090516 Acetaminophen safety

090516 Acetaminophen safety

The season of colds, coughing, and flu bring on an increased use of acetaminophen, which is one of the ingredients in Tylenol and other over-the-counter medications for controlling pain and fever. Accidental overdoses of these products end up with thousands of people admitted to the emergency room each year.

According to the Harvard Men’s Health Watch, 600 and more products contain acetaminophen and inadvertently combining these products can push you into the danger zone. Each dosage, no matter where it came from, adds up. You must be careful not to exceed the daily limits otherwise you risk damaging your liver.

As previously mentioned acetaminophen, helps control pain and fever. It does not reduce inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) help control inflammation. In those individuals who cannot tolerate NSAIDs, due to the irritation these drugs sometimes cause to the stomach and intestinal lining, acetaminophen is tolerated. Thus, an individual attempting to control chronic pain, such as in older adults, may be tempted to use more than the recommended dose per day.

The problem arises when this dosage is exceeded because acetaminophen has a much and narrow wonder of safety when compared with ibuprofen and naproxen. This is not to minimize the danger of NSAIDs because they too can make you sick but it just takes a larger amount of these to reach a dangerous overdose. In the case of an acetaminophen overdose, damage to the liver occurs which sometimes means a liver transplant or death.

This happens when the body breaks down the acetaminophen. During this process, a part of this drug, which is toxic to the liver, is left behind. If too much is taken at one time or over a period of days, an accumulation of this toxic byproduct builds up. If it is more than the body can handle the results are an overdose.

The generally recommended maximum daily dose for an average healthy adult is no more than 4000 mg^[1] including all other drugs that contain acetaminophen. In certain cases dosages of 4000 mg daily may still be toxic to the liver. To be on the safe side the recommendation is take only what you need and not exceed 3000 mg a day whenever possible.

Staying within these limits may mean a talk with your doctor or pharmacist to find out what your toleration (danger area) is, which is based on your age, body size, and your present health status.

Avoiding an accidental overdose

• When purchasing cold and flu remedies look at the label and find out if it contains acetaminophen. If it does, be aware of how much and then stay within the guidelines listed earlier.
• The over-the-counter acetaminophen products list the milligrams in each pill. Some contain 325, 500, or 650 mg in each pill, which means you have to be especially cautious when taking the 500 or 650 mg pills because you can easily exceed your daily limit by taking too many of these.
• Follow the recommended dosages. Don’t be tempted to add just a little bit more; it could be hazardous to your health.
• Drinking alcohol while using acetaminophen causes the liver to convert more of the acetaminophen into the toxic byproducts mentioned earlier. The suggested limit of alcohol consumption is no more than two standard drinks per day for male and one drink per day for a female.
• Finally, ask your doctor or pharmacist if any of your prescription medications will adversely interact with your acetaminophen.

Acetaminophen: taking it safely^[2]

	325 mg	500 mg	650 mg extended release
How many pills at a time?	1 or 2	1 or 2	1 or 2
How often?	Take every 4 to 6 hours	Take every 6 hours	Take every 8 hours
The safest maximum dose per day for the majority of adults	8 pills	6 pills	4 pills
Do not exceed more than this within a 24-hour period.	12 pills (3900 mg)	8 pills (4000 mg)	6 pills (3900 mg)

[1] This is a maximum daily dose for a healthy adult weighing at least 150 pounds.

[2] January 2014, Harvard men’s health watch. “The maximum daily dose for a healthy adult who weighs at least 150 pounds is 4000 mg. However, in some people, taking the maximum daily dose for extended periods can seriously damage the liver. It’s best to take the lowest dose necessary and stay closer to 3000 mg per day as your maximum dose. If you need to take high doses of acetaminophen for chronic pain, check with your doctor first.”