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still an CWE should be done anyways, even if it is a safe amount.the cleaner,the purer,the better,the safer. what if someone ended up drinking without doing a CWE?and anyways id assume any large amount of acetaminophen would be bad for someones liver.
theres no excuse for not doing a CWE its quick and simple and needs nothing but some water coffee filter and the ability to follow simple directions.
Less if alcohol or other drugs affecting the liver are taken
This is a very important point. The amount of paracetamol the liver can take can be almost halved if one is taking enzyme inducing drugs like St Johns Wort, or if one frequently consumes more than the "rda " of alcohol.
Might be a good idea to make a sticky thread giving info on paracetamol toxicity ect, as alot of posts pop up here ever so often on this subject? If a mod thinks this is a good idea I can start the ball rolling!
SWIM just got back from the E.R about an hour ago after taking 17,500 in 26 hours time! This is no lie!! Go check the other liver repair thread for details before he went, and how scared he SWIM was!! SWIM is back home after only a couple of hours at the E.R and they ran blood tests on him, and urine tests.. EVERYTHING came back 100% perfect! They monitored SWIM for hours but didn't give him anything to counteract it or anything.. As a matter of fact the DR. himself told SWIM that since he was a 300lb man that he didn't even ingest enough to be lethal.. He broke it down into ml per kilo or some technical crap.. Bottom line SWIM is ALIVE and WELL..
SWIM reccommends this high of dose to KNOW-ONE!!!! SWIM was very lucky and thanks god for not having liver failure! SWIM has also at many other times taken over 20,000mg of tylenol 3-4 days in a row even.. SWIM technically should be dead, but thankfully isnt!
p.s- The D.R from the E.R that was told the 100% truth about SWIM taking 35 5/500 vicodion in 26 hours,, after wrote a script for #20 of oxycodone IR..NO TYLENOL! SwIM had to tell him the drug name as he looked it up in his medical book.. ONLY IN AMERICA
No More than 4g Paracetamol (acetominithingy) in 24 hours.
Swim is not sure exactly how paracetemol effects the liver but it seems that most of the time damage to liver is done is when people are taking too much over an extended period of time. So would taking 4gs of paracetamol all at once as a one off cause more damage to the liver as tapering the 4gs dosages out throughout the day?
I'm not so sure about that. Acute liver damage only tends to occur with acetaminophen (paracetamol) overdose, as the liver normally has enough glutathione stashed away to effectively clear the drug. It is only when these glutathione reserves are depleted by the huge dose of acetaminophen that the concentration of reactive metabolites becomes dangerously high. 4g acetaminophen at once would be quite harsh as the massive spike in drug levels puts a strain on the liver's antioxidant cache. 1g every 6 hours would be more manageable as this gives the liver more time to replenish the glutathione reserves. There is a risk of cumulative toxicity too though.
Chronic paracetamol use probably does slowly damage the liver over many years just through low-level radical damage, but this is probably no worse than drinking alcohol, eating a high fat diet etc.
The biggest danger with chronic use of acetaminophen is that it causes gastric bleeding and ulcers in many users. This is a common side-effect of acetaminophen and many NSAIDs.
In the context of codeine use it's also fortunately a totally avoidable problem. Anyone that has a chronic requirement for codeine but does not wish to also consume the acetaminophen could perform a relatively simple cold water extraction (CWE) to separate the codeine from the acetaminophen. It's bad to get into the habit of consuming large doses of something as toxic as acetaminophen when there is no medical reason to do so, even if it is still below a lethal threshold.
Once swiy gets good at CWE's it should be done EVERY time. Even when swim wants 3 or 4 pills for a headache of 12.8/200 codeine/ibuprofen swim STILL does a CWE.
Swim thinks there is no excuse not to use CWE, it takes a few minutes. As long as swiy keeps coffee filters handy (buy a few boxes at a time they only cost 1 or 2 dollars), swiy can CWE anytime they want.
Swim does use a cwe but was just curious about how paracetemol effects the liver as some people who take shortcuts (incorrect filters, dont cool water to near freezing, etc) can end up with a still quite high dose of paracetamol. The ideal way to find out how much apap has got through would be to weigh the pills before the CWE and then dry and re-weigh the paracetamol left in the filter.