5 ms·

What does ingesting 10g of acetaminophen even look like? I've got to imagine the fatal dose is far, far, far lower with chronic usage. Finding out that people a

What does ingesting 10g of acetaminophen even look like? I've got to imagine the fatal dose is far, far, far lower with chronic usage. Finding out that people are ingesting grams is profoundly disturbing.

petesergeant 6mo ago
> What does ingesting 10g of acetaminophen even look like? 20 not-especially-large tablets
- vasco 6mo ago
  Or 10 slightly larger ones edit: https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten
  - petesergeant 6mo ago
    I’ve pretty much only ever seen them sold at 500mg; are you regularly seeing them where you are sold in 1g form?
    - nbernard 6mo ago
      They are common in France, but not in such packages: There are restrictions that prevent you from buying more than than 8g/day (theoretically at least, I don't believe they are strictly applied in practice).
    - Dries007 6mo ago
      The linked size is also quite common in Belgium.
    - oblio 6mo ago
      In Europe for sure they're also sold in 1g dosing. I think the packages don't contain lots of pills, though. Definitely not US style buckets of pills.
    - SpaceNugget 6mo ago
      The .nl indicates the netherlands. Many people in the netherlands vent/joke about how the doctors here only ever tell you to take paracetamol and come back in two weeks if it's still a problem (recursive solution). However the last time I went to my GP she scoffed at me taking the maximum and suggested I take literally double the maximum recommended dose 4-5 times a day which totaled I think 2.5x the daily maximum on the package. I am very much a "believer" in science and reasonable medical authority but this experience sowed the seeds of doubt, because from what I have always heard, that can actually kill you or cause permanent liver issues. I was also taking diclofenac simultaenously, and when I told her how many mg, she asked "where can you even buy such small doses, that's what I would give a small child" =/
      - toast0 6mo ago
        My understanding is double the max dose of paracetamol is the LD50. Seems crazy for your GP to advocate for that. Published recommended dose is assuming average weight, so maybe if you're a very large person, the advice makes some sense, but wow.
    - sumea 6mo ago
      They are widely sold at 1000 mg (1g) tablets in Europe, but in many countries they require doctor's prescription. There are also purchase limits to the number of pills you can buy at once.
- throwaway27448 6mo ago
  Is this not suicidal behavior?
  - applfanboysbgon 6mo ago
    This can easily happen over the course of 24 hours if you're in "fuck me I'll do anything to make it stop" levels of pain. I've taken more than 20 ibuprofens in a day a few times in my life, which, while not medically advised, did not kill me. I actually had no idea acetaminophen was so dangerous.
    - sozforex 6mo ago
      Just in case, ibuprophen does not work well for pain relief [at lest for some kind of pain]. Paracetamol [acetaminophen] usually is much better against pain. And paracetamol + ibuprophen can help with strong pain for which neither paracetamol or ibuprophen work at normal doses.
      - topham 6mo ago
        Not really. Both address different sources of pain, and do so using different processes. Ibuprofen is a Nonsteroidal Anti-inflammatory Drug (NSAID) that reduces pain and inflammation, while acetaminophen does not. (Acetaminophen is believed to act mainly in the brain rather than at the site of injury). Ibuprofen- Fundamentally, if the pain is caused by inflammation, reducing the immune systems response to it can reduce pain, but if the pain is more acute it won't make a dent. With acetaminophen, taking more isn't a solution in most cases, you need another method to reduce the pain further if it doesn't achieve its goal. (That's why it's combined with things like codeine, which affects the brain in a different way for an additive effect)
        kgwgk 6mo ago
        > you need another method to reduce the pain further I don’t know about “most cases” but often you don’t want to reduce the pain _further_, you want to reduce the pain _again_. (Having an alternative definitely helps in the meantime.)
- fc417fc802 6mo ago
  As an American this is such a weird question to me. I purchase my ibuprofen and benadryl in bottles of anywhere from 400 to 1000 pills every few years.
colechristensen 6mo ago
Taking too much acetaminophen is bad for you but 10g is 20 extra strength pills and that much isn't likely at all to kill you but damage your organs is quite possible. Reading this might make someone in a bad place think that much will do the job and it won't. Tylenol poisoning's most likely outcome is permanent organ damage and pain, don't try it.
devmor 6mo ago
I have taken 4-5g in a day while suffering from intense pain before. There is a limit to the amount of opioids they will prescribe you, even if you are in mind shattering pain. For instance while attempting to get your dental insurance to actually cover a treatment you may find yourself between risking organ damage or risking $5000+ in ER visit bills only to have them refuse to give you anything but Tramadol.
- 4gotunameagain 6mo ago
  It is mind boggling how statements like that are possible in the US. I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction.
  - AnthonyMouse 6mo ago
    > I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction. Having a condition that actually warrants strong opioids and not being able to get them at any price is definitely not an improvement. The problem is fundamentally that we want to pretend doctors can always distinguish two people describing the same symptoms when one person actually has them and the other is trying to get drugs. The often can't, so you can either make it hard for people to get pain medications even if they need them, or you can make it easy for people to get them even if they don't. And between these the second one is unambiguously better, because the first one is the government screwing innocent people and the second one is guilty people screwing themselves.
    - freedomben 6mo ago
      > And between these the second one is unambiguously better, because the first one is the government screwing innocent people and the second one is guilty people screwing themselves. Could not agree more. Depriving people with legitimate pain of opioids is IMHO legitimate torture. It's a bit of a variance on the trolley problem in that the doctor/government isn't causing the pain, but their inaction is prolonging it.
mzl 6mo ago
I've been prescribed slightly more than 5g per day (2 x 650mg tablets every 6 hours) for pain after an operation jointly with ibuprofen, which is scarily close to the limits.
- TheOtherHobbes 6mo ago
  I managed to overdose by accident with severe dental pain. Wasn't thinking straight, took about 8g - which is even more scarily close to the limits. I'm fairly sure that caused some liver damage. I wasn't aware of anything apart from feeling a bit weird. At the time, I had no idea it was potentially deadly.
hannob 6mo ago
Buy a pack of 20x500mg (just checked, common size in Germany), take 2-3 every half hour for a while. Sure, that's extreme. But if you're unaware of the risks, you feel sick, and you believe it's helping you. I mean, people aren't killing themselves in masses with it, but it happens every now and then. Easily imaginable that one in a few million people will have enough tendency to take more pills and is unaware of the overdose danger.
- themanualstates 6mo ago
  And think of the children!
simplicio 6mo ago
Extra strength tylenol is 500mg a tablet, so 20 pills. Think most of the accidental ODs are due to people not realizing its included in other cold meds, and also being loopy from whatever illness they're trying to manage, and so end up forgetting when they last took the meds. Its also a pretty popular choice for people trying to kill themselves, though, so I suspect a non-trival chunk of ODs in the statistics given in the article were intentional.

