Why acetaminophen is the 'most common cause of liver injury' in Canada
Source: CBC News
Health Canada's new labelling rules for acetaminophen are not strict enough, and the extra-strength products should be removed from store shelves, some doctors say.
Acetaminophen is one of the most widely used pain and fever relievers in Canada and worldwide. It is safe if used properly, but too much can be dangerous, particularly over time.
"It is the most common cause of liver injury. Period. Full stop," said Dr. Michael Rieder, a pediatric clinical pharmacologist at Western University in London, Ont.
Read more: http://www.cbc.ca/news/health/acetaminophen-toxicity-health-canada-1.3764672
maxsolomon
(33,252 posts)is being shot in the Liver.
etherealtruth
(22,165 posts).... and actually address identified problems
LeftyMom
(49,212 posts)maxsolomon
(33,252 posts)sorry if you thought I was serious. 538 has me feeling cynical today.
Stuckinthebush
(10,841 posts)Good one!
Sen. Walter Sobchak
(8,692 posts)Dorian Gray
(13,479 posts)I think a lot of the problems come bc it's used in prescription meds that combine it with an opiod. People who build up tolerance to the opioids take more and more, and then it can damage livers.
etherealtruth
(22,165 posts).... however, the greatest risk is with inadvertent overdose associated with the use of multiple products that may be acetaminophen containing (refer to article).
It appears most damage is associated with inadvertent overdose ... but not associated with ingesting a "shit ton" (unless a shit ton is the equivalent of 1-2 "extra" doses)
Sen. Walter Sobchak
(8,692 posts)etherealtruth
(22,165 posts)Again, sorry for being obtuse
Yo_Mama
(8,303 posts)There's a whole bunch of risk factors here:
http://emedicine.medscape.com/article/820200-overview#a4
In chronic acetaminophen toxicity, the role of fasting, reduced glutathione stores, and enhanced metabolism remains unclear. Risk factors for chronic acetaminophen toxicity include the following[18] :
Repeated administration of high doses
Repeated administration of proper doses at shortened time intervals
Fever
Poor oral intake
Young age (as due to caregiver mismanagement)
In adults, sometimes someone is ill and takes cold medicine containing the compound, drinks, and then takes the compound. In susceptible individuals, that can be enough.
Individuals with reduced liver function and certain viruses (which can affect liver function) can poison themselves with surprisingly small doses combined with some alcohol intake.
For example, mono or Epstein-Barr. You can still find medical sites recommending Tylenol for the pain and fever (such as this one http://www.uptodate.com/contents/infectious-mononucleosis-mono-in-adults-and-adolescents-beyond-the-basics), but in severe cases acetaminophen is utterly contraindicated. People don't realize that their liver is temporarily shot to hell, and then they take Tylenol at recommended doses and shut it right down.
I think it is a lethal drug that should be off the market, or sold only with very strong warnings and a usage limit recommendation of only a few days.
Sen. Walter Sobchak
(8,692 posts)Yo_Mama
(8,303 posts)demigoddess
(6,640 posts)problems like this. In the US, the problems with medicines just get covered up.
Egnever
(21,506 posts)Seems very foreign to me. I recognize there are a lot of folks out there that drink no matter what. I just can't imagine doing it personally. Last thing I would ever think of doing while sick.
Yo_Mama
(8,303 posts)I had a doctor recommend it to me once when I went to a clinic with an acute viremia. The tea/whiskey/lemon/honey combo actually does work:
http://vinepair.com/wine-blog/drunk-aunt-right-hot-toddy-cure-common-cold/
It tends to disrupt viral replication in the bloodstream. But only one, and you don't combine it with other cold remedies. Then you wrap up well and sweat it out. Really works.
Combining alcohol and tylenol is a very, very bad idea. Back when these cures were commonly used, people weren't combining them with all the OTC cold/flu remedies available now. The combination can be lethal. I wouldn't do a hot toddy with ibuprofen or anything except aspirin on the same day!
And people who drink every day probably don't stop that when they get ill.
rurallib
(62,387 posts)And by reading the article I see it is yes:
"I'm on call to the liver transplant program for this province. I just got a phone call literally two days ago from another hospital of somebody who was a heavy consumer of alcohol and took Tylenol and now they're in severe liver injury and they were calling for a transplant or possible transplant assessment."
