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If you're taking the same dose for a while and out-of-the-blue, you're suddenly getting nausea, it's time to have a liver profile done. Simple blood test at any doctor's office.
If you are getting an unexplained rash, then you've got some bigger problems- that is a very early sign of liver damage.
There is hope if this is happening to you because the liver can regenerate approximately 3/4 of itself. But you need to get to a doctor.
Sudden nausea is not normal. It's not something that naturally happens long-term with opioid use if you're tolerant and haven't changed your dose. It has everything to do with APAP. Masking this with anti-nausea meds and antacids is doing yourself a disservice *IF* it's related to the APAP.