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The Healthy Geezer

Acetaminophen: Widely Used but Dangerous in Large Doses

By Fred Cicetti

August 31, 2007

Acetaminophen is the most widely used pain-reliever and fever-reducer in the world. It is contained in more than 100 products. Tylenol is the best known over-the-counter (OTC) acetaminophen product.

It is also a component of well known prescription drugs such as Darvocet and Percocet. Acetaminophen also is known as paracetamol and N-acetyl-p-aminophenol (APAP).

Acetaminophen is available without a prescription. Follow the directions on the package label carefully. If your doctor prescribes it for you, the prescription label will tell you how often to take it.

Taking too much acetaminophen can lead to liver damage. The risk for liver damage may be increased if you drink three or more alcoholic drinks while using medicines that contain acetaminophen.

The maximum daily dose of acetaminophen is 4 grams in adults. The toxic dose of acetaminophen after a single acute ingestion is about 7 grams in adults. The at-risk dose may be lower in some susceptible populations, such as alcohol abusers.

When dosing recommendations are followed, the risk of liver toxicity is extremely small.

Acetaminophen is one of the most common pharmaceutical agents involved in overdose, as reported to the American Association of Poison Control Centers.

Widespread use causes problems

Adults should not take acetaminophen for pain for more than 10 days without talking to a doctor. Acetaminophen should not be taken for high fever, for fever lasting more than 3 days, or for recurrent fever without a doctor's supervision.

There are basically two types of over-the-counter (OTC) pain relievers. Some contain acetaminophen and others contain non-steroidal anti-inflammatory drugs (NSAIDs). Examples of OTC NSAIDs are aspirin, ibuprofen (Advil), naproxen sodium (Aleve), and ketoprofen (Orudis).

NSAIDs are associated with stomach distress. You should talk to your doctor before using NSAIDS if you are over 60, taking prescription blood thinners, have stomach ulcers or other bleeding problems.

NSAIDs can also cause reversible damage to the kidneys. The risk of kidney damage may increase in people who are over 60, have high blood pressure, heart disease or pre-existing kidney disease, and people who are taking a diuretic.

You should talk with your healthcare professional if you have questions about using an OTC medicine before using it in combination with other medicines -- either OTC or prescription medicine. Combining prescription medicines and OTC medicines can lead to problematic drug interactions.

All older adults should consult their doctors before taking any OTC medication or herbal product.

Often, older adults use many drugs at the same time, including prescription and OTC drugs. They also process drugs differently than younger adults. This is why older adults need to be especially careful about drug-drug interactions.

If you’re a senior, talk with your doctor about all of the drugs and herbal health products you take. He or she can tell you whether you are at risk for having a bad reaction from taking an OTC drug.

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All Rights Reserved © 2007 by Fred Cicetti

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