Liver Damage?

[Mild_Man]

I am by no means an experienced drug user. The only things I've done would be alcohol a few times and I smoke cigarettes once in awhile. I got a bottle of hydrocodone pills for my wisdom teeth but never needed them, so I saved them in case I would ever wish to try them later on. Now, I've read that for severe liver damage to occur with APAP, an amount of 7g+ is needed over a 24hr period and the reccomended dose for Tylenol is 4g max a day for an adult. I tried one of them one day and then the following weekend took three. Now, what I'm asking is that can liver damage still occur in doses below the 4g max of APAP? And also, does the threat of liver damage increase if you take more of the daily reccomended dose but just take it all at once? I don't know if 1.5-2.0 grams of APAP once a week would do any harm and if so if I should bother extraction.

-Thanks for any insight

[candy]

Hi Mild Man,
As a nurse, I think your OK. Unfortunately, Acetominophen can be toxic to the liver in high doses. In the case of an intentional overdose it can be fatal. It is a common way for teens to overdose. Something I had seen when I worked in Pediatrics.
With acetominophen(Tylenol) it is metabolized in the liver and produces a metabolite that decreases glutathione, an antioxidant in the liver. In large doses, the supply of glutathione is decreased by the metabolite, resulting in necrosis of the liver. Although this is not fatal, chronic use of Tylenol can lead to a decrease in the function of the liver.
With some of the narcotics containing acetominophen, such as Vicodin, Codeine, Darvocet; When abused or taken in excess, liver damage can occur.
Symptoms of liver damage may not be seen until a great deal of damage has occured.
As I said, I think your OK, if taking them every so often and only a few at a time.
But, I am not a doctor or a pharmacist and don't know your physical history. Just making a suggestion not giving medical advise.
Good luck.

[Mild_Man]

Yeah, thanks for the insight. Just wondering, again, now would taking a safe dose say for a 24hr period but taking it all at once overload the liver, even though it's still a safe dose I'd just be taking it all at once?

[candy]

Hey Mild Man,
IMO as long as it is a safe dose, I think you should be OK. Taking it over a 24hr. period as prescribed should not be a problem.

[Mild_Man]

Hey Mild Man,
IMO as long as it is a safe dose, I think you should be OK. Taking it over a 24hr. period as prescribed should not be a problem.

Yeah, I know that for Tylenol the reccomended dose is 4g for 24hr period. I'm still just wondering like say I had a safe dose that is even lower than what Tylenol reccomends for a daily max dosage but I take it all at once. Will this oversaturate the liver even though it is perfectly fine over a 24 hour period, even below what Tylenol advises? Sorry if I am repeating myself or if you have already answered it but I don't know much about this stuff. :(

[candy]

Hey Mild Man,
It is really hard to say. I don't want to suggest that you do take the dose you would like to all at one time and then say something awful happens to you.
I really don't like to advise anyone to do anything that could be potentially harmful.
Being a nurse, I try to educate and make suggestions on topics such as prevention.
IMO you should trust your gut instinct. I doubt that any type of fatal reaction will occur and if someone were to be doing this on a daily basis, I might suggest cutting down to avoid long term problems.
I hope this is helpful in some way. I just don't feel comfortable telling you to take them and everything will be fine. I would feel terrible if something happened to you.
As someone who dabbles in opiates myself, I try to advocate for others and provide education to keep those who use safe.
I don't want to scare you off from asking questions or seeking information, so please don't hesitate to do so on in a forum post or in a private message.
Be well

[Mild_Man]

Hey Mild Man,
It is really hard to say. I don't want to suggest that you do take the dose you would like to all at one time and then say something awful happens to you.
I really don't like to advise anyone to do anything that could be potentially harmful.
Being a nurse, I try to educate and make suggestions on topics such as prevention.
IMO you should trust your gut instinct. I doubt that any type of fatal reaction will occur and if someone were to be doing this on a daily basis, I might suggest cutting down to avoid long term problems.
I hope this is helpful in some way. I just don't feel comfortable telling you to take them and everything will be fine. I would feel terrible if something happened to you.
As someone who dabbles in opiates myself, I try to advocate for others and provide education to keep those who use safe.
I don't want to scare you off from asking questions or seeking information, so please don't hesitate to do so on in a forum post or in a private message.
Be well

Yeah, I understand how it's hard to give out advice since everyone's body's function differently. Thanks for the advice though. I think once a week or less of this moderate dose should be alright, also since I'll probably run out of them anyways and won't use them again since I don't really know any drug connections.

