NewsBrief - Fibro meds

[INaBOX]

NEWSBRIEF: The U.S. FDA says it's asking the makers of combination painkillers to limit the amount of acetaminophen the drugs contain and to start including warning labels about the dangers of liver damage. Acetaminophen is the drug in Tylenol.
This will effect several of the drugs that are commonly used to treat fibromyalgia pain, including Vicodin (hydrocodone/acetaminophen), Percocet (oxycodone/acetaminophen), and Tylenol with codeine. The level of acetaminophen in these drugs will drop to a maximum of 325 mg.

read more here:
http://chronicfatigue.about.com/
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[PickMeUpRoadie]

Originally Posted by INaBOX

NEWSBRIEF: The U.S. FDA says it's asking the makers of combination painkillers to limit the amount of acetaminophen the drugs contain and to start including warning labels about the dangers of liver damage. Acetaminophen is the drug in Tylenol.
This will effect several of the drugs that are commonly used to treat fibromyalgia pain, including Vicodin (hydrocodone/acetaminophen), Percocet (oxycodone/acetaminophen), and Tylenol with codeine. The level of acetaminophen in these drugs will drop to a maximum of 325 mg.

read more here:
http://chronicfatigue.about.com/
scroll down mid way

They honestly should have done this from the start. Thanks for the link.

[Fortune]

Originally Posted by INaBOX

NEWSBRIEF: The U.S. FDA says it's asking the makers of combination painkillers to limit the amount of acetaminophen the drugs contain and to start including warning labels about the dangers of liver damage. Acetaminophen is the drug in Tylenol.
This will effect several of the drugs that are commonly used to treat fibromyalgia pain, including Vicodin (hydrocodone/acetaminophen), Percocet (oxycodone/acetaminophen), and Tylenol with codeine. The level of acetaminophen in these drugs will drop to a maximum of 325 mg.

read more here:
http://chronicfatigue.about.com/
scroll down mid way

Wow, I cannot believe it's taken this long.

I feel like 325 mg is still too high, but I think acetaminophen is a terrible drug and should actually just be replaced.

[PickMeUpRoadie]

Originally Posted by Fortune

Wow, I cannot believe it's taken this long.

I feel like 325 mg is still too high, but I think acetaminophen is a terrible drug and should actually just be replaced.

That is a little extreme imho. APAP works well for headaches and is pharmacologically different from ibuprofen and naproxen sodium (meaning it will be work on different issues and can be used at the same time). There is even evidence that it works on the cannabinoid system on some level.

Less of it, yes. Elimination, no.

[Fortune]

Originally Posted by PickMeUpRoadie

That is a little extreme imho. APAP works well for headaches and is pharmacologically different from ibuprofen and naproxen sodium (meaning it will be work on different issues and can be used at the same time). There is even evidence that it works on the cannabinoid system on some level.

Less of it, yes. Elimination, no.

Hey, I tend toward black and white thinking, and am reacting to the overmarketing of acetaminophen in simply everything.

[TheRoof]

Originally Posted by Fortune

Hey, I tend toward black and white thinking, and am reacting to the overmarketing of acetaminophen in simply everything.

Acetaminophen is used a lot of the time to prevent abuse in the more "Smarter" patients (a GOOD chunk of them are narcotic seekers) who know their drugs.

My uncle is an MD, and he always used to tell me patients would come to his office and he would prescribe them prescription strength tylenol (Acetaminophen products) for some pain-problems, then they would claim they were "Allergic" to Tylenol and they were wanting Oxycontin/Codone instead.
Too bad those "patients" don't realize that Oxycontin has a huge amount of acetaminophen in it.
The scare tactic works, for me.
I heard it takes 12-14 Tylenol at the same time. To really mess up a totally healthy persons liver.

BUT hey, if that's the risk they want to take with their lives. They should read the instructions before taking it. Taking too much of anything is bad for you.

[Canuck223]

Originally Posted by TheRoof

Acetaminophen is used a lot of the time to prevent abuse in the more "Smarter" patients (a GOOD chunk of them are narcotic seekers) who know their drugs.

