What is the max dosage of acetaminophen ?

Acetaminophen, which is also known as paracetamol, is a commonly used OTC (over-the-counter) pain reliever (analgesic) and fever reducer (antipyretic). People use it for headaches, and minor aches and pain. Liver injury from acetaminophen overdose remains a serious public health problem despite ongoing regulatory and educational efforts over the past several years to improve the safe use of medicines that contain acetaminophen.

Fioricet contains acetaminophen 325 mg per tablet. The max dosage of an adult for acetaminophen goes down from 4000mg to 3000mg per day (http://www.medicalnewstoday.com/articles/231915.php). So only acetaminophen, you should not take more than eight tablet fioricet per day. IF you take more than eight fioricet tablet per day, you will hurt your liver.

acetaminophen

From tylenol website, they lowered the maximum daily dose for single-ingredient Extra Strength TYLENOL® (acetaminophen) products sold in the U.S. from 8 pills per day (4,000 mg) to 6 pills per day (3,000 mg). The dosing interval has also changed from 2 pills every 4 – 6 hours to 2 pills every 6 hours.

Acetaminophen Mechanism of Action

Paracetamol (acetaminophen) is generally considered to be a weak inhibitor of the synthesis of prostaglandins (PGs). However, the in vivo effects of paracetamol are similar to those of the selective cyclooxygenase-2 (COX-2) inhibitors. Paracetamol also decreases PG concentrations in vivo, but, unlike the selective COX-2 inhibitors, paracetamol does not suppress the inflammation of rheumatoid arthritis.

It does, however, decrease swelling after oral surgery in humans and suppresses inflammation in rats and mice. Paracetamol is a weak inhibitor of PG synthesis of COX-1 and COX-2 in broken cell systems, but, by contrast, therapeutic concentrations of paracetamol inhibit PG synthesis in intact cells in vitro when the levels of the substrate arachidonic acid are low (less than about 5 mumol/L).

When the levels of arachidonic acid are low, PGs are synthesized largely by COX-2 in cells that contain both COX-1 and COX-2. Thus, the apparent selectivity of paracetamol may be due to inhibition of COX-2-dependent pathways that are proceeding at low rates.

This hypothesis is consistent with the similar pharmacological effects of paracetamol and the selective COX-2 inhibitors. COX-3, a splice variant of COX-1, has been suggested to be the site of action of paracetamol, but genomic and kinetic analysis indicates that this selective interaction is unlikely to be clinically relevant.

There is considerable evidence that the analgesic effect of paracetamol is central and is due to activation of descending serotonergic pathways, but its primary site of action may still be inhibition of PG synthesis.

The action of paracetamol at a molecular level is unclear but could be related to the production of reactive metabolites by the peroxidase function of COX-2, which could deplete glutathione, a cofactor of enzymes such as PGE synthase.

Medicines containing acetaminophen

Acetaminophen is the most common drug ingredient in America. More than 600 medicines contain acetaminophen. These include both prescription medicines and medicines available without a prescription, also called “over-the-counter,” or “OTC” medicines. To prevent acetaminophen overdose, you need to be able to read labels and recognize when their medicines contain acetaminophen. The active ingredients in OTC medicines are clearly listed on the label, and the word “acetaminophen,” is listed on the front of the package or bottle and in the Active Ingredient section of the Drug Facts label. On prescription labels, acetaminophen is sometimes listed as “APAP,” “acetam,” or other shorted versions of the word. To know what is in your medicines, read the list of active ingredients on the label each and every time you take a medicine.

You may be surprised to learn just how many medicines contain this acetaminophen:

Common Over-the-Counter Brand Name Medicines Containing Acetaminophen

  • Actifed®
  • Alka-Seltzer Plus LiquidGels®
  • Anacin®
  • Benadryl®
  • Cepacol®
  • Contac®
  • Coricidin®
  • Dayquil®
  • Dimetapp®
  • Dristan®
  • Excedrin®
  • Feverall®
  • Formula 44®
  • Goody’s®
  • Powders Liquiprin®
  • Midol®
  • Nyquil®
  • Panadol®
  • Robitussin®
  • Saint Joseph®
  • Aspirin-Free Singlet®
  • Sinutab®
  • Sudafed®
  • Theraflu®
  • Triaminic®
  • TYLENOL® Brand Products
  • Vanquish®
  • Vicks®
  • Zicam®
  • *And store brands