petesergeant 6mo ago

> What does ingesting 10g of acetaminophen even look like? 20 not-especially-large tablets

vasco 6mo ago
Or 10 slightly larger ones edit: https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten https://www.24pharma.nl/paracetamol-eg-1000mg-120-tabletten
- petesergeant 6mo ago
  I’ve pretty much only ever seen them sold at 500mg; are you regularly seeing them where you are sold in 1g form?
  - nbernard 6mo ago
    They are common in France, but not in such packages: There are restrictions that prevent you from buying more than than 8g/day (theoretically at least, I don't believe they are strictly applied in practice).
  - Dries007 6mo ago
    The linked size is also quite common in Belgium.
  - oblio 6mo ago
    In Europe for sure they're also sold in 1g dosing. I think the packages don't contain lots of pills, though. Definitely not US style buckets of pills.
  - SpaceNugget 6mo ago
    The .nl indicates the netherlands. Many people in the netherlands vent/joke about how the doctors here only ever tell you to take paracetamol and come back in two weeks if it's still a problem (recursive solution). However the last time I went to my GP she scoffed at me taking the maximum and suggested I take literally double the maximum recommended dose 4-5 times a day which totaled I think 2.5x the daily maximum on the package. I am very much a "believer" in science and reasonable medical authority but this experience sowed the seeds of doubt, because from what I have always heard, that can actually kill you or cause permanent liver issues. I was also taking diclofenac simultaenously, and when I told her how many mg, she asked "where can you even buy such small doses, that's what I would give a small child" =/
    - toast0 6mo ago
      My understanding is double the max dose of paracetamol is the LD50. Seems crazy for your GP to advocate for that. Published recommended dose is assuming average weight, so maybe if you're a very large person, the advice makes some sense, but wow.
  - sumea 6mo ago
    They are widely sold at 1000 mg (1g) tablets in Europe, but in many countries they require doctor's prescription. There are also purchase limits to the number of pills you can buy at once.
throwaway27448 6mo ago
Is this not suicidal behavior?
- applfanboysbgon 6mo ago
  This can easily happen over the course of 24 hours if you're in "fuck me I'll do anything to make it stop" levels of pain. I've taken more than 20 ibuprofens in a day a few times in my life, which, while not medically advised, did not kill me. I actually had no idea acetaminophen was so dangerous.
  - sozforex 6mo ago
    Just in case, ibuprophen does not work well for pain relief [at lest for some kind of pain]. Paracetamol [acetaminophen] usually is much better against pain. And paracetamol + ibuprophen can help with strong pain for which neither paracetamol or ibuprophen work at normal doses.
    - topham 6mo ago
      Not really. Both address different sources of pain, and do so using different processes. Ibuprofen is a Nonsteroidal Anti-inflammatory Drug (NSAID) that reduces pain and inflammation, while acetaminophen does not. (Acetaminophen is believed to act mainly in the brain rather than at the site of injury). Ibuprofen- Fundamentally, if the pain is caused by inflammation, reducing the immune systems response to it can reduce pain, but if the pain is more acute it won't make a dent. With acetaminophen, taking more isn't a solution in most cases, you need another method to reduce the pain further if it doesn't achieve its goal. (That's why it's combined with things like codeine, which affects the brain in a different way for an additive effect)
      - kgwgk 6mo ago
        > you need another method to reduce the pain further I don’t know about “most cases” but often you don’t want to reduce the pain _further_, you want to reduce the pain _again_. (Having an alternative definitely helps in the meantime.)
fc417fc802 6mo ago
As an American this is such a weird question to me. I purchase my ibuprofen and benadryl in bottles of anywhere from 400 to 1000 pills every few years.