[duke_nemmerle]

The guidelines I'd use are to try to avoid going over 4G of acetiminophen in a 24 hour period and don't mix large doses of acetiminophen with alcohol. I haven't always followed said guidelines, but I'd say that if you do, you're likely to be able to safely consume without much liver damage. Then again, day in day out usage of 4G likely isn't great on your liver either.

[GMorris]

For goodness' sake! I don't think I've EVER seen such a paranoid drug abuser in my life. Over the years I've taken handfuls of Percocets and Hydrocodone pills at a time and I actually went to a GI expert to find out if there were any harmful effects. The doc took my blood and made me wait several days, then said that I had only "high triglycerides", which I expected. I was taking 10 - 12 of the Lortab 7.5/500 at the time and drinking moderately to excessively as well. Needless to say, I'm still alive and (as far as I can tell) well. I was really worried that my liver had suffered severe damage, and don't get me wrong, it can over time, but a few heavy doses aren't likely to hurt anyone, especially if they are young and healthy to begin with. Your results may vary, but at 40 years old I tested just fine and am still kicking (not dope) at 44!

[Mild_Man]

For goodness' sake! I don't think I've EVER seen such a paranoid drug abuser in my life. Over the years I've taken handfuls of Percocets and Hydrocodone pills at a time and I actually went to a GI expert to find out if there were any harmful effects. The doc took my blood and made me wait several days, then said that I had only "high triglycerides", which I expected. I was taking 10 - 12 of the Lortab 7.5/500 at the time and drinking moderately to excessively as well. Needless to say, I'm still alive and (as far as I can tell) well. I was really worried that my liver had suffered severe damage, and don't get me wrong, it can over time, but a few heavy doses aren't likely to hurt anyone, especially if they are young and healthy to begin with. Your results may vary, but at 40 years old I tested just fine and am still kicking (not dope) at 44!

Yeah, well everyone's body's react differently but yeah I didn't figure a little bit here and there would do any damage or any harder damage. I just was worried since on erowid.org some guy was saying how you really shouldn't take more than 2 of the things because of liver damage even though I thought to myself that's still way below the daily allotted limit for APAP intake.

[DaOxyMan]

hey bro you'll be alright..don't abuse em too much but i take bout 5g tylenol a day prescribed to me asi have been for years and i'm cool..also when i used to only do vics/percs, i would often eat up to 15 or so vics at a time, which is way too much apap and i'm fine i think.but then again im an idiot.and only 19 so who lknows maybe my livers about to fail but all that is just a precaution.just don't take mass amounts of APAP if you don't have to thats my advice..im from OHio too man what city ill hook you up with some connect?

[msdope]

Hey, I'm just starting to worry about my liver after years of abuse. I too did like ten to fifteen perc's or Lortab (my favorite) at a time. I'm alive, and who knows if my liver is screwed or not. I'm not yellow nor are the whites of my eyes so I take that as a good sign.

Pretty much if you're looking to get high you won't worry if you even have a liver left. I was taking ten to fifteen Tylenol PM's at a time unti recently. Now that I stopped because I ain't getting high off them.

Good luck to you. You'll be O.K. I think.

[Mild_Man]

hey bro you'll be alright..don't abuse em too much but i take bout 5g tylenol a day prescribed to me asi have been for years and i'm cool..also when i used to only do vics/percs, i would often eat up to 15 or so vics at a time, which is way too much apap and i'm fine i think.but then again im an idiot.and only 19 so who lknows maybe my livers about to fail but all that is just a precaution.just don't take mass amounts of APAP if you don't have to thats my advice..im from OHio too man what city ill hook you up with some connect?

