Common Over The Counter Pain Relievers Can Cause Toxicity
You have a headache and it’s a severe headache, so severe that you can’t function. You decide to take two Tylenol (650 mg). Two hours later you feel a little better but the pain is still severe enough to keep you from your daily tasks. The directions on the bottle read take 2 tablets every 4 to 6 hours, so you’re probably thinking taking two tablets a couple of hours early shouldn’t hurt anything, and your headache is about to get the best of you. You think about it for another minute or two and then decide to take an additional two tablets. Is there anything wrong with what you just did? Perhaps you rationalize it by saying that taking two more tablets equaled about 1300 mg which is probably prescription strength (a doctor would have prescribed this), and taking the additional two tablets did alleviate the pain; the headache is gone! You actually feel better and can function. But the truth is without the advice of a physician you should never exceed the recommended dose of any over the counter medication, particularly Tylenol.
Tylenol, a common and popular medication, is made of acetaminophen a pharmaceutical analgesic and antipyretic agent. It is the most widely used analgesic in the United States; used primarily for the relief of fever and other minor aches and pains. Access to acetaminophen is quite easy and because of this there is a huge potential for overdose and toxicity.
This may be surprising to learn, but acetaminophen toxicity is by far the most common cause of acute liver failure in both the United States and the United Kingdom. There are two reasons for this: (1) Widespread availability and (2) people underestimate the potential for toxicity.
The recommended dose for Tylenol is 325 - 650 mg every four to six hours. In adults the minimum toxic dose of acetaminophen for a single ingestion is 7.5 to 10 grams. Which means it would take the ingestion of 7,500 mg to 10,000 mg to be toxic. The half life of Tylenol is about four hours, but the concentration is peaked (at its fullest potential) two hours after ingestion. So though you may feel no relief in two hours the medication is still in your system.
You’re probably saying “well that could never happen to me. I could never ingest that much medication without realizing it.” Well…. it doesn’t take long to develop a tolerance for medication. Also In just a two hour period our above scenario had you ingesting 1300 mg. What if there was no relief after taking the 1300 mg? How long would you wait before taking an additional two tablets or more? Granted this is just a case scenario, but it does happen.
The thing to note here is that when you’re in pain you just want to feel better and when you’re in severe pain it’s hard to maintain the proper perspective. This is how so many people have gone into acetaminophen toxicity and liver failure.
Signs of acetaminophen toxicity include anorexia, nausea, vomiting, malaise (a feeling of general discomfort), and diaphoresis (increased perspiration). More severe symptoms may include right upper quadrant pain and tenderness liver enlargement and decreased urinary output. Once hepatic failure (liver failure) has occured there is jaundice (yellowing of the skin or eyes), renal failure, bleeding, encephalopathy (disease of the brain) and cardiomyopathy (disease of the heart muscle), which could lead to death.
Never underestimate the potency of any drug with acetaminophen in it, and always follow the directions as given. If over the counter analgesics aren’t enough to relieve your pain seek the advice of a physician for something stronger and don’t exceed the recommended dose. If you are taking Tylenol or any analgesic at home document the dose taken and the time on a medication log. This will help you to better remember not to overlap your dosage times. If you have developed a dependency please seek help.
Here is a number that you can call. 1-800-662-HELP or visit the website http://www.findtreatment.samhsa.gov
Doing these things could protect your liver and your life.
REFERENCES:
Wilkiperdia : http://en.wilkipedia.org/wilki/Acetamenophen
Emedicine : Toxicity, Acetamenophen - Germaine L Defendi, MD, MS, FAAP
http://www.emedicine.com/ped/topic7.htm
Sharon Rowe has been a registered nurse for over ten years. She presently operates her own online health form business. She noticed during her years in nursing the growing need for a development of health forms to be used primarily for in home use. Visit her at http://www.yourmedform.com
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