New Here - Day 3 Tylenol Dosage Question

[Kwick]

Hi All,

It's day three for me on Harvoni and I'm feeling lots of symptoms (nausea, muscle aches, headache, no appetite and the runs) but I don't care because I feel I will be cured and am fortunate to be given this chance .  Plus, my cousin was on the historical horrendous treatments 3 times ending in failure and compared to his symptoms this is a cake walk. 

I want to make sure that I'm not impeding my treatment and have a question about the maximum Tylenol dosage that I can take. The nurse said not to exceed 1,000 grams but she must have meant milligrams.  I like to take Tylenol PM at night so I took 1 pill at night which is 500 mgs for the past 3 nights.  Would it be ok to take Tylenol during the day not too exceed 1,000 milligrams?

Also, the same nurse said that I could take my protonix medication for gerd but she didn't explain the possible interaction. After reading the pamphlet I saw that I could take protonix under fasted conditions with Harvoni but decided to eliminate the medication during treatment.

Any thoughts on taking milk thistle?

Its wonderful to have a forum to ask questions and talk to people about the same problem. 

[Long_Haul]

Hi Kwick and welcome to the forum. The 1st thing you should do is make sure you are drinking a lot of water. Simple guideline is to take your weight, devide by two and this is the number of ounces you should be drinking.

You should run any medications or supplements by you doctor or you can call the Gilead Hotline to get an expert answer.
Sorry you are having side effects, but they should subside shortly.

Best Wishes,

AL

[Amj1951]

I agree with long haul, Its all in the water!! I agree too, I would call your doctor for the information. We can tell you what we do but I think its a little different for everyone and your doctor knows YOUR situation.

For me the side effects were worse the first few days and then they went away.

Fingers crossed yours symptoms vanish too : )
Good luck,
Meredith

[Lukey]

Hi -

I needed Tylenol for 2 or 3 days, then my headache and flu like side effects went away. I was given the OK by my gastro's FNP to take up to 1000 mg a day. I think I took 750 mg one day and that was the most I ever took, and I'd gone several years w/o taking it prior to that. For me at least, the sides didn't last long and I've heard others say the same.

I'd still ask your MD's nurse or assistant if some Tylenol is OK.
I am not familiar with Tylenol PM, I only used plain tylenol.

Joe

[Lynn K]

This is the recommendation for patients with cirrhosis:

People with cirrhosis who take acetaminophen (sample brand name: Tylenol) should not take more than 2,000 milligrams per day (four extra-strength tablets). Many over-the-counter and prescription medications to treat cold and flu, fever, pain, and other common maladies contain acetaminophen, so it’s important to check the labels of any medications for acetaminophen as an ingredient and to add up the milligrams they each contain.

But always best to go with you doctors recommendations.

Yes I have normally been taking Prilosec but currently not taking while on treatment.

Good luck

[Kwick]

Thanks to everyone who responded to my questions, Katherine

[Chelle]

Lynn: Thank you for the Tylenol info! I'm on day 4 of S/O. Had an intense headache yesterday, which I rarely get.  It may be allergy related.  I was disappointed when I called the "24/7" nurse hotline at 7pm to see if I could take Tylenol and was told a nurse wasn't available until the morning.

Good to know I can take a small dosage if I need it.  Appreciate everyone's help.
-Chelle

[Jmayer1969]

I found some good information today, questions I have been asking my doctors since 1995 when I first found out I had Hep C Geno 1A.