Common Prescription Medicines Containing Acetaminophen

  • Endocet®
  • Fioricet®
  • Hycotab
  • Hydrocet®
  • Hydrocodone Bitartrate
  • Lortab®
  • Percocet®
  • Phenaphen®
  • Sedapap®
  • Tapanol®
  • Tylenol® with Codeine
  • Tylox®
  • Ultracet®
  • Vicodin®
  • Zydone®
  • *And generic medicines

Important Acetaminophen Warning from FDA

Taking too much acetaminophen can cause liver damage, sometimes serious enough to require liver transplantation or cause death. You might accidentally take too much acetaminophen if you do not follow the directions on the prescription or package label carefully, or if you take more than one product that contains acetaminophen.

To be sure that you take acetaminophen safely, you should

  • not take more than one product that contains acetaminophen at a time. Read the labels of all the prescription and nonprescription medications you are taking to see if they contain acetaminophen. Be aware that abbreviations such as APAP, AC, Acetaminophen, Acetaminoph, Acetaminop, Acetamin, or Acetam. may be written on the label in place of the word acetaminophen. Ask your doctor or pharmacist if you don’t know if a medication that you are taking contains acetaminophen.
  • take acetaminophen exactly as directed on the prescription or package label. Do not take more acetaminophen or take it more often than directed, even if you still have fever or pain. Ask your doctor or pharmacist if you do not know how much medication to take or how often to take your medication. Call your doctor if you still have pain or fever after taking your medication as directed.
  • be aware that you should not take more than 4000 mg of acetaminophen per day. If you need to take more than one product that contains acetaminophen, it may be difficult for you to calculate the total amount of acetaminophen you are taking. Ask your doctor or pharmacist to help you.
  • tell your doctor if you have or have ever had liver disease.
  • not take acetaminophen if you drink three or more alcoholic drinks every day. Talk to your doctor about the safe use of alcohol while you are taking acetaminophen.
  • stop taking your medication and call your doctor right away if you think you have taken too much acetaminophen, even if you feel well.

Talk to your pharmacist or doctor if you have questions about the safe use of acetaminophen or acetaminophen-containing products.

Fioricet dosing information and fioricet overdose treatment

Usual Adult Dose of Fioricet for Headache:

Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

Acetaminophen 325 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 tablet(s), capsule(s), or tablespoonful(s) orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 500 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet or capsule orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 750 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet orally every 4 hours.
Maximum daily dose: 5 tablets

Usual Pediatric Dose of Fioricet for Headache:

12 years and older:
Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

Fioricet Overdose Treatment

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include insomnia, restlessness, tremor, diarrhea, increased shallow breathing, uneven heartbeats, seizure (convulsions), or fainting.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of Fioricet can be fatal.

The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.

Overdose symptoms may also include insomnia, restlessness, tremor, diarrhea, increased shallow breathing, uneven heartbeats, seizure (convulsions), or fainting.

A single or multiple drug overdose with this combination product is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended. Immediate treatment includes support of cardiorespiratory function and measures to reduce drug absorption.

Oxygen, intravenous fluids, vasopressors, and other supportive measures should be employed as indicated. Assisted or controlled ventilation should also be considered.

Gastric decontamination with activated charcoal should be administered just prior to N-acetylcysteine (NAC) to decrease systemic absorption if acetaminophen ingestion is known or suspected to have occurred within a few hours of presentation.

Serum acetaminophen levels should be obtained immediately if the patient presents 4 hours or more after ingestion to assess potential risk of hepatotoxicity; acetaminophen levels drawn less than 4 hours post-ingestion may be misleading.

To obtain the best possible outcome, NAC should be administered as soon as possible where impending or evolving liver injury is suspected. Intravenous NAC may be administered when circumstances preclude oral administration.

Vigorous supportive therapy is required in severe intoxication. Procedures to limit the continuing absorption of the drug must be readily performed since the hepatic injury is dose dependent and occurs early in the course of intoxication.

Is Fioricet Addictive?

While it seems like CNS depressants get the bulk of the attention right now regarding prescription medication addiction, but Fioricet is addictive though it maybe dependency. Some bad guys may tell you fioricet is addictive. No, Fioricet is not addictive. But when you take fioricet for a longer time, you maybe depend on it. If you think normal dose fioricet cannot relieve your headache, please stop taking it and go to your street doctors and let them prescribe a new headache reliever.