:) A connection would be nice but I still don't know you. I live like an hour an a half or less east-northeast of Cleveland so it's probably a wee-bit too far. Yeah, I think the occassional amount I'm doing should be fine even though I'm doing it all at once. I think it'll just oversaturate the liver if you take it in a high amount all at once or over a day accumulated.

[GMorris]

I've heard of folks who would take as many as 60 hydro pills a day, and 12 - 15 at one time, yet they never had any liver damage and that's after months, even years of that kind of abuse. At the same time, an old friend of mine who was REALLY desperate for a buzz drank a big bottle of NyQuil, which had somewhere around 6 -10 GRAMS of Tylenol in it. He was admitted to the hospital that day and almost died because of it. Some people are just more sensitive to the stuff. I think my buddy was also drinking pretty heavily at the time, which probably made it much worse than it usually would have been. Just plain stupidity!

[candy]

The liver is one of those organs that can function with a moderate amount of damage. Because the liver is the only organ that can regenerate it itself, symptoms of damage, may not be seen until there is extensive damage done.
And as I said, everyone is different. Factors include a history of liver disease or alcoholism.
Being a nurse, I just don't feel comfortable encouraging anyone to take any kind of medication over the prescribed dose. It is a personal decision and something I just don't do.

While I encourage questions and want anyone to feel free to ask, I will not encourage anyone to take more than the prescribed dosage. I would feel like shit if someone followed my advice and something happened, whether serious or not.
You have to respect that.

[Mild_Man]

The liver is one of those organs that can function with a moderate amount of damage. Because the liver is the only organ that can regenerate it itself, symptoms of damage, may not be seen until there is extensive damage done.
And as I said, everyone is different. Factors include a history of liver disease or alcoholism.
Being a nurse, I just don't feel comfortable encouraging anyone to take any kind of medication over the prescribed dose. It is a personal decision and something I just don't do.

While I encourage questions and want anyone to feel free to ask, I will not encourage anyone to take more than the prescribed dosage. I would feel like shit if someone followed my advice and something happened, whether serious or not.
You have to respect that.
Yeah, there's always a risk of negative consequences with any drug so one can never definitely advise someone it's safe to go ahead with it, especially taking more than is reccomended.

[duke_nemmerle]

For goodness' sake! I don't think I've EVER seen such a paranoid drug abuser in my life. Over the years I've taken handfuls of Percocets and Hydrocodone pills at a time and I actually went to a GI expert to find out if there were any harmful effects. The doc took my blood and made me wait several days, then said that I had only "high triglycerides", which I expected. I was taking 10 - 12 of the Lortab 7.5/500 at the time and drinking moderately to excessively as well. Needless to say, I'm still alive and (as far as I can tell) well. I was really worried that my liver had suffered severe damage, and don't get me wrong, it can over time, but a few heavy doses aren't likely to hurt anyone, especially if they are young and healthy to begin with. Your results may vary, but at 40 years old I tested just fine and am still kicking (not dope) at 44!

Yo man, I'm not being smart with ya at all, but the guy will hopefully stay paranoid. If I had, I'd be a lot happier today I'm sure :)

[Zoop]

Yeah, that's what it is. Some people's bodies are just real sensitive to APAP, some are not.

Myself, I guess I am not. Back about five years ago, I was taking 10 lortab 10/500's (half gram APAP per tablet) four times a day. That was a total daily dose, day in and day out, of 20 grams tylenol per day. After about a year of that, when I ended up in rehab (big surprise, huh?), they did some liver tests on me and it turned out that my liver enzymes were pretty high. I never felt sick or anything from it, but it was damaging my liver.

That is the extreme (20 grams APAP a day), so man, like 5 grams of tylenol is not gonna do anything.

Some people, on the other hand, DIE from taking 20 grams of tylenol. It is a relatively popular way of offing oneself.

Milk thistle extract is an EXCELLENT herbal supplement for allaying the toxic effects on the liver, and also, glutathione, which I think you can buy in supplement form.

