By Jessie Szalay, LiveScience Contributor
Source: http://www.livescience.com
Acetaminophen
is an over-the-counter pain reliever that may be used to help with mild to
moderate headaches, muscle aches, backaches, sore throats and other cold
symptoms, menstrual cramps, toothaches and reactions to shots. It is also
sometimes used to help ease the pain of osteoarthritis.
Acetaminophen
is the name used in the United States and Japan; internationally, the drug is
known as paracetamol. It is sold under dozens of brand names, such as Tylenol,
Panadol and Mapap. It is also a component in more than 100 medications,
including Alka-Seltzer Plus Cold & Sinus, NyQuil Cold/Flu Relief, Percocet
and Excedrin.
Acetaminophen
belongs to drug classes analgesics (pain relievers) and antipyretics (fever
reducers). It works by elevating the pain threshold so that only more intense
pain is registered as such. It also tells the brain to cool off the body during
fever.
Dosage
Acetaminophen
is available as a tablet, chewable tablet, capsule, liquid, drops (no longer
produced in the United States), extended-release tablet, orally disintegrating
tablet and rectal suppository. Oral forms can be taken with or without food. It
is important not to crush or chew extended-release tablets, as this can
increase the risk of side effects since the medicine will be released all at once.
Acetaminophen
will probably work better if taken when the first signs of pain occur,
according to the National Institutes of Health (NIH).
The
NIH recommends that doses not exceed 4,000 mg of acetaminophen per day (the
amount of eight Extra Strength Tylenol). If taking acetaminophen for fever, do
not take it for more than three days unless directed by a doctor. For pain
relief, adults should not take acetaminophen for more than 10 days and children
should not take it for more than five, unless directed by a doctor.
Do
not give children acetaminophen products that are made for adults. Determine a
child’s dose of acetaminophen products based on his or her weight or age.
Acetaminophen
may be included in other medications for coughs or colds. It is important to
check the labels carefully if using two or more products at the same time, as
taking multiple medications containing the same active ingredient(s) could
cause an overdose.
Side
effects
According
to the NIH,
the following are serious side effects of acetaminophen. If experienced, call a
doctor immediately and stop taking the drug:
- rash
- hives
- itching
- swelling
of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower
legs
- hoarseness
- difficulty
breathing or swallowing
Overdose
According
to the NIH,
“acetaminophen overdose is one of the most common poisonings worldwide.”
Although it is usually quite safe in small doses, it can be dangerous or even
deadly if taken in large quantities. The minimum toxic dose in a single
ingestion for adults is 7.5-10 g and 150 mg/kg; 200 mg/kg in children ages 1-6.
The
NIH lists the following as symptoms of acetaminophen overdose:
- nausea
- vomiting
- loss
of appetite
- sweating
- extreme
tiredness
- unusual
bleeding or bruising
- pain
in the upper right part of the stomach
- yellowing
of the skin or eyes
- flu-like
symptoms
In
case of these symptoms, patients should seek medical help immediately. If
medical attention is received within eight hours of overdose, there is a good
chance of recovery. Emergency room treatment may include laxatives, poison
antidotes, and activated charcoal. If a large overdose goes untreated, it may
lead to liver damage or death within just a few days.
Toxicity
In
August 2013, the FDA issued a safety announcement about three rare, but
potentially lethal, skin disorders that are associated with acetaminophen. The
disorders are Stevens-Johnson syndrome, toxic epidermal necrolysis, and acute
generalized exanthematous pustulosis. Any patient who has a skin reaction,
including a rash or a blister, while taking acetaminophen should immediately
stop taking the drug and seek emergency medical attention.
In
response to this warning, concentrated forms and drops of acetaminophen for
children are no longer being produced in the United States.
Liver
damage
In
the United States, acetaminophen is the most common cause of acute hepatic
failure and the second most common cause of liver failure requiring a
transplant.
On
Jan. 14, 2014, the FDA issued a statement “recommending
health care professionals discontinue prescribing and dispensing prescription
combination drug products that contain more than 325 milligrams (mg) of
acetaminophen per tablet, capsule or other dosage unit.” Though the risk of
liver damage from overdose of acetaminophen has long-been known, this most
recent recommendation is targeted at reducing the number of people who overdose
by unknowingly taking too many medications that contain acetaminophen.
Liver
damage occurs when the liver’s glutathione pathway is overwhelmed by too much
of acetaminophen’s metabolite, NAPQI. Toxic compounds then accumulate in the
liver and damage it. There are three symptomatic phases of liver damage:
nausea, vomiting, loss of appetite, and other flu-like symptoms; an inactive
phase during which there is no discomfort; and the appearance of liver blood
test abnormalities. For this reason, it is important to seek medical help when
initial symptoms appear.
Patients
should be sure to tell their doctor if they have any history of liver problems
or drink more than two alcoholic beverages per day.
Hydrocodone
and acetaminophen
Hydrocodone
is a strong narcotic pain reliever. It is sometimes combined with acetaminophen
(a non-narcotic) for increased pain relieving effect. It is prescribed to
relieve moderate to severe pain, and is a main ingredient in many prescription
painkillers.
Hydrocodone
may be habit-forming. Combined with acetaminophen, it may impair thinking or
reactions. It may be best not to drive or do anything that requires alertness
while taking this medicine.
Codeine
and acetaminophen
A
combination medicine of codeine and acetaminophen may be prescribed to treat
mild to moderately severe pain. Codeine is narcotic pain reliever and can be
habit forming, so it is important not to exceed the prescribed dose. According
to the NIH,
serious side effects are difficulty breathing and mood changes, and if
experienced, a doctor
should be consulted immediately.
Information
on this page should not be construed as medical advice nor an attempt to make
diagnoses.
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