Foods You Should Avoid
Alcohol – No brainer. The most important change for anyone diagnosed with hepatitis is the complete elimination of alcohol from his or her life. Learn why quitting alcohol is a necessity.
Wheat and Gluten – Gluten is highly inflammatory, because we were not really designed to digest it. Furthermore, the GMO grains have a higher gluten content. Most wheat flower is GMO’d to create a wheat that is resistant to pesticides and climate stressors. These strains are very hard to digest and, therefore, inflammatory. Learn about gluten’s role in liver disease and how to protect yourself.
Tap Water –Your tap water may contain more than you bargained for, including heavy metals, chlorine, fluoride, inorganic chemicals and compounds that the liver is not able to process. Even the shower you take every day has toxins in it which are absorbed through the skin and inhaled through the lungs. Filtered water is of course better than tap water. Consider having your water tested to decide what is most appropriate for you and your family. For greater safety, you may want to consider drinking bottled water. Distilled water is another possibility, but there is some controversy over its benefits, therefore you may wish to take distilled water in moderation.
Junk Foods – These are our favorite foods but the name fits. Junk is junk, meaning worthless. Our body does not get a good source of nutrition from junk foods and, most often, they are full of all the things we need to stay away from - including fats, sugars, empty calories, chemicals and additives. Our poor livers don’t need this added stress.
White Flour (unless it is organic and unbleached) – Bleached white flour has been chemically processed. Lots of vitamins and minerals are lost during the process; about 78%. When we consume this chemically-altered product our bodies need extra vitamins and minerals in order to process it and utilize it. Try these recipes for Gluten-Free All-Purpose Flour or Gluten-Free Whole-Grain Flour instead.
Hydrogenated Oils – Hydrogenated (they are refined) oils are another product that is hard for the liver to handle. This includes any type of oil or fat that hardens when cold. A better choice would be flaxseed oil or virgin olive oil.
Dairy Products – Dairy foods are extremely hard to digest. Learn the link between liver disease and dairy products.
Fruit Juices – These beverages are high in concentrated sugar. Sugar is a shock to the liver, stresses the digestive process, stresses the pancreas, and it feeds the Hepatitis C virus.
Artificial Sweeteners – The first word gives you the first clue: artificial. These sweeteners are extremely hard for the liver to process. Find out how to keep foods sweet with liver disease.
Processed Foods – We all know processed foods contain unnatural substances, preservatives, fillers and chemically treated substances. Common sense tells us this is not healthy for us.