colechristensen 6mo ago

Taking too much acetaminophen is bad for you but 10g is 20 extra strength pills and that much isn't likely at all to kill you but damage your organs is quite possible. Reading this might make someone in a bad place think that much will do the job and it won't. Tylenol poisoning's most likely outcome is permanent organ damage and pain, don't try it.

devmor 6mo ago

I have taken 4-5g in a day while suffering from intense pain before. There is a limit to the amount of opioids they will prescribe you, even if you are in mind shattering pain. For instance while attempting to get your dental insurance to actually cover a treatment you may find yourself between risking organ damage or risking $5000+ in ER visit bills only to have them refuse to give you anything but Tramadol.

4gotunameagain 6mo ago
It is mind boggling how statements like that are possible in the US. I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction.
- AnthonyMouse 6mo ago
  > I guess it is much better than the situation before that, where you paid $5000+ and they also gave you an opioid addiction. Having a condition that actually warrants strong opioids and not being able to get them at any price is definitely not an improvement. The problem is fundamentally that we want to pretend doctors can always distinguish two people describing the same symptoms when one person actually has them and the other is trying to get drugs. The often can't, so you can either make it hard for people to get pain medications even if they need them, or you can make it easy for people to get them even if they don't. And between these the second one is unambiguously better, because the first one is the government screwing innocent people and the second one is guilty people screwing themselves.
  - freedomben 6mo ago
    > And between these the second one is unambiguously better, because the first one is the government screwing innocent people and the second one is guilty people screwing themselves. Could not agree more. Depriving people with legitimate pain of opioids is IMHO legitimate torture. It's a bit of a variance on the trolley problem in that the doctor/government isn't causing the pain, but their inaction is prolonging it.

mzl 6mo ago

I've been prescribed slightly more than 5g per day (2 x 650mg tablets every 6 hours) for pain after an operation jointly with ibuprofen, which is scarily close to the limits.

TheOtherHobbes 6mo ago
I managed to overdose by accident with severe dental pain. Wasn't thinking straight, took about 8g - which is even more scarily close to the limits. I'm fairly sure that caused some liver damage. I wasn't aware of anything apart from feeling a bit weird. At the time, I had no idea it was potentially deadly.

hannob 6mo ago

Buy a pack of 20x500mg (just checked, common size in Germany), take 2-3 every half hour for a while. Sure, that's extreme. But if you're unaware of the risks, you feel sick, and you believe it's helping you. I mean, people aren't killing themselves in masses with it, but it happens every now and then. Easily imaginable that one in a few million people will have enough tendency to take more pills and is unaware of the overdose danger.

themanualstates 6mo ago
And think of the children!

simplicio 6mo ago

Extra strength tylenol is 500mg a tablet, so 20 pills. Think most of the accidental ODs are due to people not realizing its included in other cold meds, and also being loopy from whatever illness they're trying to manage, and so end up forgetting when they last took the meds. Its also a pretty popular choice for people trying to kill themselves, though, so I suspect a non-trival chunk of ODs in the statistics given in the article were intentional.