tylenol). First case I recall, the person was taking tylenol nightly with a glass of wine. Here's some links on the current understanding of Liver injury and paracetamol:
Apparently it's not always overdosing: Paracetamol-induced hepatotoxicity at recommended dosage (https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2796.2003.01097.x)
Acetaminophen-Induced Hepatotoxicity: a Comprehensive Update (https://pmc.ncbi.nlm.nih.gov/articles/PMC4913076/) "...in the United States, in particular, it accounts for more than 50% of overdose-related acute liver failure and approximately 20% of the liver transplant cases."
Risk Factors for Hepatotoxicity Due to Paracetamol Overdose in Adults (https://www.mdpi.com/1648-9144/57/8/752) "In the univariable analysis, significant hepatotoxicity risk factors were male gender, alcohol abuse, an ingested paracetamol dose, and a timespan from ingestion to hospital admission. The later one was the only significant risk factor in the multivariable model (adjusted odds ratio 1.08; 95% CI: 1.03–1.12)."
Paracetamol (acetaminophen) overdose and hepatotoxicity: mechanism, treatment, prevention measures, and estimates of burden of disease (https://pubmed.ncbi.nlm.nih.gov/37436926/) "Where data were available, we estimate that paracetamol is involved in 6% of poisonings, 56% of severe acute liver injury and acute liver failure, and 7% of drug-induced liver injury."
Understanding paracetamol-induced liver failure (https://link.springer.com/article/10.1007/s00134-014-3293-9)
It's why in the UK shops won't sell more than 2 packets at a time. It's statistically reduced the amount of people killing themselves with them (intentionally or by mistake).
I mean... Yeah. There are instructions on the packet. They aren't supposed to be eaten like candy.
Everyone's discussing ODing on OTC pain meds but the bigger part of this story is why he's in so much pain for so long without being able to see a Dr and receive treatment for chronic pain.
My brother in Christ, the paracetamol box LITERALLY says to never go more than 4 grams (4000 mg) in a 24hs period on any mg pills presentation
And as far as I see, that's a general rule with everything. Even those caramels for sore throat or reflux pills, where you'd need to eat thousands in a day to overdose, say the same
Don't fuck with medicine dudes
How much is a "packet"? edit: never mind, I found several conflicting answers in the other comments, no need to add even more and add to the confusion.
Isn't this why they specifically put acetaminophen in opioid+nsaid prescription painkillers, instead of ibuprofen or aspirin or naproxen? Just to discourage abuse because if you take too much it'll destroy your liver. Has always seemed a bit fucked up to me.
holy fuck how did that guy make it to adulthood without braincells...
ITT: People who don't know the difference between acute and chronic ODs and how a smaller amount over a long period can hurt you. 325mg APAP x4 will not kill you short term.
The problem was taking it every day over a long period.
Its still fucking stupid though.
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