Dangers of Too Much Acetaminophen!

Dangers of Too Much Acetaminophen!

Acetaminophen (APAP) is the most widely used analgesic (pain killer). It is available in various formulations including: liquid, tablet, capsule, and suppository. APAP has an excellent safety profile when ingested appropriately, but liver toxicity can develop in acute overdoses or chronic ingestions.

Over-the-counter combination products can be have hidden dangers especially if multiple medications containing acetaminophen are taken together. Unfortunately, initial signs and symptoms of acetaminophen toxicity are non-specific (nausea and vomiting) or absent. To avoid liver damage from acetaminophen, do not take more than 1 gram (1,000mg) of acetaminophen at once, do not exceed 4 grams of acetaminophen in 24 hours, and always check to see if over-the-counter or prescription medications contain acetaminophen. For children, do not exceed 10-15mg/kg/dose of acetaminophen and do not exceed five doses or 2.6 grams in 24 hours. If you are unsure about any medication containing acetaminophen, contact the poison center at 1-800-222-1222.

Scenarios which often result in inadvertent acetaminophen overdose include:

1. Children being given Tylenol Children’s to relieve a fever over several days


2. Treating pain (headache, toothache, backache etc.) with various prescriptions and over-the-counter pain medications


3. Treating a cold, allergies, and stuffed-up nose at the same time


4. Ingesting various generic non-aspirin products

Reasons for unintentional overdoses appear to be multi-factorial and include:

1. Simultaneous use of multiple products containing APAP


2. Inadvertently exceeding the maximum daily dose of 4 grams (4,000mg) of APAP in adults or 2.6 grams (2,600mg) of APAP in children


3. Unaware of various over-the-counter (OTC) products that contain APAP


4. Co-ingesting OTC’s and prescription medications that contain APAP

Common prescription medications containing Acetaminophen include:

1. Acetaminophen and Hydrocodone (Vicodin, Lortab)


2. Acetaminophen and Propoxyphene (Darvocet)


3. Acetaminophen and Oxycodone (Percocet, Endocet, Roxicet)


4. Acetaminophen and Tramadol (Ultracet)


5. Acetaminophen and Butalbital and Caffeine (Fioricet)


6. Acetaminophen and Isometheptene and Dichloralphenazone (Midrin)

Common over-the-counter preparations containing Acetaminophen:

Acetaminophen
 Tylenol, Non Aspirin Pain Relief, Tylenol Children’s, Tylenol Infants, Tylenol Sore Throat

Acetaminophen and Diphenhydramine
 Excedrin PM, Tylenol PM, Legatrin PM, Sominex Pain, Tylenol Severe Allergy, Anacin PM Aspirin Free

Acetaminophen and Pseudoephedrine
 Alka Seltzer Plus Cold and Sinus, Children’s Tylenol Sinus, Infant’s Tylenol Cold, Sinutab Sinus Maximum Strength Without Drowsiness, Sudafed Cold and Sinus, Sudafed Sinus Headache

Acetaminophen and Aspirin and Caffeine
 Excedrin, Genaced, Goody’s Extra Strength Headache Powder, Vanquish Extra Strength Pain Reliever

Acetaminophen and Pseudoephedrine and Chlorpheniramine
 Alka Seltzer Plus Cold, Children’s Tylenol Cold, Comtrex Allergy Sinus, Thera-Flu Flu and Cold, Sinutab Sinus Allergy



These are just some of the many preparations containing acetaminophen on the market.
This is taken from Minnesota Poison Control Center web site