If you are going to fioricet addictive, you have to take 1500mg butalbital. It may take more than 35 tablete fioricet. More than six pill fioricet may hurt you, and more than nine fioricet per day will kill you by the acetaminophen within fioricet. How can you abuse it ?

What are CNS depressants?

Central nervous system (CNS) depressants, a category that includes tranquilizers, sedatives, and hypnotics, are substances that can slow brain activity. This property makes them useful for treating anxiety and sleep disorders. The following are among the medications commonly prescribed for these purposes:

  • Benzodiazepines, such as diazepam (Valium®), clonazepam (Klonopin®), and alprazolam (Xanax®), are sometimes prescribed to treat anxiety, acute stress reactions, and panic attacks. Clonazepam may also be prescribed to treat seizure disorders. The more sedating benzodiazepines, such as triazolam (Halcion®) and estazolam (Prosom®) are prescribed for short-term treatment of sleep disorders. Usually, benzodiazepines are not prescribed for long-term use because of the high risk for developing tolerance, dependence, or addiction.
  • Non-benzodiazepine sleep medications, such as zolpidem (Ambien®), eszopiclone (Lunesta®), and zaleplon (Sonata®), known as z-drugs, have a different chemical structure but act on the same GABA type A receptors in the brain as benzodiazepines. They are thought to have fewer side effects and less risk of dependence than benzodiazepines.
  • Barbiturates, such as mephobarbital (Mebaral®), phenobarbital (Luminal®), and pentobarbital sodium (Nembutal®), are used less frequently to reduce anxiety or to help with sleep problems because of their higher risk of overdose compared to benzodiazepines. However, they are still used in surgical procedures and to treat seizure disorders. Barbiturates may be habit-forming: Tolerance, psychological dependence, and physical dependence may occur especially following prolonged use of high doses of barbiturates. The average daily dose for the barbiturate addict is usually about 1500 mg.

How do CNS depressants affect the brain and body?

Most CNS depressants act on the brain by increasing activity at receptors for the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Although the different classes of depressants work in unique ways, it is through their ability to increase GABA signaling—thereby increasing inhibition of brain activity—that they produce a drowsy or calming effect that is medically beneficial to those suffering from anxiety or sleep disorders.

It’s the butalbital that may be habit-forming in Fioricet, and if it contains codeine, that element may also be. Butalbital is a central nervous system depressant, and it can sedate how a person feels pain. This is combined with the pain-relieving effects of acetaminophen, which works differently than the butalbital.

As tolerance to barbiturates develops, the amount needed to maintain the same level of intoxication increases; tolerance to a fatal dosage, however, does not increase more than two-fold. As this occurs, the margin between an intoxication dosage and fatal dosage becomes smaller. The lethal dose of a barbiturate is far less if alcohol is also ingested.

Major withdrawal symptoms (convulsions and delirium) may occur within 16 hours and last up to 5 days after abrupt cessation of these drugs. Intensity of withdrawal symptoms gradually declines over a period of approximately 15 days. Treatment of barbiturate dependence consists of cautious and gradual withdrawal of the drug.

Barbiturate-dependent patients can be withdrawn by using a number of different withdrawal regimens. One method involves initiating treatment at the patient’s regular dosage level and gradually decreasing the daily dosage as tolerated by the patient.

So how do Fioricet abuse and Fioricet addiction occur?  When someone is addictive to Fioricet, it usually begins as tolerance. With a drug tolerance someone takes the substance for a period of time, and then their body becomes used to it, so they need continuously higher doses to get the same effects.  A tolerance can be developed for butalbital as well as codeine if it’s contained in Fioricet.

There is research that shows the average barbiturate addict may need to take 1500 mg of the drug to feel the effects they want. Unfortunately, people who are addicted to Fioricet also often take other opioids and narcotics either to amplify the effects of the Fioricet or when they run out of it to achieve the same effect.

While all addictions to prescription drugs are worrisome, with Fioricet, there is not only the concern of being addicted to the butalbital, but there are the risks of the acetaminophen component of the drug.

