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'Safe' Painkiller Is Leading Cause Of Liver Failure
New Scientist ^ | 12--8-2005 | Alison Motluk

Posted on 12/08/2005 3:07:50 PM PST by blam

'Safe' painkiller is leading cause of liver failure

08 December 2005
NewScientist.com news service
Alison Motluk

A POPULAR over-the-counter painkiller is now the leading cause of acute liver failure in the US - and almost half of those cases are accidental overdoses.

Paracetamol (or acetaminophen as it is known in the US) is used by millions of Americans each year, and is commonly thought to be safe. Until 1980, paracetamol was not even listed as a cause of acute liver failure. But between 1998 and 2003, the proportion of cases of liver failure caused by the drug nearly doubled.

William Lee at the University of Texas Southwestern Medical Center in Dallas and his colleagues followed patients with acute liver failure who were in a coma. Of the 275 people with paracetamol poisoning, 8 per cent received a liver transplant, 65 per cent survived without one and 27 per cent died.

Initially the researchers had suspected a direct relationship between how much of the drug is in the liver and for how long, and the extent of the damage. But people who intentionally overdosed, who tend to be identified and treated more quickly, had similar damage to those who overdosed accidentally. That suggests a clear threshold for what constitutes a safe dose of the drug.

Many of the people who had accidentally poisoned themselves did so by taking just 10 grams of the medication each day for about three days - the equivalent of about 20 pills per day instead of the recommended eight, an overdose that might be less serious with other drugs. Other people had unwittingly taken two products that both contained the drug (Hepatology, vol 42, p 1364).

Lee thinks American drug enforcers should follow the lead of the UK, which requires products that contain acetaminophen to be packaged in blister packets and sold in small quantities. "I think we should talk about limiting package size," says Lee. "You can buy 500 at a time. They're like M&Ms."


TOPICS: News/Current Events
KEYWORDS: bushsfault; cause; failure; leading; liver; medicine; painkiller; safe
I believe we know Acetaminophen as Tylenol.

And, they're correct, I have a bottle of 500 in my medicine cabinet.

1 posted on 12/08/2005 3:07:52 PM PST by blam
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To: blam

My missus has kidney failure that may have been the result of ibuprofen. inconclusive, but they found no other explaination for it either


2 posted on 12/08/2005 3:11:19 PM PST by digger48
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To: blam

Do most people not know about acetaminophen's effect on the liver? I thought it was pretty well known. I always take something else if I've had any alcohol that day.

It's also found in cough syrups and other stuff.


3 posted on 12/08/2005 3:11:43 PM PST by Sols
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To: blam
Oh ho! Back up or put on your tinfoil chapeau, this topic has been a hobbyhorse of mine for years. Most people have no idea that Tylenol is dangerous in overdose, let alone how small an amount over the recommended dose constitutes an overdose.

Then there's stuff like Tylenol #3 and Tylenol #4, that pair acetaminophen with codeine. Presumably, they add the Tylenol to prevent it being used recreationally, but how many people other than experienced druggies know the danger? And what're we saying, really? We'd rather have you die of liver failure than abuse a prescription medication?

A nurse friend of mine talks about heartbreaking cases of kids deliberately trying to suicide on Tylenol, waving cheerily on their way out of the hospital, when she knows they'll be back before long when it catches up to their livers.

Moreover, the damned stuff doesn't work at all for me. I might as well take nothing. And all this has been known about it from the beginning. How in heck it ever got adopted as the "safe" pain reliever for use in hospitals, over good old blood-thinning aspirin, is one of life's great mysteries. And, I suspect, another of life's great mysterious that could be solved by followed the money.

Phew! Now, that feels better...

4 posted on 12/08/2005 3:16:52 PM PST by prion (Yes, as a matter of fact, I AM the spelling police)
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To: digger48
"My missus has kidney failure that may have been the result of ibuprofen. inconclusive, but they found no other explaination for it either.

I thought ibuprofen causes heart failure too.

5 posted on 12/08/2005 3:21:37 PM PST by blam
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To: blam

[Lee thinks American drug enforcers should follow the lead of the UK, which requires products that contain acetaminophen to be packaged in blister packets and sold in small quantities. "I think we should talk about limiting package size," says Lee. "You can buy 500 at a time. They're like M&Ms."]


