DrugBuyers.Com: liver failure

Let me explain why APAP in high doses is bad for your liver, and then I'll answer your question.

When you take APAP, the vast majority of it gets converted into harmless metabolites. But part of it does become this stuff called NAPQI. In a normal dose, a substance in the body called glutathione binds to the NAPQI, and the end result is harmless. But when you take too much APAP, there is not enough glutathione to bind to all that NAPQI, and the NAPQI begins to kill cells in your liver and kidney. That is very oversimplified, but it gives you a picture of what happens.

Now, even though some liver cells are dying, you could still live for quite a while. APAP toxicity is notoriously quiet in coming on, you may not realize there is a problem for a long time- THAT DOES NOT MEAN YOU ARE OK. It takes a lot to get liver failure, and it is even more unlikely for you to need a liver transplant, and at that point still even more unlikely for you to die.

BUT IT IS STILL NOT A SAFE THING TO DO!!!

Even if you don't die, why would you want to risk liver failure and the possibility of needing an actual liver transplant??? Kidney failure could happen too, but that is generally something that happens when you already have severe hepatoxicity (a dangerously bad liver) and have not sought treatment.

This is exactly why I always say people should use NAC with meds in dosages higher than they are supposed to be, it's what you would be given in the ER if you OD'd on APAP, but it is also believed to have a preventive effect on liver damage. BUT IT IS NOT A LICENSE TO ABUSE APAP! Your liver will certainly thank you, but there is no guarantee that you will still be fine.

If you have been doing this, taking 30 pills a day, please get to a doctor and have a liver profile done. Just tell the doctor you have had a family member who had some liver problems at the same age as you and you want to get it checked out.

When the lab results come back, the doctor is looking to see if your ALT and AST are too high. At that point, I'd suggest coming clean to your doctor who will start you on NAC therapy. Most PCP's would probably admit you to the hospital for further evaluation, but that is a good thing here. If you catch this in time, you can save yourself and get a second chance.

Let me just say this- 300-400 mg of hydrocodone per day indicates a substance abuse problem (lemme rephrase that- virtually all medical professionals would consider that substance abuse, I'm not trying to offend anyone here, but I do want to make the point). Please at least think about getting some help; if you don't care about your liver, take some time to think about where your life is headed- and don't dose up when you realize it, get to a doctor. An addiction medicine psychiatrist could get you off of it with buprenorphine, or you could possibly get on methadone- s(he) will also be able to make educated guess about your liver damage and steer you in the right direction for treatment.

-yawkaw