### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Is paracetamol & acetaminophen the same drug?  What are the symptoms of liver damage from paracetamol and/or codeine. At times I have taken up to 10 Panadeine Forte a day for severe back pain. is this considered harmful to the liver? I am female, 63 yrs old, weigh 89 kilos, & aprox 5ft 3inches tall. I have Systemic Scleroderma, Type 2 diabetes, osteoarthritis, diverticulitis, irritable bowel, Scleroderma oesphagitis & reflux,a recent onset of gall bladder problems, have been diagnosed with fatty liver in the past, FibromyalgiaRhuematica, Chronic lower back pain, chronic fatigue, Chronic depression, hypertension.

### output:

Hi.thank you for posting query at Chat Doctor. Paracetamol at "high doses" is injurious to liver. However, 1000 to 1500 mg (1 to 1.5g/day) will probably be a reasonable dose to treat back pain unless you the pain is severe. In addition, try to avoid "alcohol ingestion" and maintain a healthy diet especially eat green vegetables and fruits. Furthermore, hot water bag and pain ointments maybe used to subside the pain rather taking high doses of paracetamol. Massage equipment for back pain are also available in the market now. Health professionals aim to diagnose properly and manage patients according to their limited knowledge. Cure is blessed by the ONE who Created us, whose power and knowledge is unlimited .hope to answer your concern. Wish you good health. Regards, Chat Doctor. 