There's a good chance of recovery for that individual, Yoshida said, but the problem is a common one.
ColemanMaskell
(783 posts)The Republic of Ireland passed a law over a decade ago to restrict the sale of paracetamol somewhat -- So you could not buy big bottles of a thousand tablets, and so on. The stated reason at the time was that many people were in a habit of taking the headache tablets for alcohol-induced headaches.
What I wonder about is whether there are other common substances that interact with acetaminophen/paracetamol/Tylenol in the same way, but it hasn't been generally noticed yet.
If the amino acid methionine is taken together with the acetaminophen, then the toxicity is ameliorated. Cysteine (as NAC) is related to methionine and is supposed to work too. Wikipedia tells us that "Paradote was a tablet sold in the UK which combined 500 mg paracetamol with 100 mg methionine,"
Ruby the Liberal
(26,219 posts)Back in college, I knew someone who died from tylenol toxicity. She took 4 before going to bed one night after she had been drinking. Poor thing never woke up.
After that, they put out PSAs on campus about not mixing the two, and to take aspirin or advil if you had been drinking in the last 24 hours (or planned to).
I never forgot that.
Spitfire of ATJ
(32,723 posts)Wow. I thought it was...
unblock
(52,126 posts)but then again, the pic would probably have made clear it's actually glenlivet, so....
Warpy
(111,169 posts)for colds, sinus headache, flu, and others that contain it. People OD when they take several of them at once when they've got a nasty cold or flu with multiple symptoms they want to medicate. Then they take an extra strength Tylenol because they hurt and their liver starts to fry. It's not just that extra strength Tylenol, which would be fine by itself. It's all that other crap that contains Tylenol.
People just won't read labels, so the best idea is to get rid of the combination products. The one that will cause the most squawking by drug warriors is Sudafed since it can be used in meth production. Oh well, better to have a meth cooker visit 20 drug stores a day to get enough for a batch than kill a bunch of people with Tylenol OD. It's a really nasty way to go.
etherealtruth
(22,165 posts)Although liver damage can be seen within the therapeutic doses .... its the inadvertent overdose through exactly what you state (in addition to use in combination with alcohol)
Coventina
(27,064 posts)I know docs love to recommend it, I cannot fathom why.
etherealtruth
(22,165 posts).... but, if I am willingly taking a drug and knowledgeable about its risks ... I at least want it to work (be worth the risk)
Doitnow
(1,103 posts)It's full of natural health aids. Some work, some don't, but at least trying them won't be harmful. Lots of guesswork, maybe, but lots of doctors do just that and only rely on our fabulous pharmaceutical industry for information.
hack89
(39,171 posts)Without actual scientific testing that could be a very dangerous assumption.
TexasBushwhacker
(20,148 posts)because NSAIDS can cause Reyes Syndrome. Alone, Tylenol does nothing for me, but I was having a big problem with arthritis in my knee a few weeks ago. My doctor suggested Aleve + Tylenol. It did the trick. But I don't drink alcohol and I was only taking more than 3 a day.
SCantiGOP
(13,866 posts)There is a prescription drug called Vimovo that is a strong dose of generic Alleve with a coating to lessen the chance of stomach problems. My uncle takes it and he says he couldn't get out of bed some days without it. He takes two a day.
The reason it is prescription is that it exceeds the recommended dose of the OTC medicine, but that is a bonus because my uncle's insurance covers it without a co-pay.
TexasBushwhacker
(20,148 posts)He did tell me I could double the OTC dose of ibruprofen, but Aleve has a better record with arthritis. I wonder if my insurance covers Vimovo.
etherealtruth
(22,165 posts)I don't mean to be an ass correcting you but if anyone has young children and teen's , it important to know the risk aspirin carries risk
NSAIDS are COX-2 inhibitors and may have some serious cardiac risks: http://www.uphs.upenn.edu/news/news_releases/2012/05/risk/
smirkymonkey
(63,221 posts)Most of my pain is stress pain from being at a computer all day or low back pain and I have found that external pain patches (Salon Pas are the best) work much better than pills. I have never really felt any relief from acetaminophen. Sometimes I will use Ibuprofen, but that's about it.
harun
(11,348 posts)like toothaches or headaches.