What is Digg?108 Comments
- chiefcrazytalk, on 10/12/2007, -1/+5Looks like I picked a bad week to stop sniffing glue.
- Jack9, on 10/12/2007, -0/+4I had open heart surgery at age 2 and again age 9. They told me then that I could not take anything stronger than Tylenol without a prescription and oh yeah, that taking too much would kill me.
I will say that if you want to kill yourself, a Tylenol overdose is just about the stupidest way to do it. You won't die, but you will likely end up on the liver transplant waiting list.
While it's nice to make light of Acetaminophen poisoning, let's look at what happens...
Phase 1 (0-24 hours after reaching toxicity)
Asymptomatic
Anorexia
Nausea or vomiting
Malaise
Subclinical rise in serum transaminases levels begins at about 12 hours post ingestion
Phase 2 (18-72 h)
Right upper quadrant abdominal pain, anorexia, nausea, vomiting
Continued rise in serum transaminases levels
Phase 3 (72-96 h)
Centrilobular hepatic necrosis with continued abdominal pain
Jaundice
Coagulopathy
Hepatic encephalopathy
Nausea and vomiting
Renal failure
Fatality
The reality is that after 36ish hours of toxicity, you're dead. Your organs are already breaking down and there is nothing to be done. Suicide attempts pass out, wake up really sick and hurting, then call the police. When paramedics arrive, they hope the victim hadn't passed out for 18 hours before they were called. - slowth, on 10/12/2007, -0/+3Acetominophen is the leading cause of DRUG-induced liver failure, mostly because some individuals choose to overdose in a suicide attempt. Hepatitis and Alcohol are the main culprits for non-drug related liver failure.
Ibuprofen is not inherently safer than Acetominophen! An individual with a stomach ulcer can bleed to death after taking Ibuprofen, Aspirin, etc.
Forgive me for harping on this subject, but it's near and dear to me...talk to your physician or pharmacist about your medications! - slowth, on 10/12/2007, -0/+3A major cause of liver toxicity is mixing acetominophen and alcohol. Also, Ibuprofen, Naproxen, Aspirin, and most other non-steroidal anti-inflammatories pose a risk for a gastrointestinal bleed.
Simply because a medication is available over the counter does not make it completely safe. Talk to your physician or pharmacist about each and every medication you are taking, even herbal remedies. - WackyT, on 10/12/2007, -0/+3The reason why hospitals use acetaminophen so much is because of the absence of interaction with so many more drugs than NSAIDs. Acetaminophen used responsibly is not dangerous. The key word in the last sentence was "responsibly" which a lot of people don't know the meaning of.
- Coltron, on 10/12/2007, -0/+3While I will agree that Ibuprofen is superior I am not willing to write off Acetaminophen. Acetaminophen, like aspirin and Ibuprofen is a very basic, very natural molecule. I've read articles about it's links to liver failure before and they all have to do with accidental overdoses or seconard exposure to other drugs. It's hardly the destructive Toxin that this article makes it out to be. It's just a case of people not reading the carefully worded instructions on the side of the bottle.
This is a Pretty irresponsible article.
Here's a much better article:
http://www.medpagetoday.com/Gastroenterology/GeneralHepatology/tb/2233 - DrDigg, on 10/12/2007, -0/+2Given the choice I would stick with acetaminophen over ibuprofen if it could cover your pain. The liver issue is with overdosing (more than 4gm/24hours). But agree with everyone that everything has its risks.
- inactive, on 10/12/2007, -0/+2Yeah, but Ibuprofen also has it's own problems. http://www.drugdigest.org/DD/DVH/Uses/0,3915,335%7CIbuprofen,00.html
No medicine is 100% safe. - amatasu_zero, on 10/12/2007, -1/+3You're all stupid for not reading the story and only the headline
"people who had accidentally poisoned themselves did so by taking just 10 grams of the medication each day for about three days - the equivalent of about 20 pills per day instead of the recommended eight,"
Who's that stupid to take 20 pills of Tylenol in one day? - Rxbrent, on 10/12/2007, -1/+3I wonder how many of those cases are pillheads. Lortab, Vicoden and Percocets all have from 325 to 750mg tylenol per pill. In my area, many people survive on a diet of 10 to 40 of those a day. Bet they never thought the tylenol would be the part to kill them.