Updating and recharging your diet is both a mental and physical commitment – and you can do it!
Changing your eating habits can be difficult, and it definitely takes will power. However, altering your diet can have profound effects on overall health – including improved mood, energy and much more.
If you prefer, start slowly by swapping one bad food with one good food. For example, before reaching for salty potato chips, try eating baked chips instead. Rather than indulge in a bowl of ice cream, choose yogurt. Both have similar consistencies – but yogurt is so much healthier! Steer clear of alcohol by opting for flavored water or herbal tea.
Helpful Hints to Keep Your Healthy Eating on Track
1.   Plan your meals out in advance. This leaves less room for hasty decisions when you’re hungry and on the go.
2.   Chop up fresh vegetables and keep them in containers as soon as you get home from the farmer’s market or grocery store. Crunchy carrots, cucumbers, celery and tomatoes will be waiting when you're ready for a snack.
Foods You Should Eat
•   Whole wheat bread
•   Whole grain cereals
•   Oatmeal
•   Cream of Wheat®
•   Brown rice
•   Vegetables (potatoes in moderation)
•   Beans, all kinds
•   Homemade refried beans
•   Lots of vegetable juices, freshly juiced by you
•   Fresh fruit in moderation (2-3 pieces per day)
•   Better Than Milk (a soy milk; White Wave is also good)
•   Soy cheeses. Try Soy-Sation Cheddar Cheese by Lisanatti. It is made with organic soybeans, tastes like regular cheddar cheese and melts well.
•   Corn tortillas – Love those tacos! Make your own chips too; just bake in the oven until crisp.
•   Organic flour tortillas made with unbleached white or whole wheat flour
•   Organic unbleached flour (white), in moderation
•   Salsa
•   Canned tuna in small amounts. Avoid albacore as this type of fish has been shown to have higher levels of mercury.
•   Organic whole wheat pasta or semolina pasta
•   Spices and Herbs
•   Herbal teas, iced or hot
•   Lemonade made with fresh lemons and sweetened with Stevia. Love your liver with lemon water!
•   Organic virgin olive oil
•   Flaxseed oil
•   Homemade vegetable soup
•   Baked chips
•   Nayonaise instead of mayonnaise
•   Yogurt
Time to get creative! Here are just a few (of the many) dishes you can make using healthy foods:
•   Spaghetti – with or without a meat substitute. (Try a ground meat substitute, such as seitan.)
•   Macaroni and Cheese – use soy or tofu cheese
•   Tacos – using a meat substitute and lots of seasoning
•   Tostados
•   Enchiladas
•   Hamburgers – there are lots of meat substitutes at the health food store
•   Hotdogs – tofu hot dogs
•   Chili Beans
•   Tuna Salad
•   Chicken Salad
•   Puddings –using soy or almond milk
•   Cake – in moderation using unbleached flours. Eat desserts in moderation!
•   Distilled Water – with a little lemon or lime juice and liquid Stevia makes a great drink and NO CALORIES
•   Whole Wheat Waffles or Pancakes – top with a fruit puree sweetened with liquid Stevia
•   The Ultimate Meal – this is a great healthy drink; try adding a banana and 1/2 cup unsweetened apple juice
•   Pizza! – whole wheat crust, vegetarian toppings, and cheese
•   Homemade Yogurt – with or without fruit; sweeten it with liquid Stevia
•   Baked Potatoes – topped with cheese, vegetable or both
You can take almost any recipe and convert it into a healthy dish simply by using healthy foods. Looking for a new recipe to try? Take a look at these liver friendly recipes.
Eating Habit Tips
1.   Eat four, small meals per day. Never eat a large meal at one time.
2.   Do not eat for five hours before bedtime.
3.   Try new foods – you may just like them by accident.
4.   Drink lots of distilled water throughout the day.
5.   Take a digestive aid with each meal.
6.   Eat slowly and not in front of the TV.
7.   Prepare your foods ahead of time whenever possible so they are ready when you are. You can prepare soups, beans, chili beans and more – and freeze them in microwavable containers.
8.   Salt – if you do not have a problem with retaining fluids and you do not have high blood pressure then a little added salt is fine. You can tell if you are retaining fluids by pressing on your shin bone. Press and hold for five seconds; if it’s indented after releasing pressure you are retaining fluids and should reduce your salt intake. Skip these salty dishes.
9.   Chew, chew, chew. The digestive process starts in the mouth. The chewing action begins the release of digestive juices. Chew, chew, chew. Are you finished chewing?
10.   If you feel tired, you maybe have eaten too much or the wrong foods. Try lying down.
11.   Do not eat when you are angry, frustrated or bored. Instead, go take a walk and talk to yourself. This is a great way to relieve your stress. (Discover five signs that you and your liver need stress relief.)
Remember to make your changes slowly but surely. It took years to learn those bad habits and it will take time to break them.
Tips for Those with Cirrhosis
The majority of the diet is the same but there are a few important differences:
1.   Do not eat raw vegetables; steam them instead. These include carrots, potatoes, cauliflower or any “hard to chew” vegetables. Juicing is preferred.
2.   Avoid alcohol, hot sauces, spicy foods, fried foods, fatty foods and salty foods.
3.   Suggested fresh juices:
1.   Carrot, beet, cucumber
2.   Carrot and spinach
3.   Carrot, celery, parsley
4.   Take 2-3 plums with pits and crush them. Add one cup of boiling water, mix and obtain the juice. Drink in the morning and the evening.
5.   Cook soybean sprouts and adzuki beans (1/2 and 1/2 in amounts), cook into a light soup and eat.
6.   Add lecithin to foods and take as a supplement, up to 1,500 mg per day.
7.   Take 800 mg of Vitamin E per day in dry form. If you have not taken Vitamin E before, start with a lower dosage (200 mg per day) and slowly increase.
8.   Good foods to eat are broccoli, Brussels sprouts, cauliflower, onions, garlic, legumes (beans and lentils), cabbage, peppers (mild), whole grains, artichokes, beets, dandelion, and herbs such as cinnamon, licorice and turmeric.
1.   Feed Your Body Well by Going Green
2.   Onions Play a Flavorful Role in Liver Health
3.   Garlic Is Good for the Liver
4.   How Does Turmeric Impact Hepatitis?
9.   Do not take Vitamin C with meals as it enhances the absorption of iron. Take at least 1-2 hours after eating.

Eat healthy and live longer! Proper diet is a must for all of us.   hopefully this will help someone else, like it has helped me tonight.

[Jmayer1969]

My doctor said I cannot take anything until I get permission from him.  If you do take Tylenol, it is also important to call the doctor's office and let them know so they can notify your doctor.

[Chelle]

Hi Kwick-
I don't think we answered your milk thistle question. Please check with your doctor or the Harvoni hotline.  I'm taking Solvadi & Olysio which says to not take milk thistle due to possible interaction.  Best wishes! Chelle

[Moregrits]

Jmayer1969, that's a comprehensive response with diet advice. I agree with most of it, but wanted to point out that seitan is "wheat meat" made from vital wheat gluten. I make it from scratch occasionally to provide vegetarian protein. I eat whole grains including those with gluten. The gluten free craze has gotten out of control, creating a multi-billion dollar food industry for specialty foods not everyone needs. Gluten intolerance is on the rise, and there are many studies being done to unravel why. Unless you have tested positive for gluten intolerance you don't need to avoid gluten. If you suspect you may be intolerant the advice is not to eli.inate consumption before getting tested, as that skews the result. Thanks.