APAP and My Liver

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Hoping to get some insight and maybe suggestions on the long term effects of APAP (acetaminophen). I've been under the care of a PM group for over a year now, and been given various IR formulations that all have contained APAP. Given the current prescribed frequency, I get between 2500 and 3000 mg of APAP every single day. Of course my docs don't believe there is any danger since it's under the magic 4g per day mark, but I'm still concerned. Anyone know of cases where people have experienced liver issues from long term APAP doses under 4g/day, or am I just being paranoid.

The other thing is approaching my PM doc about my concerns. I've been told by other CP patients that specifically asking about meds without the APAP, can be a red flag for the docs. But then what isn't these days! It really infuriates me that I feel I have to walk on egg shells when talking about my medication with my own doctors, but that's a whole other discussion.

 
IMHO Any amount of APAP is worse for you than street Heroin PERIOD I do not mean to scare you but straight oxy is 50 times better for you than anything with APAP IT IS THE SIL<ENT reason all types of normal people need new liver transplant

But the medical Commiunity will not tell you this as they send lobbyist to Washington and wine and dine the people who make the laws. They have succeded a small victory as the largest legal amount allowed in any pill wit APAP will now be limited to 325mg per pill.

The law was just passed. google it!

 
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IMHO Any amount of APAP is worse for you than street Heroin PERIOD I do not mean to scare you but straight oxy is 50 times better for you than anything with APAP IT IS THE SIL<ENT reason all types of normal people need new liver transplant

But the medical Commiunity will not tell you this as they send lobbyist to Washington and wine and dine the people who make the laws. They have succeded a small victory as the largest legal amount allowed in any pill wit APAP will now be limited to 325mg per pill.

The law was just passed. google it!
In the UK APAP (Paracetamol) is the Number 1 selling OTC pain medication. It's crazy. Everything has APAP in it.

UK GP's never, and I mean, never, prescribe anything that isn't combined with the Paracetamol liver killer.

I believe that it was only in the last few years that Markets, Malls and Pharmacy's were told y the Government to only sell 1 packet of Paracetamol product per customer.

Again it's one of the biggest causes of liver failure in the UK...well along with Alcoholism.

It took me 12 months to get my GP to prescribe me pure DHC Dihydracodeine 30mg. You realy can't get anything stronger unless you have Cancer.

UK sucks they're so paranoid about Drug abuse...

Best

MVT...X

 
After reading Robin Hoods post I did find where the FDA "warned" manufacturers and healthcare professionals to limit the APAP to 325mg. And this was over a year ago. Hopefully this shows a change in the mindset about the danger of APAP.

 
In the UK APAP (Paracetamol) is the Number 1 selling OTC pain medication. It's crazy. Everything has APAP in it.

UK GP's never, and I mean, never, prescribe anything that isn't combined with the Paracetamol liver killer.

I believe that it was only in the last few years that Markets, Malls and Pharmacy's were told y the Government to only sell 1 packet of Paracetamol product per customer.

Again it's one of the biggest causes of liver failure in the UK...well along with Alcoholism.

It took me 12 months to get my GP to prescribe me pure DHC Dihydracodeine 30mg. You realy can't get anything stronger unless you have Cancer.

UK sucks they're so paranoid about Drug abuse...

Best

MVT...X
Not much better in the states. The APAP is used as punishment a bit. When I was committed (I mean) admitted to a hospital they fed is to me even with high liver enzyme count. A Woman I knew that passed from cancer only got OC on the way out.

 
Not much better in the states. The APAP is used as punishment a bit. When I was committed (I mean) admitted to a hospital they fed is to me even with high liver enzyme count. A Woman I knew that passed from cancer only got OC on the way out.
What?????????That should & could be punishable by lawsuit should you ever have trouble with your liver later on.

One problem you would need all the hospital charts for that stay & I mean ALL!

Ever since the medical community finally convinced the pharmaceutical companies to lower it to 325 in each pill man that that could open the door for several estates of people who eventually lost their battle with the disease and were taking 4-8000mgs per day per hospital instructions.

