OK Plotinus,

You got my attention so here goes:

First and foremost take into account this horrible tragedy. I am of the opinion that manufacturers of both tylenol and Ibuprofen (of which ther are many; i.e. Mcneil, J & J, Whitehall labs etc) do not have sufficient warning labels on their containers.

True millions of people all over the world every year take these meds with NO Problems at all. But when you hear a story such as this one, it makes you think about the toxicity of the meds that we are consuming. I never said that APAP was without risk. Quite the contrary, when not taken according to directions there are hazards.

This poor individual swallowed 20 extra strength APAP(500 mg each) for a total of 10,000 mg 0f APAP in one dose. I wonder if the newspaper actually got that number right. It is possible that they did but it is also possible that they didn't.

According to the literature the max dosage of APAP @ one time is 1000 mg (2 extra strength tylenol). The max daily dose is 4000mg (over a 24 hour period) for less than 10 days. Greater than that the max dose should not exceed 2600 mg of APAP.

Now I am not going to debate whether (20) 200mg ibuprofen is less fatal than 20 500mg extra stength tylenol because that is ridiculous. But what I will say is that all of these med combinations (hydro and APAP or ibu) when taken in greater than prescribed doses (and most of us here have been guilty of that one time or another) involve inherent risks.

Now the meds that we are prescribed that have combos of hydro or ibu are for all intense and purposes relatively safe although each has its own risks that we have discussed in earlier forums. But what I will say is that if you are concerned about exceeding the recommended doses of tylenol, talk to your md about switching you to a schedule 2 substance such as oxy IR, roxicodone or ms contin so that you can avoid the excess APAP. If that is not possible, I like the compounded hydro meds (only have 80 mg of APAP per dose) that you can buy. They are a bit more expensive, but if you take a lot of hydro and are concerned about your liver then i think that you can't put a price on your health. You could actually consume 20 of the compounded meds and still be @ only 1600 mg for a 24 hour period!! Hope your tolerance is REALLY HIGH!!!

The strange thing about this tragic death is that I have seen people take up to 40 norco a day (which I think is insane) without ill effects. Now I know that cannot be good for you but that person not only did not die, they did not even get sick (I mean sicker than they already were)!!

I hope that this tragic death has somehow enlightened us all about the inherent risks of meds in general.

Thanks and peace to all.

Voyager