Don’t Double Up on Acetaminophen
You
have flu symptoms, so you've been getting some relief for the past two days by
taking a cough and flu medicine every few hours. Late in the day, you have a
headache and you think about grabbing a couple of acetaminophen tablets to
treat the pain.
Stop
right there.
What
you may not realize is that more than 600 medications, both prescription and
over-the-counter (OTC), contain the active ingredient acetaminophen to help
relieve pain and reduce fever. Taken carefully and correctly, these medicines
can be safe and effective. But taking too much acetaminophen can lead to severe
liver damage.
Acetaminophen
is a common medication for relieving mild to moderate pain from headaches,
muscle aches, menstrual periods, colds and sore throats, toothaches, backaches
and to reduce fever. It is also used in combination medicines, which have more
than one active ingredient to treat more than one symptom.
'Tis Cold and Flu Season
The
National Institutes of Health (NIH) says that Americans catch one billion colds
per year and as many as 20% of Americans get the flu. Moreover, 7 in 10
Americans use OTC medicines to treat cold, cough and flu symptoms.
Fathia
Gibril, M.D., M.HSc., a supervisory medical officer at the Food and Drug
Administration (FDA), explains that consumers looking for relief from a cold or
the flu may not know that acetaminophen comes in combination with many other
medications used to treat those symptoms. "So if you're taking more than
one medicine at a time," she says, "you may be putting yourself at
risk for liver damage."
Symptoms
of acetaminophen overdose may take many days to appear, and even when they
become apparent, they may mimic flu or cold symptoms. The current maximum
recommended adult dose of acetaminophen is 4,000 milligrams per day, To avoid
exceeding that dose:
·
don't take more than one OTC
product containing acetaminophen,
·
don't take a prescription and
an OTC product containing acetaminophen, and
·
don't exceed the recommended
dose on any product containing acetaminophen.
"When
you're at the store deciding which product to buy, check the 'Drug Facts' label
of OTC cold, cough and flu products before using two or more products at the same
time," Gibril says. If you’re still not sure which to buy, ask the
pharmacist for advice.
FDA
has an online list of brand names of products
containing acetaminophen.
Rely on Health Care Experts
Acetaminophen
is used in many commonly prescribed medications in combination with pain
relievers such as codeine, oxycodone and hydrocodone. As of January 2011, FDA
reported that overdoses from prescription medicines containing acetaminophen
accounted for nearly half of all cases of acetaminophen-related liver injury in
the U.S. When your health care professionals prescribe a drug, be sure to ask
if it contains this active ingredient, and also to inform them of all other
medicines (prescription and OTC) and supplements you take.
Even
if you still have fever or pain, it's important not to take more than directed
on the prescription or package label, notes FDA supervisory medical officer
Sharon Hertz, M.D. But be careful, the word "acetaminophen" is not
always spelled out in full on the container's prescription label. Abbreviations
such as APAP, Acetaminoph, Acetaminop, Acetamin, or Acetam may be used instead.
When
buying OTC products, Hertz suggests you make it a habit of telling the
pharmacist what other medications and supplements you’re taking and asking if
taking acetaminophen in addition is safe.
When
the medicine is intended for children, the "Directions" section of
the Drug Facts label tells you if the medicine is right for your child and how
much to give. If a dose for your child's weight or age is not listed on the
label and you can't tell how much to give, ask your pharmacist or doctor what
to do.
If
you're planning to use a medication containing acetaminophen, you should tell
your health care professional if you have or have ever have had liver disease.
Acetaminophen
and alcohol may not be a good mix, either, Hertz says. If you drink three or
more alcoholic drinks a day, be sure to talk to your health care professional
before you use a medicine containing acetaminophen.
This
article appears on FDA's
Consumer Updates page, which features the latest on all FDA-regulated
products.
January
24, 2013
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