Whoa. I’m guessing that you’re aware of acetaminophen toxicity and potential liver damage? It sounds like you are but I’d like to be sure.
I’ve been told that 2,000 mg per day of tylenol is perfecly safe.
Okay, cool. Thanks.
In fact, liver damage with acetaminophen is very rare in healthy patients with doses under 4000mg. 2000g is far lower than that.
Yes- hence this thread !!
This is MIGHTY useful. I never go over. My concerns are as much over the long-term constant use as they are over over-dosing daily.
Sure, but most people who take 4g/day do this for chronic issues (pain that lasts several years). By all means liver function tests should be done annually. But there should not be excessive cause for concern. And less so at 2000mg daily if there have not been any issues identified.
I had been prescribed oxycodone when I had a kidney stone. I ended up only taking two, with the only effect being that it took care of the pain and helped me sleep. No hallucinations, no desire to take more because it “made me feel so good”.
A friend had been prescribed a low dose of gabapentine for her restless legs and it made her totally loopy. My nightly dose of 1600mg does nothing to my brain but help me sleep. So it’s obvious that it affects different people in different ways.
I have fatty liver disease, which was fortunately detected early enough that the major treatment so far has been lose weight and don’t touch alcohol to avoid putting any unnecessary stress on my liver. I also have to watch my acetaminophen intake, for the same reason.
Good to know! And I hope 2,000mgs every day for a long time does not harm the liver.
Doses under 4000mg daily seem to be well tolerated. There is some evidence acetaminophen reduces liver inflammation and aging. It can cause a small increase in blood pressure, (PATH-BP trial) under 5mmHg, but probably less than the actual pain. Its biggest problem is that, by itself, it is not always very effective for back pain and neuralgia. Some, even most, medicines used for pain need extra caution in the elderly. Tylenol remains safer than most.
May be worth the reminder that … if you’re taking a fair amount of Tylenol … it isn’t wise to also be drinking a fair amount of booze.
There’s a school of thought that says that the liver is evil and must be punished, but … maybe not so much.
ETA:
I may have missed it, but I don’t think the OP is taking gabapentin, one of the GABA drugs that the Mercotan mentioned.
When I had a cyst pressing a nerve in my spine I had intense pain that gabapentin quashed almost immediately. That was two spine surgeries ago, though. My crumbling spine is again pressing on nerves and no surgery is indicated nor have outpatient procedures worked.
I’m back on the gabapentin although it’s not having the miraculously effects of the first go-round. NSAIDs, acetaminophen, and opioids don’t work for me either. I tried going off it, but while the pain levels didn’t change I felt poorly in other ways. Maybe withdrawal, but not classic side effects. Going back on made me notice that I sleep appreciably better.
So if the OP is looking for a possible pain aid that is also a sleeping, check with your doctor about the GABA drugs.
When I started on gabapentin, it was a very low dose to get acclimated to it, until the loopiness faded away. Then it was gradually increased.
@JaneDoe42, are you sure the back surgery won’t help you?
I have had increasing knee pain. My knees dislocated frequently in my younger years, and when you get old and creaky, knees HURT. I cannot even kneel anymore. At all. 16-17 years or so, I complained of knee pain to my PCP, and got a referral to an ortho, who sent me for PT. That helped a lot. But as time passed and I did the usual slack off on the exercises post PT, the pain was back. At that time, commercials on TV touted Cymbalta for knee pain. I asked my PCP about it, and she immediately prescribed it.
The knee pain was gone. It’s still gone.
My neck has given me grief for many, many years. Ages ago, I had PT for it, which helped. Sort of. My neck pain joined forces with my chronic headaches, and I was left to muddle along with 2 Vicodin a day. I took that for years. I augmented the Vicodin with ibuprofen. Lots. I’m sure that is directly related to my CKD 3 today.
My left shoulder not only hurt, but I seemed to have lost my full range of motion of it. Off to an ortho who specialized in rotator cuff surgery. When I mentioned some of the shoulder rehab seemed to help my neck pain, he referred me to his “neighbor” on another floor, who specialized in necks. Boy, did I get excited! I had a neck MRI, and saw this different doctor.
Diagnosis: pinched nerves in my neck. Forget Vicodin. He put me on Percocet 5mg 3x day.
My God.
That was in 2014. I have since had many ablations to my neck. They worked beautifully in the beginning, but gradually they stopped helping me. I have had gradual increases in medication, I now take Percocet 10mg 3x day, along with extended release morphine, 15mg 2x day.
Without the opioids, I can do nothing. I sit in my recliner, barely moving, keeping heat on my neck as often as possible. I have had PT several times, and it does help some. God’s true blessing to the world was the invention of Lidocaine 5mg pain patches. The combination of everything together enables me to be a (somewhat) functioning human being. One that can be around other human beings and not bite their heads off.
Your smartest move would be a pain management specialist. They have the training and the knowledge and the experience to find whatever combination of therapies to enable you to participate in your life, not just sit back and watch it go by.
My PCP had a dismissive attitude towards pain management. The PCP I have now doesn’t like me taking both Percocet and extended release morphine. She told me to pick one. I said, “It ain’t gonna happen.” I am monitored by Pain Management (I pee in a cup every few months) and I have a contract.
My main recommendation is to get a prescription for Lidocaine patches. They do an incredible job for me.
I’m retired, so I don’t have to do anything I don’t want to do. If I had the demands of a daily job, my pain story would be entirely different. Because of the opioids, I do not drive any more, and because of the acetaminophen in the Percocet, I don’t drink. I never was much of a drinker, but now I don’t even have an occasional drink.
I wish you only the best.
~VOW
Pain is such a funny thing.
I wrecked my feet ankles and knees, being a pointe dancer up thru my late teens. (maybe of late hips have been a bit creaky.)
That’s it, tho.
If you saw my feet you’d cringe.
I should be in pain. I should have swollen knees and ankles. So far I’m not.
The same with all the meds and other things we do for pain. Every ones experience will be different.
I can say what I’d do, but will it help someone else?
I agree with this. People have such different reactions to the same drug. I take codeine cough syrup. I don’t drive on it, just in case. But I’ve played bridge and done actuarial work and felt completely fine, mentally. My bridge results were good, and the actuarial work still looked good a week later. The same dose knocks my husband out and he’s totally non-functional.
A pain specialist is familiar with the options and various reactions to them, and should be able to help you navigate the choices, and hopefully find something good enough.
Oh, and if you haven’t tried lidocaine patches, you should. My mom couldn’t take nsaids, didn’t get relief from acetaminophen, and opioids made her loopy. Lidocaine patches were a godsend.
I was on Gabapentin short-term after this April’s cervical spinal work. Couldn’t tell what made me more stoned- the Oxycodone( not sure of which opiate I was on, I use that term here broadly ) or the Gaba. I cut out the Gaba after a day or two and the overall fugue state abated greatly.
Whatever I lean into moving ahead, I want to avoid that stuff.
Hi,
Wow. Hell of a path you’ve had to walk.
I am going to find a Pain Management specialist upon my return from the holidays. The first one, 22 years ago, was thoughtful AND attentive AND had a broad spectrum of choices for us to consider. I have to believe that - the Opioid Crisis notwithstanding- there are even more options now.
Lidocaine patches haven’t touched the cervical ( pre-Op) or the lower spinal pain. Nothing.
And, that’s the RX strength. The OTC strength? No doubt they do help some people. For me, I’m standing in line at CVS to throw money away.
I think doing something about this should be a very high priority–whether diet, exercise, weight loss drugs, bariatric surgery…