A New Painkiller Problem

We’ve all heard the warnings, the cautionary tales of people in legitimate pain being prescribed a medication to help, which ultimately ends up becoming a bigger health problem than the one it was meant to treat. The dangers of long-term use of prescription painkillers like Vicodin or Percocet have been covered extensively by the media, and parents and teens are also cautioned about the misuse and abuse of these powerful drugs. But in all those warnings, no one’s mentioned acetaminophen – until now.

Acetaminophen is often used in opioid pain meds like oxycodone (Percocet), hydrocodone (Vicodin) and codeine (Tylenol with Codeine). If someone on these medications then takes an over-the-counter pain medication containing acetaminophen, it could lead to trouble. The problem is those prescription pain meds are what are called “combination drugs,” which already contain acetaminophen. Getting too much can lead to liver damage. As a result, the Food and Drug Administration (FDA) is asking doctors to stop prescribing combination drugs that have more than 325 milligrams of acetaminophen per dose.

“Many consumers are often unaware that many products (both prescription and OTC) contain acetaminophen, making it easy to accidentally take too much,” the FDA said in a statement Tuesday. The FDA says no data show that taking more than that amount provides enough benefit to outweigh the risk of liver damage.

This isn’t the first time the FDA has addressed this issue. In 2011, the federal agency asked manufacturers to limit the amount of acetaminophen in prescription combination drugs to 325 mg per capsule or tablet by January 2014. While more than half of the manufacturers complied, some combination drugs with higher amounts of acetaminophen remain on the market. So the FDA is stepping up its game, beginning the process of withdrawing approval of prescription combination drugs from manufacturers that have not complied.

While prescription abuse carries bigger dangers, many don’t realize that acetaminophen overdose is one of the most common poisonings worldwide. National Institute of Health data shows that too much of this pain reliever can lead to liver failure or death. The FDA has set the recommended maximum for adults at 4,000 milligrams per day and warns consumers to avoid taking more than one acetaminophen product at a time.

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