FDA Considers Banning Acetaminophen-Based Pain Killers

Greg George writes "The FDA has determined that Tylenol enhancing pain killers are dangerous enough to potentially be pulled from the market. Drugs including Vicodin, Hydrocodone, Lortab, Maxidone, Norco, Zydone, Tylenol with codeine, Percocet, Endocet, and Darvocet may be permanently banned from the US market, even if the patient has a prescription from a doctor. The problem is the key ingredient — acetaminophen — can easily damage or destroy a patient's liver if more than 2000 mg are used per day. In many cases that means if you take a pain killer and then take two extra strength Tylenol, you may have gone over the maximum dosage per day."

Comments

Vicodin?

[Megaweapon]

As long as it doesn't cause Lupus...

not really a ban

[mr100percent]

Before everyone screams bloody murder, the fact remains that you'll still be able to buy the stuff, separately. Percocet, for example, is actually a mix of oxycodone and acetaminophen. You can buy them separately as Oxycontin and Tylenol (or paracetamol in the UK).

It's the combination that causes problems; people wind up overdosing. Overdosing on the oxycodone portion is not all that dangerous (you could swallow 2 dozen of them at once though I would definitely not recommend it) compared to Tylenol, which can damage your liver. Thirty extra-strength tylenols at once can destroy your liver and you'll die within 72 hours. These medications have acetaminophen in them as an an anti-inflammatory to work with the painkiller, but they wind up being the deadlier part of the drug since people take too much. A few people think they can commit suicide by swallowing the whole prescription, but what happens is the codeine-based painkiller part wears off in hours and then the agonizing abdominal pain of liver failure begins until they're dead 3 days later.

You'll still be able to buy the separate ingredients, hydrocodone is Vicodin and Norco, oxycodone is Percocet, etc. There are other formulations; Percodan is nearly the same as Percocet except it uses aspirin in place of acetaminophen (Tylenol)

Re:not really a ban

[BrokenHalo]

Thirty extra-strength tylenols at once can destroy your liver and you'll die within 72 hours.

If you're lucky. Things have a tendency to go wrong with this course of medication, resulting in a fucked liver and a death spread over several weeks. It happened to my sister-in-law, and it's not pretty.

If you want to kill yourself, I'd suggest a nice clean OD on smack.

Re:not really a ban

[Bitch-Face Jones]

I'm not so sure about that. One of the reasons that drug companies put acetaminophen in things like hydrocodone and dextropropoxyphene in the first place is because they make it more difficult (ironically) to overdose on or use recreationally. If you try and just down 12 vicodin at once, all of the acetaminophen in it is going to make you pretty sick, so you have to jump through quite a few hoops (like using a cold water extraction) if you want to get the good stuff out without having to deal with the acetaminophen.

Re:not really a ban

[DurendalMac]

Acetomenaphine is the only OTC painkiller that is safe for pregnant women to take AFAIK. Aspirin is a big no-no and Ibuprofen is iffy at best. It's always good to have options. You can burn a hole in your stomach with too much Ibuprofen. Should that be pulled from the market too?

Bottom line: READ THE DAMN LABEL. Make sure you're not taking too much. Check with your doctor if you're not sure. A lot of medications will screw you up if you take too much. Equip yourself with knowledge and you'll be fine.

Re:not really a ban

[Anonymous Coward]

Most people have no idea what the maximum safe dosage of acetaminophen is. And even if they do, the point is that it's easy to take your vicodin prescription and then take some Nyquil without realizing that Nyquil has acetaminophen as well. The average person is not a pharmacist, and really shouldn't be expected to be one.

When I had surgery on my hand my doctor's instructions for frequency of use on the vicoden would have put me over the 4000mg limit. The pharmacist told me I needed to make sure I only took 5 a day instead of 6 (or something like that, can't quite remember what the frequency was anymore).

Now imagine my doctor had written the prescription correctly for 5 doses a day. There's no reason for most people to know the maximum daily dose value. It would have been quite easy to take the maximum dosage just on pain pills, then take a few doses per day of some OTC med (maybe something for allergies) that lists acetaminophen in the small print and exceed the max dose by quite a bit. Nyquil Sinus for example has 650mg per dose and allows up to 6 per day. Accidentally exceeding 4000mg would be easy.

Re:not really a ban

[radtea]

No, actually they will still inject, and they will have a higher chance of contracting Hepatitis or HIV.

