Knee pain

Symptoms & Treatments
21

Also, the NICE articles simply site patients satisfaction with pain relief, not complications from continuous, high dose use. The concern comes when patirnts mix tylenol with other hepatotoxic drugs, often with no knowlege. I took tylenol daily, at max doses KNOWING i could trash my liver. However, one set of elevated LFTs accompanied by right, upper quadrant pain was enough to tell me that needed to stop pronto.

http://www.drugwatch.com/2014/01/28/fda-limits-acetaminophen-liver-damage/
http://emedicine.medscape.com/article/820200-overview
http://www.emedicinehealth.com/acetaminophen_tylenol_poisoning/article_em.htm


GrumpyCat said:

Seriously. Don't ever take tylenol in high doses unless you hate having a functioning liver. The dosing for almost all meds is to take the lowest effective dose, and this definitely holds true for tylenol. I don't think there are different schools of thought. It is the number one contributer to modern hepatotoxicity.

flow said:

Maybe the guidance is different in the UK and US, GrumpyCat? Paracetamol (which is what we call Tylenol in the UK) is the recommended first-line analgesic for all sorts of pain relief, including all mild-to-moderate pain, and pre- and post-operatively if you have a hip replacement or bone fracture. (See for example this national guidance: https://www.nice.org.uk/guidance/qs16/chapter/quality-statement-4-a... and http://cks.nice.org.uk/analgesia-mild-to-moderate-pain#!scenario ). I was prescribed 4g/day for 12 weeks, post THR.
Of course, people should always talk to their doctor about any drug changes, and if you're on MTX or have any other risk factors for liver problems, you shouldn't take it at all.

GrumpyCat said:

This is absolutely NOT how to take tylenol. It is every bit as dangerous as MTX As far as hepatotoxicity. Some nurses don't update the information they give to patients. Odd like to link an article, but my phone won't allow it. Just Google, tylenol toxicity.

flow said:

Just a comment about Tylenol/Paracetamol... I wasn't impressed when I was told to take it after my hip replacement - it didn't seem likely to be helpful at ALL! But the ortho nurse explained (and then I found out it was true for me) that generally we take it in the wrong way - just occasionally when we've already got a pain that we want to get rid of. It doesn't work well like that; but for many people, it is much more effective if you take it regularly at maximum dose, and then it builds up and starts working properly after about 48 hours, and provides pretty good relief for as long as you take it. You might be unlucky and be one of the people who don't respond to it at all, but if you've just been taking it the 'normal' way, try the 'max dose' way before you give up on it :)

Golfnut said:

Thanks grumpycat

I can't take nsaids I'm afraid so all I'm left with is tylenol which is just useless. Must ask doc for an emergency strong med. have been on mtx for about 14 months and am at max dose - just wondering if it's actually helping at all. I tried heat but that was worse - ice seemed to help a little bit. I will definitely ask them to look at my knee xx
22

It’s weird, but I do check different recommendations. It’s not like the FDA has never had a lapse in judgement. I tend to lean more towards more conservative measures as long as they have been set by reputable groups. As I go on with chronic illness, I become more Grumpy, and lean even more on trust but verify. I’ve met nurses who don’t necessarily know how to give good instructions, or admit not knowing an answer. Trust but verify. Also, we’ve found in recent years that things we have believed to be harmless and are sold without prescription, can be every bit as harmful as a prescribed med. I hate to be such a nag, but I worry that people may still feel that there are meds that are always safe, and that’s simply not true. Often, reward outweighs risk, but it is always food to know what to be on the look out for. You’ll have to forgive me. My brain doesn’t work as it once did, and I rarely have the fully evolved thoughts that I used to. It is taking me numerous posts, conveyed several ways before I feel like I’ve finally said what I started out too. Don’t age. It blows.

23

I promised you an update .... my tender spots under my knees along with multiple others that I have are, my rheumy says, not enthesitis. It's too extensive. Mine is secondary fibromyalgia.