Acetaminophen

The concern regarding acetaminophen or Tylenol is not new today. The medicine itself has been around for possibly a hundred years, but as Tylenol since 1961 (so says Microsoft's Encarta). The concerns about acetaminophen and the liver are also not new. I recall learning as a young adult that people who drank a lot should not use Tylenol. What I did not know is that even the recommended dose of acetaminophen can cause harm to the liver and it is said in the literature that 200 persons lose their lives each year from acetaminophen overdoses.

As early as 2002, health care professionals were raising concerns and requesting some label changes because too many products, both over the counter and prescription, contain this drug. People were and continue to be inadvertently taking in more than the 4g limit.
Acetaminophen Toxicity
Maren Mayhew, MS, ANP, GNP

Knowing now that it can cause liver damage in non alcoholics really concerns me. Knowing that it can cause harm after taking the recommended dose for four days, concerns me more. It is likely that all of the medicine hasn't been metabolized and excreted before more is ingested. It is building up.

Today an FDA panel suggested a change to the recommended daily dose of the drug. I hope that the FDA itself mandates the label change. Even if they do not change the label dose, YOU know it is too high. In fact,It sounds like extra strength tablets at 500mg a pop are too strong a dose period.

That being said, I am not sure why so many of us think that more is always better. I was the same before the Vioxx recall. I then read about NSAIDs and just changed my whole way of thinking about any pills. I went almost a year without taking anything because I thought I would have a heart attack if I took one pill. Now, when I have a bad headache or muscle problem I take ONE 200 mg ibuprofen and wait. I am amazed by two things. One is that it works, just one pill works and two, I used to take three or four, at once. We all need to rely less on medicine and more on ourselves. Instead of extra strength everything we need minimal strength as we seem to be low on common sense.

We had a saying at WFUBMC when medicating the elderly.. start low and go slow. Sounds like we ALL need to take that advice.

So be mindful as well... acetaminophen is in many products. Also, on some medication bottles it is referred to as APAP. Here is a link that offers a wonderful print out to help you. Also below is a link to an FDA web source on this issue.

http://familydoctor.org/otc/knowmeds.html

http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm168830.htm

Most importantly, do NOT take more than the recommended dose and do not take it for more than a few days. If you have been consuming acetaminophen (Tylenol) on a regular basis please let your health care provider know this.