FDA Issues New Warnings Over Acetaminophen

Five Warnings About Acetaminophen

Not many of us would think that popping an over-the-counter painkiller is that big of a deal if we have a headache or muscle pains.  However, the Food and Drug Administration recently issued five pertinent warnings to doctors about prescribing high doses of acetaminophen with combination drugs (e.g. Percocet or Vicodin).  Specifically, they say that acetaminophen in doses higher than 325 mg can cause liver damage if taken incorrectly.  Read on for some surprising warnings about acetaminophen:

1. Acetaminophen is not great for muscle pain: surprisingly, acetaminophen is not great for relieving muscle pains because of the way it operates on enzymes in the body.  Acetaminophen is known as a non-opioid analgesic and blocks the enzyme called cyclooxygenase, which helps the body to produce lipid compounds that cause pain and inflammation when your cells are injured.  While most non-opioid painkillers work in the peripheral nervous system (which are not connected to the brain and spinal cord), acetaminophen is believed to operate in the central nervous system.  Because acetaminophen works on the part of the nervous system associated with the brain and spinal cord, it is effective as a painkiller for headaches, but not muscle pains, since the muscles are related to a separate part of the nervous system.
2. It’s in more than Tylenol: acetaminophen can be found in a range of products that you may commonly use aside from Tylenol.  For example, it can be found in Percocet, Vicodin and Tylenol with codeine, in addition to many other over-the-counter drugs including Excedrin, Robitussin and Sudafed.
3. It’s easy to take too much: the recommended daily maximum dosage of acetaminophen for adults is 4,000 mg.  While that may seem like a lot, it doesn’t take much to overdose.  In fact, one gel capsule of Extra Strength Tylenol contains 500 mg.  Taking too much acetaminophen can lead to liver damage and even death, and this is exemplified by the fact that overdoses of the painkiller are some of the most common poisoning deaths worldwide.
4. It isn’t a good way to fight a hangover: although you may be used to taking an acetaminophen to ward off the effects of a hangover, it isn’t the best idea, especially if you’re a chronic excessive drinker.  Acetaminophen is metabolized by the liver and so is alcohol, so if you’re drinking heavily for nights on end and taking acetaminophen on top of it, you’re making your liver do double-duty.  You may not notice the signs of liver damage right away either, although you can quickly become very ill or die from taking too much acetaminophen after drinking.
5. It’s not a cure-all for children: it’s important to be careful with dosing for children and to not pass out acetaminophen generously.  Bottles of acetaminophen have a dosing guide printed on them, which should be carefully followed based on weight and age.

Who knew acetaminophen could be so dangerous?  The good news is that if taken properly, including at the right dosages and for the right reasons, it is typically an effective painkiller.