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Old 11-26-2011   #11
 
Jackson, Wyoming
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The 4g a day limit has been lowered to 3 FYI. Not sure if all facilities are recognizing it yet, but the that is the latest recommendation. I dont understand why the non-APAP combos aren't used more (ie vicuprofin).
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Old 11-26-2011   #12
 
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Realize, however, the reason the narcotic is packaged with the APAP is because the different medications relieve pain by affecting different receptors in the body. The two meds act synergistically and provide much better relief than either medication alone.
Right...
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Old 11-26-2011   #13
 
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I'm a naproxen guy myself.
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Old 11-26-2011   #14
 
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Originally Posted by wyosam View Post
The 4g a day limit has been lowered to 3 FYI. Not sure if all facilities are recognizing it yet, but the that is the latest recommendation. I dont understand why the non-APAP combos aren't used more (ie vicuprofin).
Somebody better tell the makers of Tylenol about this because they sell Arthritis Formula Tylenol with a recommended dose of 1300mg every 8 hours. That's 3000mg in 24 hours. Their label warns not to exceed this dosage, but it sounds like this dose is already excessive.
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Old 11-26-2011   #15
 
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Oops - that was supposed to say 3900mg in 24 hours.
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Old 11-26-2011   #16
 
Westminster, Colorado
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I'm pretty sure the FDA still says 4g, what was lowered was how much can be combined with a narcotic. (FDA limits acetaminophen in prescription combination products; requires liver toxicity warnings)

If you drink enough to beat up your liver with Tylenol, you probably drink enough to get ulcers, bleeding issues or kidney failure with NSAIDs, to get a head bleed with aspirin, and to stop breathing with narcotics. Which is why if we lived in a sane society, MJ would be de-medicalized and alcohol would get way more restricted - but that's a totally different conversation. Basically, if you're drinking away the pain, it's time to stop drinking. And I'll admit it can kind of suck to practice what I preach on that.

I would give hydrocodone alone before using Vicoprofen. There's not enough ibuprofen to make a difference if you have working kidneys, and way too much if your kidneys are on the edge.
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Old 11-26-2011   #17
 
North Bend, Washington
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Wait- so I'm not supposed to be washing down my Motrin with beer? Damn....
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Old 11-27-2011   #18
 
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I hate it when the drug labels says "do not take with alcohol", but they don't say what the problems will be or how much alcohol. I'll ty it once, nothing bad, so I do it again.

OK, doing acetaminophen (Tylenol) with alcohol is bad. How much Alcohol? What if I drink 2 beers over 3 hours in the evening? What if I do 5 beers on a river trip?

How bad is alcohol with NSAIDs like Naproxen (Aleve), Ibuprofen, or Meloxicam? If I do 880 mg of Naproxen, how much alcohol can I drink? I guess the more accurate question is, how much naproxen can I take if I drink 2 beers an evening?
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Old 11-27-2011   #19
 
Westminster, Colorado
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Two beers an evening - in a normally sized, normally hydrated male - shouldn't impact your NSAID use unless you develop gastric ulcers.
Likewise for APAP as long as you're not pushing the daily dosing limits.
The problem comes in with regularly elevated consumption of either or both. So chasing your 6-pack with 3000mg of Tylenol day after day is likely going to end up in liver failure some years down the line, even though neither one on their own might have. Putting down a case a day, or 1-2 fifths, is just counting down the time until you turn yellow.

You're kind of getting to the biggest problem with medicine. People are all different, and the situations vary, but our system and expectations are set up for definitive answers. Basically, for any concrete question the most honest answer is "it depends." Sorry.

As for personal anecdote: I drink way less since I've gone into medicine than I did before, but still use OTC pain meds in limited amounts.
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Old 11-27-2011   #20
 
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Good thread. Can we talk vitamin I? I self medicate with ibuprofin very frequently. I should have a knee replacement but that's not gonna happen in this medical system. So its not unusual for me to take 2400 or more mgs in a day to deal with swelling and pain. I go without as much as I can. I also drink a couple beers a night... Feedback?
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