Everytime I have a hospital stay or visit I ask for ALL the records of my stay & I DO MEAN ALL!!

 
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of course but it should not be taken every day for pain.

Read the warnings on a tylenol box!!!!!!!! You will never even want to touch a pill ever again!

 
Jesus

We have 'Calpol Liquid' for toddlers up to the age of 6...1 dose has 125mg APAP, supposed to give two does from the age of 2.

It scary.

 
In the UK APAP (Paracetamol) is the Number 1 selling OTC pain medication. It's crazy. Everything has APAP in it.

UK GP's never, and I mean, never, prescribe anything that isn't combined with the Paracetamol liver killer.

I believe that it was only in the last few years that Markets, Malls and Pharmacy's were told y the Government to only sell 1 packet of Paracetamol product per customer.

Again it's one of the biggest causes of liver failure in the UK...well along with Alcoholism.

It took me 12 months to get my GP to prescribe me pure DHC Dihydracodeine 30mg. You realy can't get anything stronger unless you have Cancer.

UK sucks they're so paranoid about Drug abuse...

Best

MVT...X

You think that sucks???

I broke my hand went in to an urgent 24 hr center it was around 3:45am, I was not under the influence of anything it was purely a work related incident which they covered thank god, and the f'ing doctor wrote me for 20x ibuprofen 800mg...I was like "ARE YOU F'ING KIDDING ME?!??" the bitch took an xray and as if my blackened/green hand wasn't obvious enough. She said it's our policy here to help aid in the process of preventing controlled substances from being diverted to the blackmarket or abused. Bitch please, went to my GP next day he saw it and said, "jesus christ they gave you ibuprofen only?!?" I left with 30 ambien (usually only #15), my usual fill on soma (60 w/fills), and 60x20 'contins and 60x5 mallinkroft instant percs, no tylenol. My doc understands and actually insisted on no tylenol containing pk's. He thinks it's evil when the pharm put in 500mg+ APAP in products as well and personally never writes anything over 325. When I moved he put in my record that I had *cough cough* severe GI issues with any acetaminophen containing products for the sole purpose that if and when I found a new doc I would never get any kind of pain killer with any APAP in it. I miss my old doc.

 
theres a new class action lawsuit in the us against these companies that use APAP and the liver damage it has caused. If I were you i would push your doctor to prescribe medicines like norco 10-325 (same as lortab 10-650) but half the aceto. even better if you are on lortab 5's you'll get 1/4 of the aceto if you cut the 10-325 in half. Also if you are on percocets then suggest moving up to roxicodone and possibly splitting them in half or whatever you need to as they have more oxycodone. Some doc's insist that the aceto will not do anything to you. The best thing to tell them is that relatives, usually parents, siblings, grandparents have a history of liver problems that docs believe is due to aceto. so if you show the doc you are at a high risk then they will be more apt to give you what you want. Also if you are trying to go to roxy from percs you may want to stress that you don't want an increase in dosage, just the lack of aceto... like if you take 90 percocet 7.5 ask for 45 roxi 15mg and split them in half.

 
What you can do, this is a little bit dicey but guaranteed to get you pk meds w/o APAP. Request bloodwork, the night before go out and drink with your buddies, first thing in the morning drink 1/4 -1/2 bottle of cough syrup before the blood work. Your AST and EST will be elevated especially your AST. I did this after a recommendation from a friend, jacked up my AST levels showed a doc got what I wanted. If you have a gp who understands just ask and tell him everytime you take "X product which happens to contain APAP" you feel nauseous and sick. To seal the deal you need to be allergic to codeine (which is actually more common than you think). That leaves only semi/primarily synthetic based pk meds and the first line is: oxy.

