Is it OK to take Tylenol?

[LorrieC]

The first nephrologist I saw, discontinued meloxicam abruptly. He said I could take all the Tylenol I wanted. I googled Tylenol and some of the articles said acetaminophen could cause kidney damage. I usually take one 500 mg. tablet unless I am in dire pain and then I take two. I also take 81 mg. of Ecotrin for my heart. Should I continue the Tylenol?

[lowraind]

This is everything that I have ever heard about tylenol:

"Over-the-counter Tylenol (generic acetaminophen) is often the best choice for people with high blood pressure, heart failure, or kidney problems. However, high doses of Tylenol can damage the liver, so take the lowest dose you can to get enough pain relief. Never take more than 4,000 milligrams (mg) a day."

[LorrieC in reply to lowraind]

I can't believe the nephrologist said to take all the Tylenol I wanted! My husband's liver enzymes increased when he too two 500 mg. caps a day along with a high dose statin.

[orangecity41 in reply to lowraind]

My Doctor told me the same thing, and took me off Meloxicam that another Doctor prescribed.

[RickHow]

My doctors all tell me acetaminophen is fine. Try to take doses of 250mg. If necessary 500mg is okay on occasion, but not to make a habit of it. Everything else Nsaids, ibuprofen, etc., DO NOT TAKE

[LorrieC in reply to RickHow]

I've gone cold turkey with meloxicam. I usually take one 500 mg. Tylenol per day. Perhaps I should take 250 mg. twice daily.

[RickHow in reply to LorrieC]

I think that's a smart move to take 250 twice a day. It might even provide you more balanced relief.

[LorrieC in reply to RickHow]

Rick,

The same nephrologist who said I could take all the Tylenol I wanted, told me I could use Voltaren gel. This is a NSAID which is applied topically. I know it is affecting me systemically, for I am getting the same blood spots on the top of my hands as I did with meloxicam. Do you think enough is being absorbed to affect my kidneys?

[RickHow in reply to LorrieC]

Well I'm certainly no nephrologist. But I did some simple google searches on this gel. It says it "MAY BE" safe if you have renal disease since only a small amount gets absorbed into the bloodstream, and therefore the kidney. There just have been no studies. So it sounds if you are not applying a large amount, you should be (may be) fine. However it clearly states not to use the gel if you have kidney disease AND at the same time you are using the gel your medications include any diuretic, ACE, ARB, or Beta Blocker. It seems the nephrologist should know your medications and would not prescribe it knowing this warning. But sometimes, a doctor will decide to go against warnings if the benefits from the drug outweigh the risk. It seems it is time to talk to your doctor. Tell him/her what you found about the gel and question if it is safe. Also I did a bit of looking into Acetaminophen . It has a "half life" (the time that it lasts in your system and provides effective relief) of generally 2 to 3 hours, or up to 4 hours. So if you are taking 500 all at once, the relief is gone after 4 to 6 hours. If you try 250mg is would be wise. You would get 4 to 5 hours from the 1st 250, then another 4 to 5 hours from the 2nd 250 (assuming 250 provides you relief).

[LorrieC in reply to RickHow]

I took 250 mg and just returned from a mall. By the time I left, I was in pain. Three weeks ago, I took one meloxicam 15 mg. and I had no pain at all walking the mall. This is why I asked the nephrologist if I could take only one meloxicam when I knew I would be walking a lot and he said I could not. My friend who also has Stage 3 ckd was taking 15 mg per day as I was. She questioned her doctor and he told her she could decrease the dose to 7.5 mg per day. I called a pharmacist and she also said I could take it with a GFR of 49, but I don't want to chance it. My GFR was 59 when I had pneumonia last year and it decreased to 40 within a week. The nephrologist said it could be from the Vancomycin. I googled it and it said the doctor has to be careful with the dosage of the drug with someone with ckd. Thanks for your input.

[RickHow in reply to LorrieC]

keep trying combinations. You will find one that works, I am surprised that you experience pain? What causes this? Ckd at stage 3 and egfr in 40's would be uncommon to cause pain.

[LorrieC in reply to RickHow]

I don't have pain due to ckd. My pain is in my knee and both feet from plantar fasciitis and neuropathy. Meloxicam is the only medicine that has helped me.

[Bet117]

I was told by 2 nephrologists that Tylenol was fine to take for a headache, fever, etc.

Tylenol PM in excess can alter liver function tests.

[LorrieC in reply to Bet117]

I aw a new nephrologist yesterday and he said it was OK to take Tylenol. I take either 1/2 or a whole Extra Strength Tylenol daily. I guess less is more.

[Bet117]

Thanks, Lorrie!

[RonaldoResuelto]

As RickHow stated above, I am also not a nephrologist, and will not make a recommendation, but Tylenol is available in an extended-release tablet.

[LorrieC in reply to RonaldoResuelto]

Nice to know. I will look into it. Thanks