Here is some info from a friend of mine who deals with tylenol all the time

[Guest guest]

Here is some info from a friend of mine about tylenol.....hope you find it of

interest...Mark

Feo,

I was looking thru my reference material and could not find any info

specificaclly related to diabetes or pancreatic problems. Tylenol is probably

considered the safest OTC pain reliever on the market. On a molecular level,

Tylenol is unrelated to any other pain reliever. Most over the counter pain

relivers are refered to as NSAIDs. This include ibuprofen (Motrin or Advil),

naproxen sodium (Naprosyn or Aleve), asprin and the COX2 inhibitors (Viox,

Bextra, Celabrex). Asprin, Ibuprofen and naproxen are sort of first generation

NSAIDs. What NSAIDs do is inhibit certain enzymes that mediate pain in an

injuried part of your body. These enzymes sensitize the nerve endings at the

point of injury and cause swelling and inflamation. The main enzyme responsible

for the pain and inflamation is the COX2 enzyme. The first generation NSAIDs

not only inhibit the COX2 but also the COX1 enzyme. The COX1 enzyme has nothing

to do with pain mediation, it is a " house keeping " enzyme. In other words, the

COX1 helps maintain certain tissues in the body like the kidneys and the lining

of the stomache. This is why some people get an up set stomache when taking

asprin, ibuprofen or naproxen. In addition, prolonged use of ibuprofen in high

doses has been associated with reduced renal function. This is where the COX2

inhibitors come in. They supposedly inhibit only the COX2 enzyme and not the

COX1, thus less stomache upset and renal degredation. You probably have seen in

the news, however, some of the other side effects the COX2 inhibitors have been

alleged to cause (heart attacks, etc.).

But I digress. Getting back to Tylenol. As I stated previuosly, the Tylenol

molecule is unlike any other pain reliever's molecule. It is alot smaller. It

is a pain reliever and a fever reducer, and has no effect on inflamation. It

reduces the pain threshold in the spinal cord. Tylenol is primarily metabolized

by the liver. About 90% or better of it is metabolized into harmless

substances. About 5% is metabolized into a more toxic substance referred to as

CYP450. The liver can only metabolize so much CYP450. As long as that

threshold is not met, then the liver handles the CYP450 fine and will function

normally. If, however, the liver becomes overwhelmed with CYP450, over dose can

occur. 7 to 10 grams of Tylenol in an 8 hour period is considered an overdose.

This would be about 14 to 20 pills of the Tylenol extra strength in an 8 hour

period. The highest recommended dose of Tylenol is 4 grams in a 24 hour period.

As long as you stay 4 grams or under in a 24 hour period, you should be fine.

Please keep in mind that Tylenol or Acetominphin (generic name) is used in

combonation with alot of other medications (cold, sinus, other pain relievers),

so make sure you count your grams. One of the reasons why it is used in combo

with other drugs is because it is considered so safe and has few side effects.

It is the only pain reliever pregnant women are allowed to take.

Tylenol has been around for about 50 years. There has been over 150 studies of

Tylenol covering all sorts of disease states. One study followed patients who

used 2600 mgs per day for two years and found no liver dysfunction. Another

study followed patients who took 4 grams a day for six months and found no liver

dysfunction.

On occasion you see the media bashing Tylenol about overdoses, liver dysfunction

etc. The clinical evidence supporting Tylenols efficacy and safety is

overwhelming.

Hope all this info is helpful. If you have specific questions, let me know

Jeff