Yes, but most anti-drug people are arguing from the basis of a puritan's punitive mythology, in which taking drugs is pleasurable and therefore drug takers "deserve" to be harmed. You can see this in puritans of all stripes: environmental puritans are often opposed to safe and effective means of disposal of nuclear waste because they would make nuclear power safer, which would be unacceptable because humans aren't supposed to have access to clean, cheap power, we're supposed to suffer for any pleasure we get, because we "deserve" to.

I have no idea what "deserve" means, other than, "I don't like what you're doing and want to see you get hurt as a consequence of doing it." It's a primitive, pre-scientific concept based on rudimentary rationalizations around social control behaviours in our primate ancestors, I think.

If You Drink Alcohol Avoid Acetaminophen

[eldavojohn]

The problem is the key ingredient - acetaminophen - can easily damage or destroy a patient's liver if more than 2000 mg are used per day.

Disclaimer: Not a doctor or med student but my three sisters are nurses/researchers.

My older sister warned me when I started college that if I was going to drink I should avoid acetaminophen at all costs. Luckily, I don't get headaches or have had a need for a painkiller in a very long time and I think it's been about six years since I've taken them. If you are a heavy drinker, avoid acetaminophen as your liver's already dealing with the alcohol and crap in the American diet and doesn't appreciate it. My sister told me that people who use acetaminophen during hangovers may be putting themselves at a much higher risk for liver diseases. I'm a little concerned these have been out for this long when there's safer alternatives. I'm sure the companies that stand to profit have tons of tricks up their sleeves yet.

Re:House, MD

[ae1294]

So does House still have a working liver at this point?

The whole reason he got into medicine in the first place was to be near a supply of fresh new organs. It was ether THAT or start APPLE and he just couldn't stomach the idea of rampant fanboys.

Re:Only because of stupid people.

[jlechem]

'The people that are stupid and dont read the bottle that says" DO NOT TAKE MORE THAN XXX in a 24 hour period." It's clear as day on the fricking bottle.'

Not really look at a tylenol bottle. Yeah it says no more then 6 or 12 in a day but it's incredibly tiny and hard to read. And nowhere does it talk about using it with other drugs of that type other then a generic consult your doctor blah blah blah. And who talks about tylenol with your doctor? I means it's been on the market a while and is 100% safe right? I agree there is a lot of stupid shit out there but I feel this case isn't one of them.

Alcohol

[sexconker]

So when will the FDA ban alcohol for destroying people's livers?

Why BAN and not WARN?

[Fallen Kell]

Seriously here. Why not make sure that there are STRONG WARNINGS on these drugs and require that they also place the warnings on TV Ads (not just in the small print, but actually required spoken warning about exceeding the 2000mg limit, and mention that other drugs like prescription pain killers may also contain this substance and to check with your doctor). I mean, if people know that over-dosing on this WILL seriously damage and potentially kill your liver, they will pay a little more attention to how much they are taking...

As it currently is, with the current ads and warnings, more people think that something like Tylenol with Codeine is pretty safe to take. I mean, its Tylenol, safe for your stomach (too bad just not necessarily safe for your liver).

Re:So wait...

[phizix]

The FDA made the drug companies put acetaminophen into the narcotic painkillers to keep people from recreationally overdosing on them (same as they "denature" ethyl alcohol that you can buy at the hardware store by poisoning it with methyl alcohol)...

This is not true at all. Acetaminophen and narcotics are mixed because the combination is a much more effective pain reliever than either alone.

Jaundiced junkies in the ER,

[pigwiggle]

my wife sees it all the time - dead livers. The concern isn't for people taking this on prescription. They can get a different preparation if necessary. Good riddance. Better yet, get rid of the whole prescription regime. Many doctors are sick of being the narcotic gate keeper. On one side is the DEA looking to pull your license and prosecute, on the other a patient who may or may no be in pain. It's the doctors responsibility to correctly identify drug seekers. Chronic pain rarely kills. What would you do if your livelihood could be taken away for prescribing narcotics to a patient who you believed to be in pain, but was a very clever junkie? I have a feeling there are a lot of chronic pain sufferers that aren't having their pain managed correctly because their physician fears being accused of over prescribing narcotics. More senseless shit brought to you by the War on Drugs. As the late but not so great Bill Hicks said - it's not a war on drugs, it's a war on personal freedom.