[GMorris]

Well, I'm not asking anyone to kill themselves or anything, but there is such a thing as being TOO paranoid. Hell, if you want a buzz bad enough, you won't heed too many warnings anyway, at least that's been MY experience! I'm thankful that I don't need or want any kind of APAP mixtures. Only the occasional Tylenol PM when I haven't had any alcohol. Even on those nights I'll still think about it, ain't that weird?

[Mild_Man]

I like hydrocodone but I'm starting to notice how weak it is, even taken in sufficient quantities and after waiting enough time for tolerance to basically diminish.

[paesan]

If your that worried about liver damage just do a cold water extraction, that should remove most of the apap...

[Arok11]

You know you can crush up Vics or Percs, mix with warm (not hot) water, then cool the water, strain it through a coffee filter, and remove the majority of the tylenol, while retianing the majority of the narcotic. Drink the filtered solution, and your liver will thank you:)

[SomniGod]

I agree... being a big advocate of the ol CWE... I would knock out that nasty apap...and drink down a healthy dose of hydrocodone... that's ME... to each his own. mmmm.... remember when 30mg's hydrocodone got ya rocked?!?!? The good ol days!

~S~

[Mild_Man]

You know you can crush up Vics or Percs, mix with warm (not hot) water, then cool the water, strain it through a coffee filter, and remove the majority of the tylenol, while retianing the majority of the narcotic. Drink the filtered solution, and your liver will thank you:)
Yeah, I might do that if I can get some more but I'm worried I'll lose too much hydro. How many mgs of hydro is usually lost through the extraction method?

[ontario_opiophile]

At some points when I was younger I would take like 60 Tylenol 1's. I would feel REALLY ill about 40 minutes later and it's been about 5 years since and my liver is fine. A friend told me I was going to have liver failure within 2-3 days and I was pretty worried for a while. But I did live and my liver is fine. I've never have a problem with it so far. I highly doubt taking 12 hydro pills a day will harm you if you do it for even a long period of time. It could harm some people but It wouldnt harm me. If you wanted to take a few hydro's occasionally then you wouldnt have a problem, just don't exceed 8 a day, and don't take them for long periods of times. If you have hepatitis or something that comprimises your liver you might wanna do a cold water extraction so it will be easier on your liver. No one should take more than 5 pills at once. I really recommend doing a cold water extraction if you're going to be consuming more than 5 pills every 8 hours. Most of us need way more than 5 plls every 8 hours to maintain a buzz so all the "hard-core" junkies would benefit from the cold water extraction. I'm not a doctor so don't take my advice. It's not proven to be safe, this is just what I would believe is safe, so don't take anything literally. Research acetaminophen and hydrocodone to find out as much info as you can so you can weigh the pro's and the con's and make an informed decision. It's generally safe to use up to 3-4 grams (3000-4000mg) of tylenol per day. But this is in no way a set rule or fact. It's just what the tylenol(acetaminophen) company says on their packages. Also, don't use 3-4 grams a day for a long time or you probably willdamage your liver, despite what the tylenol company says. If you do overdose and take enough to start giving you bad side effects, seek help. Don't confuse too much hydrocodone with too much tylenol though. There is an antidote for tylenol poisoning that can be given if you take large amounts. The damage from tylenol takes 2-3 days to set in so you have limited time and you may not even notice there is damage till it's too late. All they do is give you another drug which is the antidote and you are pretty much cured of the od of tylenol. I think you can buy it in health food store too(but i'm not sure). It's called, N-acetyl-cysteine and is available in the hospital if you can't get find it anywhere else. Sorry for the rant. I just wanted to clarify everything for people who are ill informed. Most of you know all this already.

[GMorris]

I like hydrocodone but I'm starting to notice how weak it is, even taken in sufficient quantities and after waiting enough time for tolerance to basically diminish.