Acetaminophen can cause liver damage or failure when high amounts are taken, and it can be an acute situation where it happens very suddenly. It’s important for people who take Fioricet to be aware of this. Acute liver failure can occur in doses of more than 4,000 mg in a day. In addition to the dangers of acetaminophen, with Fioricet abuse, there is the risk of overdosing on butalbital as well.

Butalbital can cause respiratory depression and excessive sedation, so Fioricet addiction is dangerous in multiple ways. If you or someone you know may have a Fioricet abuse problem, it’s important to seek professional help, because it’s an addiction that can very easily be dangerous or deadly.

 

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Fioricet is a combination medication commonly used to treat tension headaches but doctors also recommend it for recurring migraines.

Document Detail: You’ve probably heard of Fioricet. It is a combination medication commonly used to treat tension headaches but doctors also recommend it for recurring migraines. Acetaminophen is used to decrease the pain associated with muscular tension and caffeine increases the efficiency of the pain-killing effect.

The last constituent of Fioricet is butalbital, a powerful sedative having the property to reduce anxiety and induce relaxation. This barbiturate is also responsible for the sleepiness appearing after Fioricet intake. Fioricet is available as tablets for oral administration, to be taken whole, by mouth, with or without food.

The recommended dosage is of 1-2 tablets every 4 hours or as the doctor prescribes. Fioricet treatments can cause nausea and this is why most patients prefer to take this medication without food. Talking to the doctor about the nausea problem could lead to finding out essential information on how to reduce this unwanted effect. In fact, he/she can prescribe antihistamines for the nausea but there is also the possibility of lying down one hour after taking the medication.

The dosage for Fioricet is adapted according to each patient and the medical condition.

Throughout the entire period of the treatment, the doctor will monitor constantly the progress of the patient and the general response to the administration of the drug. One of the side-effects caused by Fioricet is drowsiness. There are a lot of patients who report to the doctor complaining of day-time somnolence and in many cases the dosage of Fioricet is lowered. By going to the doctor, you can find out all there is to be known about Fioricet. You will be instructed to take it as soon as the first symptoms of tension headaches appear.

Fioricet is prescribed with extreme caution and medical specialists advise against using this medication for prolonged periods of time and in high doses.

It may cause dependence and severe withdrawal symptoms if the treatment is stopped of all a sudden. These symptoms are extremely varied, including flu-like symptoms with running nose and watery eyes.

At the same time, there are patients who experience more serious symptoms with abnormal behavior, mental confusion and seizures. The best thing to prevent withdrawal syndromes is to ask your doctor to reduce the dosage gradually. You can also ask about the addiction potential presented by Fioricet and you will certainly be informed that this medication should not be taken in larger quantities or more frequently than indicated.

Regular checkups are a must when you follow a treatment with Fioricet.

Talk to your doctor if you have started to use more than the usual dosage, if you notice the headaches to have become worse or if they appear often. Only a healthcare professional can decide if you need dosage adjustment or special tests performed in order to determine the cause of your headaches. Never try to solve these problems by yourself and do not believe the higher doses of this medication will do the trick.

In high doses, acetaminophen can do permanent damage to the liver and an overdose can even lead to death. The important thing to remember is that acetaminophen overdose symptoms take usually two days to appear. The condition is extremely urgent and must be treated immediately. The first two signs one should look for is yellowing of the skin and extreme nausea.

Nevertheless, Fioricet overdosing is a combination of all the symptoms caused by acetaminophen, butalbital and caffeine.

Barbiturate overdosing is likely to cause mental confusion, comatose states, sever fatigue, hallucinations and dyspnea. The treatment must be applied urgently, as butalbital can affect the vital centers of the brain. As for caffeine, high doses can lead to seizures, excessive perspiration and severe diarrhea. You can certainly understand that Fioricet is not something you take without consulting your doctor.

Before taking the medication, it is for the best that you tell your doctor if you have a history of substance abuse, alcohol addiction or if you have ever suffered from respiratory disease. Depression, liver disease and porphyria should also be mentioned.

Porphyria is a severe metabolic disorder and butalbital is not recommended to be used in such cases.

Fioricet can also interact with certain types of medication, including blood thinners, benzodiazepines, narcotic pain medication and tricyclic antidepressants. Be sure to discuss all these aspects with your doctor.

Remember, butalbital has a powerful effect on the central nervous system and this effect might be enhanced if you take MAO inhibitors at the same time.

