Thank them for screwing everything up for the folks who need the medicine. Tell them I hope they OD and die a horrible death. :mad:
Um, ok. I’ll pass that along.
There’s no “technically” about it. Acetaminophen is simply NOT and NSAID because it has little to no anti-inflammatory properties.
Funny - I thought it already required a doctor’s prescription…
At least, the last time I picked it up for my spouse it required a prescription. In fact, it was a script that required protocols above and beyond the norm, such as being on paper, hand-carried, and requiring me to produce ID in order to pick up for the patient. Funny, just like the pure morphine he’s getting. How is that NOT controlled?
And, by the way - I can NOT get behind your banning of a pain killer instrumental in controlling the pain of his terminal cancer. It is a powerful drug and, like all such, it can help or harm. Rather like the chemotherapy he was on, which fit the term “poison” much more so than the hydrocodone/acetaminophen does.
Yeah, I get it - some people have mis-used and/or abused the hydrocodone/acetaminophen formulation and wound up either very sick or dead. I’m sorry about that. You know what? People have also OD’d on drugs like Valium, or insulin, or a lot of other drugs that can be harmful or fatal if misused. What aren’t you crying foul about that? Or is it just that those other drugs aren’t as “fun” to abuse?
Yes, illness or death is a risk for hydrocodone/acetaminophen, just like for a lot of other stuff. That’s not a good reason to summarily ban it given that it has valid uses and can be safely utilized by most who get it for legitimate purposes.
I will admit I don’t have a cite. But then again you didn’t provide a cite supporting your view either.
But think about what you are asking… you are asking Big Pharma to come out and say they are producing a potentially dangerous drug. That’s like trying to find a cite the shows to tobacco companies admitting that, yes, our product is very dangerous, is quite addictive and might kill you. In fact, here they are lying, under oath, about that very thing to congress:
You are just not going to find that kind of evidence. Conversely, I challenge you to prove that it’s not. Let me ask you this, if that’s not a large part of the reason why not A) push a version without it and B) why reformulate it so it won’t dissolve. That had to be a very expensive proposition. There really isn’t a good alternate explanation.
And why are they fighting and resisting the FDA in this regard? Or The American College of Medical Toxicology? The reason is they are acting in what they believe is their own best self interest and addicts be damned. Our resident doctor has provided some pretty compelling information backing up what a lot of other professionals think.
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I’m proposing banning the combination. If the doctors want to prescribe tylenol and hydrocodone separately, they can do it all they want. Being able to control each medication separately would make it much safer.
Both of these may cause stomach upset, and aspirin can cause bleeding/bruising to be worse. It causes less hassle to use acetaminophen by default.
One important thing to do when making a combination is time between doses !
Its ok to reduce the dose to only last to the duration of the shorter one…
Which is perhaps what is desirable… ibuprofen can be effective for up to eight hours.
But I think they want the opoid to be shorter acting, so that you can wake up without it in your system. You won’t be addicted after you use it once… So that might be why they don’t make it as an 8 or 12 hour treatment ??
As a kidney patient who recently got an up close and personal look at what happens when the kidneys get overloaded with pain meds:
Opioids all stress the kidneys. It is what they do. end of discussion.
The very first thing a newly diagnosed kidney patient hears is “NO NSAIDS”.
Acetaminophen is not an NSAID - it is well tolerated by the kidneys.
So - you have a drug which will tax the kidneys to matter what (hydrocodone) so yoou want to pair it with something a bit more gentle. That means no aspirin or NSAID.
The Vicodin story has another wrinkle - drug classification.
Hydrocodone is Sch II - same as all the other opioids.
Until the recent hysteria re “Opioid OD Deaths”, the combination drugs were Sch III - available just like any other prescription drug - no DEA paperwork.
So Vicodin was a back-door narcotic - if an MD wanted/needed a narcotic pain killer without all the hassle of the Sch II controls, Vicodin was the drug of choice. IIRC, even dentists could prescribe Vicodin (they are severely restricted in prescription writing).