- teknotant, on 10/12/2007, -0/+2Moderation is key
- strlen, on 10/12/2007, -0/+2If you follow the instructions (which do describe the side effect -- that is possible liver failures), you should be fine. I do wonder how many of these failures are possibly a) botched suicides b) people trying to do tylenol in order to ``get high'' on Dextrometophan (a dissociative anesthetic and an ingredient in many Tylenol preparations).
Yes, it is potentially dangerous -- but following the instructions should give people no reason to worry. Also, it doesn't just go for Tylenol: it is for any medication containing acetaminophen (which means you shouldn't be taking more than one such medication at the same time, in recommended doses). - ericscampbell, on 10/12/2007, -0/+28 extra strength Tylenol per day is the recommended maximum dosage (i.e. 8x500mg = 4000mg per day)
Poison control info:
...A typical poisonous dose of acetaminophen is either 15 g (that is, 30 extra-strength tablets) at once or 5000 or more mg/day over several weeks.
British study:
...Twenty-one patients in this group accidentally took an overdose of the common pain reliever, and in 13 of these alcohol was a factor in the toxic reaction. ...The median dose of an accidental overdose was 11 grams, and it proved fatal for four patients. - hammerattack, on 10/12/2007, -0/+2My brother learned this the hard way. He used tylenol to control fever from an infection. Between taking three the recommended dosage, and the actual virus itself, his liver got tanked. It looked like I was going to have to donate half of mine for a while there.
What kills me is, abuse of ephedra based substances causes ephedra to be banned. Abuse of Tylenol gets little or no oversight from our FDA. This is one more example why government needs to be out of the drug business. - Sazime, on 10/12/2007, -0/+1As far as the suicide comments go, I can attest to this. My bro tried it this way and the EMT that treated him said as much. Whoo hoo over the counted suicide attempts.
- oldcyborg, on 10/12/2007, -0/+1If people would take drugs as they are PREscribed, then there wouldn't be any problem, but they don't. Then again, the drug companies do add it to everything, and some people just don't notice and don't realize that the stuff mounts up.. I have chronic and permanent liver damage, but I can't blame mine on Acetophenomen(Tylenol)..... Read the labels, and follow the instructions. Otherwise you are ticking time bomb.....
Cyborg
I already knew this, but I can't say it was here, or anywhere else for that matter.... so digg on~~ - c0ugar, on 10/12/2007, -0/+1By the way, only way to meet or exceed 4000 mgs is you would need to take 2 500 mg capsules every 3 hours.
- hitek86, on 10/12/2007, -0/+1The reason that Tylenol can be so damaging to your liver is because the enantiomer (fancy chemistry word for a molecule that is almost exactly the same as another chemical, except that it isn't super-imposable) of the major drug attacks the p75 cell membrane proteins that trigger apopstosis (in your liver, almost exclusively). The company that makes Tylenol is liable to slack off on refining the product (acetaminophen) and introduce some of the impurities in the drug. Mind you that it is fairly hard to accurately separate enantiomers, except for a process called resolution.
- Nullifidian, on 10/12/2007, -0/+1I've always wondered why NyQuil actually contains alcohol and Tylenol when its known that they both metabolize in the liver. A great cold cocktail but has deadly potential.
- jakejarvis, on 10/12/2007, -0/+1http://www.newscientist.com/article.ns?id=mg18825295.000 - much more informative.
- CableCarrier, on 10/12/2007, -0/+1Well. I'm not gonna use Tylenol anymore.
