|
|
Acetaminophen, sold under the brand name Tylenol
and also included in more than 200
over-the-counter cold and flu remedies and other
medications, is the most widely used painkiller in
the United States. Up to 100 million Americans
take acetaminophen every year.
|
|
|
|
|
|
Overdoses (both intentional and
accidental) of acetaminophen are
the leading cause of acute liver
failure in the United States.
|
While most people assume Tylenol and
other over-the-counter medications that
contain acetaminophen are harmless, the
drugs are actually surrounded by a
growing controversy as to their safety
-- even when taken at the recommended
dosages.
Liver Damage Possible Even at
Recommended Doses
It's well known that overdosing on
Tylenol (which is commonly done
accidentally, as we discuss below) can
harm the liver. However, a study
published in the Journal of the
American Medical Association found
that even at recommended doses, the drug
shows signs of causing organ damage.
Out of 106 patients in the study, 41 of
them (39 percent) who took acetaminophen
alone (Extra Strength Tylenol) or in
combination with another drug had their
liver enzymes
increase to more than three times the
normal upper limit. It is at this
threshold (when liver enzymes increase to
three times the normal level) that doctors
typically become concerned about potential
liver damage.
Further, another 27 patients had enzyme
levels increase more than five times
normal, and eight patients had levels
that increased eight times the normal
enzyme level. Their enzyme levels
continued to increase for up to four
days after the acetaminophen was
stopped, and their enzyme levels did not
return to normal for as long as 11 days,
researchers said.
"This study shows that even taking
the amount on the package can be a
problem for some people," said Dr.
William M. Lee of the University of
Texas Southwestern Medical School, who
was not involved in the study.
Long-Term Tylenol Use May Damage the
Kidneys
A study published in the Archives of
Internal Medicine found that 10 percent
of women who took
acetaminophen over an 11-year period had a
30 percent decline in kidney filtration
function.
The more acetaminophen taken, the
greater the damaging effects. Among
women who took between 1,500 and 9,000
tablets during the study, risk of kidney
impairment increased 64 percent. Those
who took more than 9,000 tablets had an
even greater risk.
Further, an article in Life Extension
magazine points out that several studies
have shown that regular use of
acetaminophen may double your risk of
kidney cancer.
Accidental and Intentional Overdosing
Common
Acetaminophen overdose is the leading
cause of acute liver failure in the
United States. While some of these stem
from intentional overdoses (England has
placed restrictions on the number of
acetaminophen pills that can be sold at
one time due to suicide concerns), many
are accidental.
In fact, each year more than 56,000
people visit an emergency room because
of
acetaminophen overdoses, and 100 people
die from unintentionally taking too much.
|
|
|
|
|
|
Check how much
acetaminophen is in
every drug you take
(both prescription and
over-the-counter) by
reading the label. Add
up the amounts to make
sure you are not
exceeding the maximum
daily recommended dose
of 4,000 milligrams.
|
When taken at the highest
recommended dose, experts say
acetaminophen is generally
safe, but acknowledge that the
margin of error is very small.
According to Lee, the maximum
dose of many acetaminophen
medications, including Extra
Strength
Tylenol, is set too high. In the
case of Extra Strength Tylenol,
the maximum dose is two
500-milligram pills every six
hours, or 4 grams a day.
If a person inadvertently
takes an extra pill, an extra
dose, or a different
medication that may also
contain acetaminophen (it's
also in the prescription
narcotics Vicodin, Percocet,
and others), they can easily
surpass the upper limit and
put themselves at risk of
liver damage, liver failure
and even death.
"Just a doubling of the
maximum daily dose can be
enough to kill," says Dr.
Anne Larson of the University
of Washington Medical Center.
And " ... if two is good,
10 is better in some patients'
minds," she says.
Adding to the problem is the
sheer number of products
available that contain
acetaminophen.
"You can take a
prescription med that has
acetaminophen in it, and a
cough syrup that has
acetaminophen in it, and then
if you take an Extra-Strength
Tylenol, you can have 4 grams
of acetaminophen," says
Matthew Grissinger, a pharmacist
and medication-safety analyst
for the Institute for Safe
Medication Practices.
"There's too much choice
out there. It's out of
hand."
Acetaminophen Safety Tips
If you use Tylenol,
over-the-counter cold and flu
remedies or any other drugs
that may contain
acetaminophen, be sure to
follow these safety tips:
-
Make sure you don't exceed
the maximum daily
recommended amount, which
is no more than 4,000
milligrams of
acetaminophen a day, or
eight extra-strength pills
(and to be safe you may
want to stay well under
it).
-
Read the labels on all the
drugs you are taking, even
if you're not sure it
contains acetaminophen.
Add up the amount of
acetaminophen to be sure
you're under 4,000
milligrams a day.
-
If you are in a vulnerable
population -- which
includes those who
regularly use alcohol,
have hepatitis or other
liver disease, or have
kidney disease -- you should
discuss acetaminophen use
with your doctor. You will
likely need to limit your
use to no more than 2,000 to
3,000 milligrams a day.
-
Follow dosage information
for children carefully, as
overdose can occur
quickly.
-
Be aware that some
products containing
acetaminophen also contain
aspartame,
which can be dangerous in
those with phenylketonuria.
Recommended Reading
the Risks?
|
