Acetaminophen: Very safe except when it isn't

[nancylebov]

This American Life did an hour about acetaminophen (the active ingredient in Tylenol).

(Transcript)

The short version is that acetaminophen is a safe and useful painkiller, easier on the digestive tract than aspirin.... except that the dose that might fry your liver is only about twice the useful dose.

I feel like I dodged a bullet. Fortunately, I've had very little need for medications, but when I'd read the directions, I'd always have a feeling of "I'll use my own judgement" when I'd read the bit about how much to use how often for how long. The sensible thing seems to be to research it *all*.

A good bit of the hour is spent on the 30 years it took the FDA to upgrade the warnings on acetaminophen. Neither the FDA nor McNeil Consumer Healthcare (the maker of acetaminophen) exactly cover themselves with glory, though both were making vague efforts to improve matters. It's plausible that McNeil was more of the problem.

There's also somewhat about the problem of the baby doses having been higher than the child size-- the hypothesis was that a some of the liquid version for babies would dribble out, so it was reasonable to have some extra acetaminophen...

Well, now the concentration for babies is the same as that for children, and the warnings are better, though not as strong as they are in Europe.

However, a lot of over-the-counter combination meds have acetaminophen in them, so it's not too hard to overdose by accident. "More than 600 products contain acetaminophen now, including Excedrin, Theraflu Dristan Tablets, Sudafed Cold and Cough, Robitussin Cold and Flu, Alka Seltzer Plus Cold and Sinus, several types of Mucinex and Midol, most kinds of NyQuil, and stronger prescription painkillers like Percocet and Vicodin."

Comments

[redbird]

I sometimes find it frustratingly difficult to find non-combined OTC medications: not just finding ones without acetominophen, but dextromethorphan (cough suppressant) without guaifenesin (expectorant). Not only does that feel like the cough medication version of rum and Coke, the last thing I want if I'm trying to sleep is to cough more.

I understand some people want combined medication; I just want the option, even if it's less convenient to swallow two doses if I do want both drugs at once.

[andrewhickey.info]

That's surprising -- in Britain, stories of paracetamol (the word we use for it) overdoses are drummed into you at school, with tales of exactly how horrible a way it is to die, and how horribly dangerous it is. It's surprising that it's not so well known in the US.