- WackyT, on 10/12/2007, -0/+1Yup. It also attacks the kidneys. I switched from acetaminophen to NSAIDs, ibuprofen mostly, quite a few years back.
- Quickstrike, on 10/12/2007, -0/+1Yeah, Ibuprofen AKA Advil is quite a bit better. From what I've heard, it actually brings down imflamation rather than just masking it. Safer to use + and has always worked better for me.
- theonlybigboss, on 10/12/2007, -0/+1thats big news, thanks
- ericscampbell, on 10/12/2007, -0/+1http://www.centerjd.org/free/Lifesavers.pdf -- is a long PDF file -- so instead of making you plow through it, I've excerpted the interesting bit.
It's from a 1993-1994 case by Antonio Benedi (then an aide to President Bush (senior)) against the makers of Tylenol -- What's disturbing is that they knew this was a serious issue & didn't voluntarily put warning labels on because they didn't want people to think thier product was unsafe.
FACTS: When Antonio Benedi entered the hospital on February 10, 1993, hewas in a coma, near death, and requiredan emergency liver transplant. Duringthe prior week he had taken Extra-Strength Tylenol (a brand of acetamin-ophen) to treat flu symptoms and con-sumed three to four glasses of wine withdinner as he customarily did. WhenBenedi sued the manufacturer, McNeil,P.P.C., Inc., he discovered that sincethe late 1970s the company knew of the link between acetaminophen, alcoholand liver damage. In fact, McNeil hadreceived 60 reports of liver injuries re-sulting from the combination of alcoholand Tylenol. Trial testimony from themedical director and corporate repre-sentative from McNeil also revealed thatin December 1992, two months beforeBenedi’s injury, a Food and Drug Ad-ministration (FDA) official had sug-gested to McNeil that its new Tylenolproduct, which was very similar to Extra-Strength Tylenol, contain an alcoholwarning for individuals who consumedmore than two drinks on a daily basis.The jury awarded over $8.8 millionagainst the drug manufacturer. Benediv. McNeil, P.P.C., Inc., No. 94-345A(verdict October 20, 1994), aff’d, 66F.3d 1378 (4th Cir. 1995). Before thejury verdict, the FDA held an advisorypanel hearing where it was agreed thatall over-the-counter pain relievers con-taining acetaminophen carry a warningabout the risks of alcohol. The FDA an-nounced the plan right after the verdict.Sources: E-mail correspondence fromPatrick Malone, attorney for AntonioBenedi, July 25, 2000; Bates, Steve &Charles W. Hall, “Tylenol Verdict PutsSpotlight On Drug Labels,” WashingtonPost, October 22, 1994 - Jarrod, on 10/12/2007, -0/+1I should clarify that that's eight tylenols taken in a 24 hour period. Very easy to do when you're sick.
- obrienslalom, on 10/12/2007, -0/+1Second leading cause of liver failure:...
digg articles like this:
http://digg.com/mods/Shot_Glasses_made_out_of_ICE - seanl, on 10/12/2007, -1/+2This is an excellent example of bad science reporting. If there were any intent to actually inform the public, the title would say "Tylenol overdose is the leading cause of liver failure." The actual New Scientist article title is no better. No digg, because I feel we need to discourage this kind of sensationalist reporting.
Big news, folks: follow the directions or actual educated, trusted wisdom on how to use medications or suffer the consequences! - clay201, on 10/12/2007, -0/+1I've had problems with my liver because of tylenol. I had abdominal pain and tests showed that it was due to elevated liver toxins. Of course, I was taking up to 2000 mg at a time.
Oh, and I should note that I don't drink. - rianjs, on 10/12/2007, -2/+3"This story is assinine...some guy in a blog writes that Tylenol is the leading cause of liver failure and you guys all buy it?"
Yes. Because I actually cited my source, dumbass. - tsupersonic, on 10/12/2007, -0/+1I learned this back when I was in high school (in college now). I think it also says it on the box itself. Pretty much you should always read about side effects and consult with your doctor to see if it's safe to take the medication.