 
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This is probably a stupid question, but is ibuprofen damaging like APAP? The only thing APAP has ever done for me is break a high fever, for which I take it once or twice a year. It does absolutely nothing for pain. The reason I'm asking is:

  • Reprexain 10/200 (containing Hydrocodone and Ibuprofen)
  • Reprexain 2.5/200 (containing Hydrocodone and Ibuprofen)
  • Reprexain 5/200 (containing Hydrocodone and Ibuprofen)
  • Reprexain 7.5/200 (containing Hydrocodone and Ibuprofen)


I had no idea these existed. If they aren't as harmful as something like Norco, they would be a God's send.

You think that sucks???

I broke my hand went in to an urgent 24 hr center it was around 3:45am, I was not under the influence of anything it was purely a work related incident which they covered thank god, and the f'ing doctor wrote me for 20x ibuprofen 800mg...I was like "ARE YOU F'ING KIDDING ME?!??" the bitch took an xray and as if my blackened/green hand wasn't obvious enough. She said it's our policy here to help aid in the process of preventing controlled substances from being diverted to the blackmarket or abused. Bitch please.
At least she admitted she was a tool. I had a doctor once tell me opiates were inferior to NSAIDs. Thankfully he wasn't MY doctor, just some tard I happened to get in on a sandwich shop debate with, but shit. I'm very glad you had that GP though! No small blessing.

 
Thank you immensely for answering my question! I always assumed ibuprofen and aspirin were basically the same as APAP. About the 2.5/200 are on the list to ask my doc at my next appointment. I've shied away from regular prescription meds for several years now, because I had an aunt die of liver failure as well as a cousin, at ages 58 and 35, respectively.

I can't believe how great this board is! Everyone on here is the best! B)

 
Robin Hood aka Sherwood said:
the 1st number is the amount of Hydro that is so low I dont think you will even feel it. the lowest I have ever gone with Hydro is 7.5 but I prefer 10. If I were given a script I get the ones that are vicoprofen 10-400 I forget the exact number but the 1st number is the Hydro Which is an extremely weak pain killer IMHO not even worth the wd's that come when stopping them!
There's two factors that make me a bit different. One is physics, as I'm only 5'0" and 100 lbs. Sucks in most cases, but it makes the meds cheaper. /default_tongue.png The second is my other medications are potentiators for opiates and make me quite noticeably more sensitive to them. As far as the WD I only use the more potent stuff (I'm lucky, hydro is somewhat potent for me) on my bad days, one or two times a week. On my absolute worst it takes an oxy, but thankfully that only happens once every month or two. So I think I'll try to start with the 2.5s and see where that gets me. If I need them stronger I can always adjust later, and with the profen being 200, I could double for 5/400 until that time.

Thank you infinitely for the concern though and especially for not talking to me like I'm a junkie because I need some pain medication. I wish I knew this place existed years ago.

 
Don't forget that NSAIDS (ibuprofen, asprin, etc.) have their own negative side effects if taken long term. Most notably they can damage your stomach and/or esophagus. Ironically is seems the opiods themselves are "safer" component to all these medications. We'd all be better off if they would stop combining the medications and let us take them seperately if we need to!

 
Don't forget that NSAIDS (ibuprofen, asprin, etc.) have their own negative side effects if taken long term. Most notably they can damage your stomach and/or esophagus. Ironically is seems the opiods themselves are "safer" component to all these medications. We'd all be better off if they would stop combining the medications and let us take them seperately if we need to!
Rember Ibruprohen/NaproxeN/Melicam or or NASAIDS are great for anti inflametary but I find NO painkiller in them. Be careful.

Take low dosage Ibruprohen and the opiate of your choice preferably without. APAP.

Stay well

Best

MVT ...X

 
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Have any of you guys ever heard of or tried to do a Cold Water Extraction?

Worst case scenario, if you get a script for whatever and it's mixed some of the nasty apap/etc stuff nobody wants with their meds (which happens really often) you could just cold water extract all that shit out and be left with just the pk itself.

It's a really easy process. You don't need ANY chemical or scientific knowledge, and really the only equipment you need is something to crush the pills, a bowl, a glass, and a coffee filter. :)

 
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