I got seriously burnt out on it. If a doctor gave me a hydro script, it'd probably just sit around for ages until/unless I just had nothing else and was jonesing. Last time I tried some, I took 3 of the 7.5's and didn't feel a damned thing, even with a little beer. I know they were fresh too, as I have a friend who's in a wheelchair that gets those for "breakthrough" pain (when his MS-Contin doesn't cut it). The guy's a drugstore on wheels!

[Mild_Man]

I don't know if I should really worry about this but it's starting to bother me. About a day ago I did a CWE on 15 generic hydrocodone pills: 10mg hydro / 500mg APAP so all and all the acetaminophen level was around 7.5g. Now the first time I filtered it the solution was fairly clear which told me alot of apap was taking out but when I took the sludge and mixed it with water in the refridgerator I don't think I got it cold enough this time because the resulting solution was more milkier. I mixed both of these and took it later that night. I'm getting kind of scared that I seriously damaged my liver because that second filtering might have let alot more apap back in. I hope that in a few days I don't get hepatoxicity or something like that. I heard that in well-nourished, non-alcoholic adults 7.5gcan be enough for toxicity with anything over increasing the risk for lethality. Do you guys think I will have major problems with this 7.5g of APAP? I still got out about a spoonful of APAP sludge and I also think along the way of crushing the pills I may have lost some powder along with also losing some of the sludge on the bowl. I hope this is the case so then I really didn't take in 7.5mg. I also took 800-1000 mg of guaifenesin which is still below the daily limit. Sorry if this is so long but if you skim through it tell me what you think.

[poppy]

Well, I'm not asking anyone to kill themselves or anything, but there is such a thing as being TOO paranoid. Hell, if you want a buzz bad enough, you won't heed too many warnings anyway, at least that's been MY experience! I'm thankful that I don't need or want any kind of APAP mixtures. Only the occasional Tylenol PM when I haven't had any alcohol. Even on those nights I'll still think about it, ain't that weird?
Mokelly this post by Gmorris is a perfect example of how an adult should conduct him/herself during a discussion, see no hostility, no hysteria!!

PS Mild man I'm pretty sure you'll be fine, but its hard for any of us to give u the green light to use, imagine if we were wrong and you were the one in a million statistic. Like Gmorris, I have taken literally hundreds of risks drug wise over the years, there was much less information about then,I thought I was invincible till I hit 30, then I started thinking.Ishould say that incidently most of the people I've lost have been down to suicide rather than drug over dose. Maybe u should be looking at the impact drug abuse may have on your mental health which in my experience is far more prevelant than death from overdose.Beingmale, your liver should stand slightly more abuse, like everything else women draw the short straw at least in terms of the impact alcohol has on the liver (Candy will no doubt be able to advise much better than me on this I'm not sure if the same thing applys with drug abuse. At the end of the day when its your time to go its your time to go.

[Mild_Man]

Mokelly this post by Gmorris is a perfect example of how an adult should conduct him/herself during a discussion, see no hostility, no hysteria!!

PS Mild man I'm pretty sure you'll be fine, but its hard for any of us to give u the green light to use, imagine if we were wrong and you were the one in a million statistic. Like Gmorris, I have taken literally hundreds of risks drug wise over the years, there was much less information about then,I thought I was invincible till I hit 30, then I started thinking.Ishould say that incidently most of the people I've lost have been down to suicide rather than drug over dose. Maybe u should be looking at the impact drug abuse may have on your mental health which in my experience is far more prevelant than death from overdose.Beingmale, your liver should stand slightly more abuse, like everything else women draw the short straw at least in terms of the impact alcohol has on the liver (Candy will no doubt be able to advise much better than me on this I'm not sure if the same thing applys with drug abuse. At the end of the day when its your time to go its your time to go.

Yeah, I really hope I didn't mess anything up. I shouldn't have mixed in the second filtered solution in with the rest because it had more apap in it.

[Mokelly]

Mokelly this post by Gmorris is a perfect example of how an adult should conduct him/herself during a discussion, see no hostility, no hysteria!!