Yes, I've long said that we need the government to limit our choices as consumers in order to prevent us from hurting ourselves.

After they limit the number of pills we can buy at one time to keep us idiotic peasants from accidentally overdosing, then they can pass a law that puts a limit on how much food we can buy in one serving at a restaurant to prevent us from overeating and getting too fat or developing heart disease.

I hope the sarcasm tag is unnecessary.


6 posted on 12/08/2005 3:23:36 PM PST by spinestein (All journalists today are paid advocates for someone's agenda.)
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To: blam

Dude, go to CostCo, you can get a bottle of 1200 for the same price.


7 posted on 12/08/2005 3:24:30 PM PST by Valpal1 (Crush jihadists, drive collaborators before you, hear the lamentations of their media. Allahu FUBAR!)
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To: blam
Percoset and other similar opiate containing drugs contain acetaminophen as well. 325 mg a pill. Tylonol 3's with codeine are really just 325 mg acetaminophen with 5 mg of the opiate derivative codeine. Never, EVER drink while taking acetaminophen, that can cause liver failure. If you have cronic pain, take something else. Oxycontin contains NO acetaminophen, which is why is popular among people with cronic pain. It's bad stuff if you DON'T have cronic pain however. All drugs are dangerous if used incorrectly.
8 posted on 12/08/2005 3:24:52 PM PST by Forte Runningrock
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To: blam

Pretty much anything has a 1-1,000,000 chance of something, I guess.


I've had doctors contradicting the pharmacist on tylenol vs ibuprofen vs aspirin for a particular ache or pain


9 posted on 12/08/2005 3:27:26 PM PST by digger48
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To: blam

This has been known for years,since at least the seventies.

Too much of anything will damage something.




10 posted on 12/08/2005 3:28:10 PM PST by Mears (The Killer Queen)
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To: blam

Don't take more than 20 in 24 hours.


11 posted on 12/08/2005 3:29:46 PM PST by Crawdad (So the guy says to the doctor, "It hurts when I do this.")
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To: Mears

>>> Too much of anything will damage something. <<<

Bingo. It's amazing how many people forget that...


12 posted on 12/08/2005 3:30:40 PM PST by Keith in Iowa (You know you have bird flu if you have usual flu symptoms + desire to crap on freshly washed cars.)
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To: blam

Lets see.. can't take Tylonol - bad for my liver.

Can't take aspirin or motrin - bad for my kidney (yes, I have only 1 left).

Whats left?

I guess it's a good thing I rarely get headaches...


13 posted on 12/08/2005 3:30:54 PM PST by Trampled by Lambs (I think, therefor I Zot!)
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To: spinestein
I hope the sarcasm tag is unnecessary.

I have learned the painful way that the sarcasm tag is always necessary. There's always some moron out there that will take you seriously.

14 posted on 12/08/2005 3:31:42 PM PST by randog (What the....?!)
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To: spinestein
Yes, I've long said that we need the government to limit our choices as consumers in order to prevent us from hurting ourselves.

When they start messing with the beer limit, all bets are off.

15 posted on 12/08/2005 3:33:43 PM PST by Recovering Hermit
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To: blam

I'm an aspirin man, myself.


16 posted on 12/08/2005 3:36:50 PM PST by Jackknife ( "I bet after seeing us, George Washington would sue us for calling him 'father'." óWill Rogers)
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To: prion

Tylenol has always been the politically correct painkiller.My lefty friends all take it exclusively instead of that capitalist drug aspirin. I have no idea whatever why this seems to be the case.


17 posted on 12/08/2005 3:42:07 PM PST by arthurus (Better to fight them over THERE than over HERE.)
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To: prion

Your right on the money there. I was put on tylonol (percoset) for a year, and began showing signs of liver damage. it shouldn't be used long term, or in high doses.

I'm still on oxycontin for cronic pain, If I have a headache, I take an asprin. only if the asprin fails to work will I take ONE percoset. If that doesn't work, go to sleep. Strange that oxycontin does nothing for a headache, but does wonders for my spinal injury.

people need to be careful with acetaminaphene, and for God's sake do NOT drink while taking it.


18 posted on 12/08/2005 3:43:33 PM PST by Forte Runningrock
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To: spinestein

People really have to educate themselves.