- chevyorange, on 10/12/2007, -0/+1I prefer plain old cheap aspirin for the occasional headache. Works as well or better than anything else I've tried and is nearly free!
- duffbeer703, on 10/12/2007, -0/+1Tylenol is one of the safest drugs you can take -- but its becoming a problem for the same reason that soda consumption is becoming a problem -- "super sizing".
15 years ago, tylenol came in a 50-count bottle of 325mg capsules. Now you go out to Wal-Mart and by a 500-count bottle of 500mg.
Talk to a doctor or someone with a clue about drugs and drug interactions. Ibuprofen & Naproxen are effective drugs, but affect your kidneys & liver much more than Tylenol. That's why Ibuprofen was prescription-only until the late 80's. - ericscampbell, on 10/12/2007, -0/+1from a NY Times article a few weeks ago:
Dr. Davern and a team of colleagues from other centers led by Dr. Anne Larson at the University of Washington Medical Center in Seattle, tracked the 662 consecutive patients who showed up with acute liver failure at 23 transplant centers across the United States from 1998 to 2003.
Acetaminophen poisoning was to blame in nearly half the patients, the scientists found. The proportion of cases linked to the drug rose to 51 percent in 2003 from 28 percent in 1998. Not all the poisonings were accidental. An estimated 44 percent were suicide attempts by people who swallowed fistfuls of pills. "It's a grisly way to die," Dr. Davern said, adding that patients who survive sometimes suffer profound brain damage.
But in at least another 48 percent of the cases studied, the liver failed after a smaller, unintentional assault by the drug over several days. "I see some young women who have been suffering flulike symptoms for the better part of a week, and not eating much," Dr. Davern said. "They start with Tylenol, and maybe add an over-the-counter flu medicine on top of that, and pretty soon they've been taking maybe six grams of acetaminophen a day for a number of days. In rare cases that can be enough to throw them into liver failure."
Here's the full article (but you have to register to view the NY Times unfortunately):
http://www.nytimes.com/2005/11/29/health/29cons.html?ex=1134536400&en=62046dea8ec39fd4&ei=5070 - slowth, on 10/12/2007, -0/+1fiddelm3742, it's called water intoxication.
http://en.wikipedia.org/wiki/Water_intoxication - BBSCI, on 10/12/2007, -0/+0Alcohol and Tylenol don't mix well. I've see accounts of people destroying their liver with fairly modest amounts of the two. Is there a scientific connection?
- DrRobert, on 10/12/2007, -0/+0This is not news. In pharmacy schools they have been teaching for years that tylenol causes damage to the liver even in small doses over time. Mixed with alcohol the damage is immediate and acute although it may not be severe. There is also a cumulative effect even in small doses. Most drugs attack the kidneys and the liver. In large doses they do this in very measurable ways. In small doses the effect may be drowned out by other factors. Hospitals use tylenol because it is one of the few drugs that does not promote bleeding, which is essential in post operative patients and outweighs the risk of liver damage for short term treatment. As with anything scientific there is no definitive answer, you can only assess the state of knowledge by taking the cumulative pulse of the literature.
- AnusBreaker, on 10/12/2007, -0/+0oh yeah i forgot, no refills
- scottso, on 10/12/2007, -0/+0The NY Times wrote about this a couple of weeks ago - a mirror of the article is here:
http://www.truthout.org/issues_05/112905HA.shtml - c0ugar, on 10/12/2007, -1/+1I think those who think that you can easily exceed 4000 mgs are nuts. Taken right from a Tylenol Extra Strength bottle (500 mg each) ...
Adults and children 12 years and older:
• Take 2 capsules every 4-6 hours.
• Do not take more than 8 capsules in 24 hours
• Do not use for more than 10 days unless directed by a doctor.
