My husband took Zanaflex 3 times a day for 3 months (as prescribed) and had a huge increase in his liver enzymes. Would not have caught it but for me-a med tech-doing a chem 14 on his blood for his PSA testing (he is one year past radiation treatment for prostate cancer!). When 'troubleshooting' this liver problem, I suspected a medication reaction and he dropped all meds that weren't necessary, or that he had already been taking for a long time without issue. The liver markers went down. He added back one of the ones that he dropped and the liver markers continued on down. He is back to baseline after 3 more months and will stay away from Zanaflex now. He's on a different one now (forget which) and it seems to be working.

I say all of this to point out that many meds, not just acetaminophen, can affect the liver. Read your labels, ask your doctor. Go online and read the full prescribing information. When I went to pain management at first, I was taking hydrocodone 10/700 or 750 acetaminophen. New doc immediately switched me to one which was 10/325 because of the risk of too much acetaminophen (Tylenol), which is in so many combination cold meds, etc. Now I'm on oxycodone 10/325 4 times a day as needed and my acetaminophen level doesn't even register on the drug test and my liver function markers are very low. Even while taking MTX.

DX: Psoriatic Arthritis, Osteoporosis, Psoriasis
Meds: MTX since Oct 2009, 15mg/week. Cimzia-restarted after 2 yrs away.
Epidural Steroid Injections x8; Lumbar Radiofreq Ablation x2
SIJ Steroid Injection x3; Bilateral Radiofreq Ablation SIJ x9