PS Mild man I'm pretty sure you'll be fine, but its hard for any of us to give u the green light to use, imagine if we were wrong and you were the one in a million statistic. Like Gmorris, I have taken literally hundreds of risks drug wise over the years, there was much less information about then,I thought I was invincible till I hit 30, then I started thinking.Ishould say that incidently most of the people I've lost have been down to suicide rather than drug over dose. Maybe u should be looking at the impact drug abuse may have on your mental health which in my experience is far more prevelant than death from overdose.Beingmale, your liver should stand slightly more abuse, like everything else women draw the short straw at least in terms of the impact alcohol has on the liver (Candy will no doubt be able to advise much better than me on this I'm not sure if the same thing applys with drug abuse. At the end of the day when its your time to go its your time to go.
I know and completely agree with you man, never ment to be hostil in the first place. I know we are past this all now but I just want to specify that I was taken as being sarcastic or condasending, when in fact I was being sincere and in no way biased, I only fought back, sticking up for my first post which had been taken well out of the designed context! I swear I was sincere from the begining really! I just started getting dumb towards the end when we were bickering. Oh and picking your post apart was just asking for a fight I feel like an ass sorry don't hate me please!

[Mild_Man]

I don't know if I should really worry about this but it's starting to bother me. About a day ago I did a CWE on 15 generic hydrocodone pills: 10mg hydro / 500mg APAP so all and all the acetaminophen level was around 7.5g. Now the first time I filtered it the solution was fairly clear which told me alot of apap was taking out but when I took the sludge and mixed it with water in the refridgerator I don't think I got it cold enough this time because the resulting solution was more milkier. I mixed both of these and took it later that night. I'm getting kind of scared that I seriously damaged my liver because that second filtering might have let alot more apap back in. I hope that in a few days I don't get hepatoxicity or something like that. I heard that in well-nourished, non-alcoholic adults 7.5gcan be enough for toxicity with anything over increasing the risk for lethality. Do you guys think I will have major problems with this 7.5g of APAP? I still got out about a spoonful of APAP sludge and I also think along the way of crushing the pills I may have lost some powder along with also losing some of the sludge on the bowl. I hope this is the case so then I really didn't take in 7.5mg. I also took 800-1000 mg of guaifenesin which is still below the daily limit. Sorry if this is so long but if you skim through it tell me what you think.

I'm wondering if a mod or admin could move this post to the Q&A forums. Thanks for the help.

[Mild_Man]

Sorry, didn't know how to delete this post.

[poppy]

I know and completely agree with you man, never ment to be hostil in the first place. I know we are past this all now but I just want to specify that I was taken as being sarcastic or condasending, when in fact I was being sincere and in no way biased, I only fought back, sticking up for my first post which had been taken well out of the designed context! I swear I was sincere from the begining really! I just started getting dumb towards the end when we were bickering. Oh and picking your post apart was just asking for a fight I feel like an ass sorry don't hate me please!
Mokelly you know we've sorted out our differences! so don't worry!! Hope u and everyone else on the forum have a really wicked new years eve, and every thing they could wish for in the new year, whatever that may be.......Take Care talk to u all in 2006!!!!! Poppyxx

[VikeBuzz]

You mainly have to worry about liver damage if you are drinking a lot of alcohol and mixing drugs containing acetamenophen with it. I took 50 10/325 Norcos a day for a couple of years. That's about 16 grams of Tylenol a day. I have also taken over 10 grams of Tylenol mixed pills at a time.
I never had any trouble and I've had my liver checked multiple times. I didn't take this much drinking.
I got on pills after I gave up drinking. Most people won't have a problem, but there are small amounts of people that have problems. This is usually due to having a liver problem to begin with.
The main thing is if you plan to take a crap load of pills that contain acetaminophen, aka Tylenol, over a few days or even a week, don't drink any alcohol at all. And if you do drink make sure it's very little.
I have seen people drink a load of alcohol and take a load of Vicodin with it and have no problems.
But they didn't do it all of the time. Taking a lot of Tylenol makes you nauseated so expect that, it doesn't mean your liver has turned yellow, but if the nausea lasts for a few days without the pills you may want to get checked out.
enjoy