It's terrible that you are counting in tablets instead of actual amount of acetaminophen
Trigger warning for self harm.
The real tragedies with acetaminophen are "cry-for-help" situations where someone thinks it is the same as aspirin, and swallows a handful, perhaps washing it down with alcohol. What might have been a suicide hesitation mark becomes an entry on a liver transplant list - if they are lucky. If you have children, make sure they know which one can be deadly, especially before going off to college.
Two years ago, I was prescribed the maximum dosage: 2 × 500 mg every six hours for a couple of months. Because it wears off more quickly than that, I tried to reduce it to one and a half pill more often but that wasn't enough to have any effect. Caffeine is supposed to reinforce the effect, but of course I had to avoid that to sleep.
I also got it as intravenous liquid at a time when I couldn't swallow.
That ain't much, I don't think I've seen boxes with that little around here. Normal packaging is 30~40, and you can get larger boxes, all without a script.
Are the boxes that small because sweden tends to use an other analgesic as primary culturally e.g. aspirin or ibuprofen and paracetamol is for more exceptional situations?
> Caffeine is supposed to reinforce the effect, but of course I had to avoid that to sleep.
If the goal was pain relief, you can combine ibuprofen and paracetamol. They can be staggered or taken together (in which case there's less duration coverage but some evidence that the combination works better than either separately).
There absolutely ARE situations where ibuprofen should not be used (kidney, infections, others), even at the usual dosage.
Hence I believe that it's a terrible idea to write on the internet "they can be staggered or taken together" as if they had a simimar safety profile
No, I'd say paracetamol is the most common. I think there was an increase in teenagers that tried to overdose on it to commit suicide some years ago. You could easily get 1000mg pills before that.
I prefer acetaminophen due to the main metabolite being a reuptake inhibitor of CB-active transmitters and I don't drink. I take maybe two-four grams per year, so your 40-pill box would last for a decade.
Can't put a source but I had lessons explaining that the US had insane rates of tylenol suicide, and that are apparently correlated with the size of boxes sold otc. Years ago many countries including france put a limit on the quantities sold at once and the suicides plummeted. The US didn't because of lobbies or something.
So sad and obvious.
One memory I have of visiting our U.S. head office with a bunch of UK people was the “we have to get to Target because they sell Tylenol in ungodly quantities.” And I thought bottles of 200 pills felt ridiculous up here in Canada.
I'd be interested to know if I'm wrong though.
In my case I was talking about 500 mg tablets which are commonly branded in the US as "Extra Strength Tylenol."
The point I was trying to make is that the deadly dose divided by the therapeutic dose for acetaminophen can be as small as 7. This is a much smaller ratio than for most other common over-the-counter drugs. There's not much room for error with acetaminophen.
Well yes it is possible to define an absolute toxic dose. 100 grams is an absolute toxic dose of acetaminophen in humans, 8294 tablets is not a dose.