Children under 12 years:
do not use this adult product in children under 12 years of age. This will provide more than the recommended dose (overdose) of TYLENOL and may cause liver damage
So, do the math. 24 hours a day, every 6 hours, that's 4 doses, 2000 mgs. 3000 mgs if you would take a dose every 4 hours.
There is no responsible way to meet or exceed 4000 mgs. Saying you would switch from a brand you used to trust based on an article that already mentions what TYLENOL has mentioned and is mentioned all over the TYLENOL bottle is sad.
There is no excuse for ignorance.
RTFM or in this case RTFL(abel) - DrDigg, on 10/12/2007, -0/+0medically people - oops meant medically trained
- Kericr, on 10/12/2007, -1/+1If anybody actually managed to follow the links, they essentially said that the majority of people with liver failure from tylenol averaged about 20 pills a day. Never mind that the standard reccomended maximum dosage is 8 pills for maximum strength.
This just in: Alcohol is a deadly intoxicant. Now everybody stop drinking. - slowth, on 10/12/2007, -0/+0No NSAID is COX-2 selective. Vioxx, Bextra, and Celebrex are popular COX-2 inhibitors....see where that got them.
- Jobius, on 10/12/2007, -0/+0Derek Lowe, a medicinal chemist who writes an excellent blog called In the Pipeline, had a good article last month talking about side effects like these. The headline is "Aspirin: Not Approvable"
http://www.medicalprogresstoday.com/spotlight/spotlight_indarchive.php?id=1039 - shiftless, on 10/12/2007, -0/+0His comparison is accurate. I've seen idiots cram these things down their throats like candy.
- spiderland, on 10/12/2007, -0/+0Sigh.
http://www.newscientist.com/article.ns?id=mg18825295.000 - IraqManiac, on 10/12/2007, -0/+0truthfully I haven't taken any medicine for at least 3 years. Not even tylenol
- Terrista, on 10/12/2007, -0/+0Just from personal experience, I did not take 20 Tylenol, I took extra strength Tylenol throughout the day, and thought I was taking it every 4 hours, well for a severe migraine, and being sick.....
i have never had a medication intake issue. Well anyway, I ended up waking up in the hospital and told that I almost died that night. If it wasn't for my husband and my mother getting me to the emergency room. My breaths were 4 per minute....and my enzyme levels were extremely high....... Those who call people Dumb-asses should think twice, i consider myself an intelligent person, but because of the pain I was in, and the fever making me delirious, I almost died. Needless to say, I had to drink charcoal and drink 17 doses of mucomyst and was in the hospital for 4 days. Tylenol is a great drug. It takes away pain. I only take meds when absolutely necessary, but I will tell you this, next time I will be using ibuprofen, and my husband will set it out for me. I am lucky to be alive. People shouldn't judge others until they experience something on there own, or know someone personally that has.......
i don't even drink alcohol, and now have liver damage, just because of this. My word of advice, if you are sick or unable to think clearly, have someone set out your medicine for you, it only takes a small amount of time, but it is well worth it. - splitsixty, on 10/12/2007, -0/+0There is an anecdote for Tylenol overdose,(if taken before toxic levels become to great) so fear not suicide heads!
It smells like rotten eggs and from what I have witnessed, tastes like ***** and rotten eggs that have festered in the ass crack of an overweight man who hasn't moved from his bed in 10 years. If that doesn't make you think twice about suicide and taking Tylenol...(you can mix it with say, Hawaiian Punch)
you can even overdose on milk!!...yet no one has ever to my knowledge OD'd on weed...hmmm - ibis, on 10/12/2007, -1/+1"Acetaminophen is *NOT* the leading cause of liver failure.
Idiots who overdose on Acetaminophen is the leading cause of liver failure."
Absolutely correct. However perhaps articles like this one will educate some of those idiots. People need to realise that just because something is widely available, doesn't mean it is safe. And if two tablets is good, four or five or six isn't better. -
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