Fioricet dosing information

Usual Adult Dose of Fioricet for Headache:

Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

Acetaminophen 325 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 tablet(s), capsule(s), or tablespoonful(s) orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 500 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet or capsule orally every 4 hours.
Maximum daily dose: 6 doses

Acetaminophen 750 mg, butalbital 50 mg, and caffeine 40 mg:
1 tablet orally every 4 hours.
Maximum daily dose: 5 tablets

Usual Pediatric Dose of Fioricet for Headache:

12 years and older:
Acetaminophen 300 mg, butalbital 50 mg, and caffeine 40 mg:
1 or 2 capsule(s) orally every 4 hours as needed. Maximum daily dose: 6 doses.

What should I avoid while taking Fioricet?

This medication can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

While you are taking this medication, avoid taking diet pills, caffeine pills, or other stimulants (such as ADHD medications) without your doctor’s advice.

What is a Fioricet High?

One of the key active ingredients responsible for the so-called Fioricet high is butalbital. Butalbital is a barbiturate that’s considered short-to-intermediate acting, and it can relieve symptoms of anxiety, reduce pain, relax muscles and act as a sedative. There are many neuropsychological effects of butalbital, some of which aren’t clearly understood to this day.The belief is that the Fioricet high is caused by the fact that butalbital can increase the inhibition neurotransmitters in the brain called GABA. It can bind to certain receptor sites and ultimately central nervous system activity is depressed. This can lead to what feels like a buzz or to some people possibly a high.

So what does a Fioricet high feel like?

For the most part, it’s likely to feel similar to other central nervous system depressant effects. There is some evidence pointing to the fact that taking Fioricet can feel similar to the effects of drinking alcohol, particularly when the prescription drug is taken at higher levels.

The following are some of the common experiences that people say come along with a Fioricet high:

  • Fioricet can reduce anxiety and some people with anxiety disorders may take it for this reason, although this is not what it’s approved for. There is the potential for Fioricet to decrease feelings of anxiety even when it’s taken at a normal dose, and this is because of the impact of butalbital on GABA. For some people, a Fioricet high is actually just equated with a reduction in anxiety.
  • Depersonalization may be another effect of the so-called Fioricet high, although this isn’t necessarily something people find pleasant. It can lead to feelings of confusion and sluggishness, and this is one of the reasons Fioricet isn’t frequently used
  • Drowsiness and sedation may also be side effects of a Fioricet high, particularly when it’s taken in larger amounts. While Fioricet has a stimulant component which is caffeine when larger doses are taken the central nervous system depressant effects may override the stimulant effects.
  • Some people may obtain a sense of euphoria when taking Fioricet, although it’s not as pronounced as what would occur with something like prescription opioids. As with most other drugs, if someone does experience euphoria with a Fioricet high, it’s likely to dissipate after using the drug a few times as they build a tolerance.
  • While not everyone who takes Fioricet says they experience euphoria, some people say that it does improve their mood. This can be because of the GABA-related effects of butalbital, but also the inclusion of the acetaminophen and the caffeine. There’s also the element of stimulation that can occur with caffeine, so some people may feel this is a Fioricet high when they experience it.
  • Lightheadedness and dizziness are common side effects of Fioricet, and these may also be symptoms that people associate with a Fioricet high.
  • One of the primary reasons people will abuse Fioricet and take high doses is to achieve relaxation, which occurs because of the slowdown of the central nervous system. People who take this drug may feel relaxed and also tranquil. Some of this is because of the loosening up of muscles the drug can stimulate.

Not everyone will associate the use of this drug with the Fioricet high. Some of the factors that determine whether or not a person will experience a Fioricet high can include the dosage they take and their tolerance. Newer users may be more likely to experience what they would describe as the Fioricet high. Other factors that could influence this include the specific formulation of the drug and whether or not other substances are taken with it.

Some people may try to extract the butalbital from Fioricet and remove it from the caffeine and acetaminophen for a greater high. This is not only drug abuse, but might not even achieve the effects the person is looking for.

It’s important to realize that there can be serious and deadly consequences associated with trying to achieve a Fioricet high. This can include addiction, adverse reactions, brain damage, emotional crashes, and overdose. Since Fioricet has acetaminophen, if people abuse it to get high they may also sustain liver damage or failure.