My husband had an achy cold...took a dose of Nyquil then asked me "Where's the Tylenol?" I had to point out to him that Nyquil has 1000 mg of Tylenol per dose. Add to the fact that he used to be a heavy drinker...yikes!


19 posted on 12/08/2005 3:47:13 PM PST by 2Jedismom (Expect me when you see me!)
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To: blam

Haven't used the brand name in ages. It is about twice as expensive as some other forms of Acetaminophen.


20 posted on 12/08/2005 3:53:17 PM PST by TheLion
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To: blam

**I have a bottle of 500 in my medicine cabinet**

Don't you LOVE Costco?!


21 posted on 12/08/2005 3:53:40 PM PST by ninergold3 (aka GiantsPrincess)
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To: Crawdad
"Don't take more than 20 in 24 hours.

20!!!! Do you have a deathwish? If you have a bad pain, and not just a headache, 8 tylonol (325 mg) is max. if it doesn' work, ask for something else. Demorol, morphene. And if it's "just" a headache, see a doctor.

22 posted on 12/08/2005 3:57:08 PM PST by Forte Runningrock
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To: Forte Runningrock

Tylenol and ibuprofen are useless for my pain. They don't even touch a headache.


23 posted on 12/08/2005 3:59:30 PM PST by tutstar (Baptist Ping List Freepmail me if you want on or off this ping list.)
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To: blam

(Sigh) I am so screwed.

I can't move unless I'm on anti-inflammatories. I've taken Vioxx which worked great, but my doctor took me off it years ago. I've been switched over to Arthrotec, which is ok, and I take Claritin-D for allergy-related sinus headaches. If I get truly desperate I reach for the Tylenol #3 but I hate the side effects.

I'm very low risk for diabetes and heart disease, but I'm growing more convinced my obit will say liver failure or cancer.


24 posted on 12/08/2005 4:01:12 PM PST by Kieri
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To: Sols
I remember reading that a few drinks of alcohol can do serious damage when mixed with Acetaminophen.
25 posted on 12/08/2005 4:26:14 PM PST by rdcorso (There Is No Such Thing As A Neutral Person During A War With Radical Islam.)
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To: Kieri
I was just prescribed some Diclofenac today for pain and inflamation. Click on the link for details.
26 posted on 12/08/2005 4:29:54 PM PST by blam
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To: blam

20 a day is a lot. One a week is maybe more like it. I wouldn't dare take 20 in one day, not even during recovery from major surgery.


27 posted on 12/08/2005 4:30:40 PM PST by RightWhale (Not transferable -- Good only for this trip)
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To: blam

I know of at least one casualty to Tylenol, Alcohlics should avoid this drug even more than alcohol.

We had a Foreman working Offshore that would get plastered for a week then work for a week, returning to work one week, he was hung over ate some Tylenol and he DIED. He was 24 and in very good shape physically.

Major Oil Companies do not lecture morality, but unofficially they also do not recommend Tylenol (at safety meetings).

TT


28 posted on 12/08/2005 4:32:04 PM PST by TexasTransplant (NEMO ME IMPUNE LACESSET)
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To: blam
Many of the people who had accidentally poisoned themselves did so by taking just 10 grams of the medication each day for about three days - the equivalent of about 20 pills per day instead of the recommended eight, an overdose that might be less serious with other drugs.

If you're stupid enough to take 2½ times the recommended dosage of anything, you deserve what you get.
29 posted on 12/08/2005 4:32:17 PM PST by Xenalyte (Tom Cruise is in my closet and he won't come out.)
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To: Sols

Alka Seltzer too.


30 posted on 12/08/2005 4:35:04 PM PST by BunnySlippers
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To: prion
I agree. I find Tylenol ineffective compared to aspirin;and found out the hard way that while asprin is safe for a hurt dog, even one Tylenol is deadly.I also avoid Nutrasweet.
31 posted on 12/08/2005 4:42:15 PM PST by hoosierham (Waddaya mean Freedom isn't free ?;will you take a creditcard?)
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To: blam

They beat us over the head with this information in nursing school. My instructor just told us that they're thinking about changing the warning stating that if you drink 3 or more alcoholic beverages a day not to take Tylenol, to NO alcohol with Tylenol. Very nasty stuff.


