DEAR DR. DONOHUE: Recently I was told by a family member that the total amount of Tylenol taken in a person’s lifetime can be hazardous to one’s health. I have been taking two eight-hour pain-relief Tylenol before bedtime, as I have spinal stenosis, arthritis and degenerative back disease. This allows me to wake up in the morning without pain.

Is taking two Tylenol for pain every day bad for your health? The person who told me he saw the information on the Internet. — S.A.

ANSWER: Tylenol, generic name acetaminophen (uh-SET-uh-MIN-uh-fin), has been used by millions of people for many, many years without causing widespread harm. The medicine comes in a variety of strengths, ranging from 80 mg to 650 mg. Most adult tablets are either 325 mg or 500 mg. The upper daily limit for Tylenol has been put at 4,000 mg (4 grams). That amounts to eight 500-mg tablets a day. Recently, some authorities recommend that the daily intake be limited to 2,600 mg or 3,250 mg. On this more-stringent regimen, a person could take five or six 500-mg tablets a day.

It is also suggested that one should not take more than 1,000 mg in a single dose, and some feel that a maximum single dose of 650 mg is less risky.

What’s causing all this fuss about Tylenol? One reason is that it ranks high on the list of medicines causing liver damage due to drug overdose. Many people don’t realize that Tylenol, under the generic name acetaminophen, is combined in many over-the-counter and prescription preparations. Excedrin Sinus Headache tablets, Sinutab Sinus Maximum Strength tablets, Alka-Seltzer Cold Medicine effervescent tablets and Sudafed PE Sinus Headache Maximum Strength all contain acetaminophen. People have to look on the list of ingredients in over-the-counter medicines and in the detailed information that comes with prescription drugs to be aware of their full content.

Heavy alcohol users should not take Tylenol until they discuss the matter with their doctors. Your two pills a day are safe. Tylenol does not accumulate in the body over a lifetime of use.

DEAR DR. DONOHUE: You mentioned medicines that stimulate the salivary glands. What are they? I suffer from a dry mouth. — M.C.

ANSWER: All three of these medicines are prescription-requiring drugs: Evoxac, pilocarpine and Salagen.

Artificial salivas and mouth moisteners can be found in all drugstores. Biotene products are popular, and they come as sprays, gels, liquids and gum. OraMoist Time-Release Patches adhere to the roof of the mouth and keep the mouth moistened for a fairly long time. Sugarless gums are quite useful.

What you want to know is why your mouth is dry. Lots of illnesses and many medicines parch the mouth. Sjogren’s disease is an example of an illness in which mouth dryness is a chief sign.

Before experimenting with products to wet your mouth, see the family dentist or doctor for an opinion of why your mouth needs these products.

DEAR DR. DONOHUE: What happens to a person when his lungs collapse? Can he stay alive? Can the lungs be blown up like the inner tube of a wheel? — H.W.

ANSWER: A person can live with one collapsed lung. The condition is called a pneumothorax (NEW-moe-THOR-ax). A delicate lung bleb — often present from birth — breaks, and air rushes into the chest cavity. The incoming air compresses the lung. This sometimes happens to young, healthy athletes. The air is suctioned out.

If both lungs collapse, emergency treatment to expand them must be given quickly, or the person dies. The newspaper clipping you sent describes a man who was stabbed repeatedly on both sides of his back. The stab wounds allowed air to rush into both chest cavities and compress both lungs. This man died.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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