My uncle is an MD, and he always used to tell me patients would come to his office and he would prescribe them prescription strength tylenol (Acetaminophen products) for some pain-problems, then they would claim they were "Allergic" to Tylenol and they were wanting Oxycontin/Codone instead.
Too bad those "patients" don't realize that Oxycontin has a huge amount of acetaminophen in it.
The scare tactic works, for me.
I heard it takes 12-14 Tylenol at the same time. To really mess up a totally healthy persons liver.

BUT hey, if that's the risk they want to take with their lives. They should read the instructions before taking it. Taking too much of anything is bad for you.

I believe most tylenol products advise to avoid taking greater than 4 grams every 24 hours. For people taking it on a daily basis, I'm frankly nervous at levels above 2.5 grams a day.

You've only got one liver. You've got to keep it healthy.

If I was an MD dealing with people with chronic pain, I think I'd be tempted to try and Rx Fentynol transdermal patches rather than the combined meds. They seem like a good option to deal with a short term need like post surgery. For long term chronic use, not so much.

[Fortune]

Originally Posted by TheRoof

Acetaminophen is used a lot of the time to prevent abuse in the more "Smarter" patients (a GOOD chunk of them are narcotic seekers) who know their drugs.

Your explanation does not change my opinion of the use of acetaminophen in prescription pain medications.

There are also many reasons why tylenol can cause liver problems at lower doses for people who are using the medication legitimately:

http://www.lef.org/magazine/mag2007/...inophen_01.htm

[Lunacie]

Not to mention the increased risk of high blood pressure when taking tylenol or aleve or ibuprofen - the doctor I was seeing a couple of years ago was clueless about this. I did my own research and discovered this for myself. Within three days of stopping all O-T-C meds, my blood pressure was back to normal when taking three anti-hypertensive meds at the same time hadn't done squat.

http://www.msnbc.msn.com/id/8961817/

[TheRoof]

Originally Posted by Fortune

Your explanation does not change my opinion of the use of acetaminophen in prescription pain medications.

There are also many reasons why tylenol can cause liver problems at lower doses for people who are using the medication legitimately:

http://www.lef.org/magazine/mag2007/...inophen_01.htm

Sure... acetaminophen serves its purpose. For majority of the general public. They are perfectly content with it. From a marketing perspective, a team knows that an average "Tylenol" user will not overuse the medication.It's only if you are an outlier who decides to taste fate with your liver.

It's a pain reliever/fever reducer. For the good chunk of the population (Not considering the outliers it serves its purpose, but anything in large quantities is bad for you. ) An average person can take over 4000mg per day.
***In recommended doses (If taken with instruction the side effects are mild to non-existent) It's not a blood thinner or cause gastric irritation. In fact an Rx pain medication (Specifically Opiates) will cause more nausea and irritability in your GI tract (On top of acidification) then acetaminophen itself.


I have a minor in Chem, so I had to take 400 level course on pharmaceutical chemistry compounds. Lol
Of course we all know abuse of acetaminophen will cause hepatic change in your liver and kidneys. I remember we were writing a topic about the ethical considerations of mixing certain salts and fillers that if taken in large doses could be more toxic than the actual "main" substance in itself. That borders an ethical issue that point. I do agree that dosage SHOULD be lowered.

[Lunacie]

Originally Posted by TheRoof

Sure... acetaminophen serves its purpose. For majority of the general public. They are perfectly content with it. From a marketing perspective, a team knows that an average "Tylenol" user will not overuse the medication.It's only if you are an outlier who decides to taste fate with your liver.

It's a pain reliever/fever reducer. For the good chunk of the population (Not considering the outliers it serves its purpose, but anything in large quantities is bad for you. ) An average person can take over 4000mg per day.
***In recommended doses (If taken with instruction the side effects are mild to non-existent) It's not a blood thinner or cause gastric irritation. In fact an Rx pain medication (Specifically Opiates) will cause more nausea and irritability in your GI tract (On top of acidification) then acetaminophen itself.


I have a minor in Chem, so I had to take 400 level course on pharmaceutical chemistry compounds. Lol
Of course we all know abuse of acetaminophen will cause hepatic change in your liver and kidneys. I remember we were writing a topic about the ethical considerations of mixing certain salts and fillers that if taken in large doses could be more toxic than the actual "main" substance in itself. That borders an ethical issue that point. I do agree that dosage SHOULD be lowered.

