Better Health & Living
How Safe Is Your Painkiller?
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Safe at the dose recommended on the bottle, the painkiller acetaminophen can become dangerous and even deadly if you take too much. Overdoses send 56,000 Americans to the hospital each year with liver failure—double the number from a decade ago, according to a new study by the U.S. Acute Liver Failure Study Group. An estimated 450 people die yearly as a result of this acetaminophen-triggered condition.
“People misuse acetaminophen because it’s considered safe and mild,” says researcher Anne M. Larson, MD, medical director of liver transplantation at the University of Texas Southwestern Medical Center in Dallas. “Lots of people take more acetaminophen than is recommended on the package, figuring that if two tablets or capsules every six hours is good, then four pills every four hours must be better for pain control. Now you’ve tripled the amount you’d get in a day—and this can really get you into trouble.”
Here’s how to use this pain remedy safely.
I thought acetaminophen was the mildest, safest pain reliever on the market. What’s so dangerous about it?
For most people, it is perfectly safe. But if you take too much, the liver’s ability to detoxify acetaminophen is overwhelmed. Normally, most of the acetaminophen in a dose is converted to nontoxic compounds and eliminated in your urine. This process also produces a tiny amount of a toxic by-product that your liver neutralizes quickly. But if you take too much acetaminophen, your liver makes more toxic by-products than it can handle. They bind to liver cells and can destroy them. Usually the damage is reversible, but a small percentage of people develop full-blown liver failure, which can be fatal.
What’s the safe dose for acetaminophen, and should I give it to my children?
Currently, the safe dose for adults is 4,000 milligrams per day, taken as directed. That’s 12 regular-strength or 8 eight extra-strength tablets.
Experts warn that taking acetaminophen may not be safe if you normally drink three or more alcoholic beverages per day, because alcohol also affects the way your liver functions. And while you’re taking acetaminophen, it may be wise to avoid alcohol altogether.
For children, the safe dose depends on age and weight, so be sure you’re using the right formula and the right dose. Acetaminophen drops for infants are more concentrated than liquid formulas for older kids, so don’t use them interchangeably. Be sure to follow the dosage directions, which are based on weight, on the bottle. Measure liquids carefully and check the labels of other medications your child may be taking to avoid double dosing.
I know that women metabolize some drugs differently than men do. Do I need to be more careful because I’m a woman?
Acetaminophen itself isn’t any more toxic for women than for men; both sexes metabolize and eliminate the drug at similar rates. But women do need to be more careful because of the way they tend to use this pain reliever. Research shows that they’re more likely than men to take higher doses or take it more often than recommended. Resist the temptation to take more. If a safe dose doesn’t relieve your pain, ask your doctor about alternatives.
Can I take acetaminophen with a cold or flu remedy?
Most of the time, no. Nearly all over-the-counter cold and flu remedies contain acetaminophen. If you’ you’re not aware of or don’t don’t pay attention to this, you might also take regular acetaminophen for a headache or add a nighttime pain relief formula for sleep. This could mean you’ve taken at least double the appropriate amount of acetaminophen. It’s important to read the labels on remedies or ask the pharmacist if you’re not sure.
Most people don’t realize that there’s also acetaminophen in some common prescription pain medicines, including Vicodin, Ultracet, Darvocet, Percocet, and Tylox, as well as Tylenol with codeine. If your doctor or pharmacist doesn’t warn you, you could end up doubling up without realizing it. Ask if you’re not sure! An estimated 600 over-the-counter and prescription drugs contain acetaminophen.
What should I do if someone in my family takes too much?
Don’t wait for symptoms. Call your doctor or poison control hotline right away if you suspect that you or a relative has taken too much. You’ll probably be told to go to the emergency room. Treatment can prevent liver problems, especially if received within 8 eight hours. Signs of a potential overdose include diarrhea, loss of appetite, nausea, sweating, and vomiting—but they may not appear for 12 to 24 hours.
By Susan Flagg Godbey and the editors of Better Health & Living®
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