The offshoot of this was a quirk: plain, straight hydrocodone was not available in the US - why make a pill that no one will prescribe? If they want to go through the hoops to do a sch II narcotic, hydrocodone is not going to be their first choice. If they don’t want to do Sch II, they can’t get straight hydrocodone.
AIUI, now that even vicodin is Sch II (a move long fought) the straight hydrocodone is now commercially available.
Vicodin was made in 2 strengths: 5/500 and 10/325. The first number is mg of hydrocodone; second is mg acetaminophen. Yes, I was prescribed both.
And isn’t that more to do with avoiding the taxes that are levied on potable alcohol? The Chemist’s War of the Prohibition years notwithstanding?
Once again I am not trying to defend this drug combo. I am looking for evidence that APAP is included with hydrocodone as a deterrent to abuse.
The stated reason for this combo is that the 2 drugs work better in combination than either one alone. Hydrocodone is a narcotic that acts on opiate receptors in the central nervous system. Acetaminophen is a thought to act more peripherally but the mechanism is not well understood. The better cites for this are provided by drug companies which I think we will agree, are not without bias. weak cite
A. It is and has been available for years without acetaminophen. Vicoprofen and Lortab ASA for instance.
B. Your question is not clear to me. If you are asking can they make it so it is insoluble? I don’t know. But as some posters stated above, there are methods to remove the acetaminophen, which makes the deterring abuse argument moot.
Perhaps the simplest fact against the belief that acetaminophen is used as a deterrent
is morphine and a host of much stronger narcotics are distributed without acetaminophen. I think that is hard to disagree with.
I would like to thank you, White SIFL, for asking for a cite. I learned two things I was not aware of; The acetaminophen dose was lowered in ALL combo products at the behest of the FDA, I thought the lower doses were being prescribed as physicians became more aware of the danger. Secondly that hydrocodone is used virtually only in the US. Hmmm…
This has been proposed by the FDA.
I don’t know your particular reasons but, I’m not sure how much safer things would be.
Lots of people take too much acetaminophen all by itself. And the explosion of narcotic use and abuse in the US is well documented.
A good argument the acetaminophen is there as a deterrent is the fact that the presence of acetaminophen changes the schedule of the product.
Codeine alone in tablet form is a schedule two drug. Acetaminophen with codeine is a schedule three drug, because of lower abuse potential due to acetaminophen toxicity.
Right - because someone who can barely swallow and is already taking a handful of pills every 6-8 hours really needs to double up on the pills. What it comes down to is that you’re yet another internet blowhard who thinks he knows better than people with actual degrees and work experience in the subject.
The combo pill is one of the least dangerous drugs my spouse has been given in the past 4 months. Again, why aren’t you railing against all those other substances?
You’re being ridiculous. Compounding pharmacies could make special purpose pills for this if needed, I’m just proposing banning mass market use of vicodin - and I may be an internet blowhard, but not only do all the people with “actual degrees and work experience” pretty much all support this, but effectively that ban has already happened with the scheduling change.
Well, Hydrocodone was paired up with apap long before the dangers of too much acetaminophen were well known.
No, that’s incorrect. Acetaminophen was first marketed (as Tylenol) in the US in 1955 (I’ve also seen a claim for 1950). In 1966, acetaminophen overdose was shown to cause liver failure.
Vicodin, five milligrams of hydrocodone with 500 milligrams of acetaminophen, was introduced in the U.S. in 1978. The dangers of acetaminophen toxicity were well known in 1978.
That’s some pretty strong circumstantial evidence. “War on drugs” was started in 1971. Since heroin addicts can transfer their addictions to hydrocodone and vice versa, they would have been seen as addicts worthy of death…
It is rare to see this much opinion and outright crap in a GQ thread.
Aside from the cornfield, is there another repository for this kind of “stuff”?
OR -
The ugly side of universal access to Web 2.0:
The triumph of the “There are no facts, only opinions, and my opinions are as good as yours”.
Do you have any idea of who Qadgop the Mercotan is?
Yes