Just once I'd like to be an "average person."

I was taking maybe 4 Excedrin a day for daily headache following trauma to arm/shoulder/neck and developed extreme high blood pressure. We're talking serious risk of stroke or heart attack. Doctor prescribed three (3!) anti-hypertensives and my blood pressure remained high. Finally I did my own research, found this risk with tylenol and hypertension, stopped taking it and within 3 days my blood pressure was back to normal. How's that for ab-normal?

[Fortune]

I don't see the point in arguing this. I've made my point and defending increasingly unethical stances isn't convincing.

As far as it goes, from what I've read when I've researched this, many of the people who have suffered from acetaminophen toxicity didn't know that they had reached a toxic dose because the bottles themselves don't - or didn't at the time - have enough information on them, or they didn't know they were unable to tolerate recommended doses. If you're saying it's cool to sell a product with such a high-risk profile, I don't see the point of a back and forth.

[Piper30]

Originally Posted by Fortune

I don't see the point in arguing this. I've made my point and defending increasingly unethical stances isn't convincing.

As far as it goes, from what I've read when I've researched this, many of the people who have suffered from acetaminophen toxicity didn't know that they had reached a toxic dose because the bottles themselves don't - or didn't at the time - have enough information on them, or they didn't know they were unable to tolerate recommended doses. If you're saying it's cool to sell a product with such a high-risk profile, I don't see the point of a back and forth.

How do you know if you have reached a toxic dose? Ive been afraid of my tylenol intake for some time now. I am prescribed hydrocodone/APAP 10/325 up to 6x daily though I limit myself right now to three because of my fear. I did convince my Dr to switch me from 5/500 to reduce tylenol. My pain is quite severe right now and his wish is for me to use a patch or switch to oxy or some morphine capsule thing. But I for now refuse. I've seen too many episodes of "Intervention" where oxys were a huge problem and my fear of taking strong pain meds now at 30 and 1)becoming 100% dependant or 2)becoming so tolerant that 10 years from now I am on stronger meds or start developing resistance.

I have seen my sister struggle with this, dx with Lupus and now 48 she struggles daily with her pain much more than when she was my age. Also my mother who is dx with rhematoid arthritis and Fibromyalgia was taking ultracet and hydrocodone/apap, now just the hydro she is in constant pain...at 80 and with heart problems and diabetes she is limited on what she can take. I always consider them when I am deciding my treatment.

I have suffered from fibro for many years, pious had been the suspect but over a year ago an official fibro dx was made. Recently dx with rhematoid arthritus and of course my adhd which was dx'd as a child but not treated until a little over a year ago. I also suffer from daily headaches and once every few months or so severe migraines. RX meds for severe migraines but excedrin seems to be the only thing that helps curve my rather bad frequent head pain.

Also what concerns me greatly is many many moons ago at what was my darkest hour as a young, young woman I attempted suicide. Two of my attempts in one week contained tylenol. First was a small bottle of tylenol pm along with other pills I found of my motherd and second attempt was a large amount of tylenol simply sleep. It was nothing short of a miracle not only that i survived but to my drs astonishment my liver had made it out relatively ok.

That experience along with my knowledge of tylenol danger has me very scared to take my own pain meds...sorry I babbled. So, how do you know if you have or are reaching toxic levels? Also does anyone have experience with different pain meds that do not have tylenol and might be considered addictive?

Me=adderal 15mg 3x daily, cymbalta 60mg 1x daily, hydrocodone/apap 10/325 up to 6x daily (again, currently take max 3daily), excedrin as needed, topamax for migraine prevention 100mg and tons of supplements

[Lunacie]

I haven't tried accupuncture for the FibroMyalgia as I've been in remission,
but I did get accupunture treatments for the daily headache which "cured"
them and reduced the migraines as well.

If the Fibro should ever return in full force like I lived with it for many years,
I'd certainly give accupuncture a try. I went to a Chinese Clinic where they
really know their stuff. They study for years to become doctors of Chinese
medicine.

[Fortune]

Originally Posted by Piper30

How do you know if you have reached a toxic dose?

I don't know, but it's probably a good idea for your doctor to check your liver function if you're on really high doses.

Most of the cases I've heard of involved acute liver failure.