32 posted on 12/08/2005 4:50:27 PM PST by Siouxz ( Freepers are the best!!!)
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To: blam
From lef.org:

"When a person takes acetaminophen, it is metabolized by a number of metabolic systems in the liver, including one called the P450 system. This results in an intermediate by-product, or metabolite, that is very reactive and can kill liver cells. This intermediate metabolite is normally converted to a harmless final metabolite by an antioxidant in the liver called glutathione (Uhlig et al. 1990; Deleve et al. 1991; Richie et al. 1992). A large dose of acetaminophen reduces the glutathione supply, resulting in progressive necrosis of the liver, sometimes evidenced in as little as 5 days. Alcoholics and those on certain medications that stimulate the P450 system are at particular risk because, with increased P450 activity, more toxic intermediate is created than there is glutathione available to further metabolize it to something harmless. Although not fatal, chronic acetaminophen use decreases the functional capacity of the liver.

Acetaminophen can also cause permanent kidney damage when taken over extended periods of time. This damage can be lethal to those with underlying kidney disease. The Food and Drug Administration does not require the manufacturers of Tylenol and other brands of acetaminophen to adequately warn people with kidney disease to avoid this pain medication. However, for those in chronic pain who cannot find relief from natural pain relief therapies (see Pain and Arthritis protocols), it is suggested that Tylenol and other brands of acetaminophen be used sparingly.

To illustrate how dangerous acetaminophen can be, studies show that people who used acetaminophen on a regular basis more than doubled their risk of kidney cancer (Kaye et al. 2001; Gago-Dominguez et al. 1999; Derby and Jick 1996). Kidney cancer is very difficult to treat. The liver-kidney-heart muscle toxicities and the cancer risks of analgesic drugs have not been reported by most media sources, which reap tremendous profits from the advertising of pain relief products.

Acetaminophen poisoning is a toxic reaction resulting from the ingestion of excessive doses of the drug. In adults, dosages exceeding 10-15 grams can produce liver failure and dosages exceeding 25 grams can be fatal. Symptoms such as nausea and vomiting, profuse sweating, pallor, and oliguria (scanty amounts of urine) are associated with the onset of acetaminophen poisoning. Jaundice and pain in the upper abdomen, hypoglycemia, encephalopathy, abnormal functioning of brain tissue, and kidney failure may become apparent as drug toxicity increases."

Acetaminophen Poisoning
33 posted on 12/08/2005 4:52:17 PM PST by Ragnar54
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To: Siouxz
I am a nurse as well.

If you drink 3 alcoholic beverages a day, with or without Tylenol, you have a head start on liver problems that needs to be addressed. Moderation in everything..............except moderation.
34 posted on 12/08/2005 4:56:47 PM PST by HonestConservative (Bless our Servicemen!)
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To: blam

Milk Thistle...several folks were on the waiting list for liver transplant...they started taking Milk Thistle daily 3 caps a day...within 6 months they were NO longer on the transplant list...their livers had repaired itself because of the Milk Thistle.


35 posted on 12/08/2005 4:57:59 PM PST by shield (The Greatest Scientific Discoveries of the Century Reveal God!!!! by Dr. H. Ross, Astrophysicist)
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To: prion

I'm with you. If I need a pain-killer, I use aspirin. If I need non-aspirin, I use ibuprophen. However, I don't use any of them regularly. Acetomenaphin never worked well for me. I gave it to my children sparingly.


36 posted on 12/08/2005 5:09:39 PM PST by Clara Lou (A conservative is a liberal who has been mugged by reality. --I. Kristol)
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To: blam
I was just prescribed some Diclofenac today for pain and inflamation. Click on the link for details.

If you scroll down to the end of the document, it lists the brand name. It's Arthrotec, which I'm already on. Thanks for helping, though!

37 posted on 12/08/2005 6:01:28 PM PST by Kieri
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To: blam

That's what we need! More drug laws. Because goodness knows, we poor citizens are utterly incapable of deciding for ourselves what to put in our bodies without the nod from our pal the government.


38 posted on 12/08/2005 6:09:27 PM PST by mysterio
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To: blam
I have long avoided acetaminophen because of reported liver problems; for back and knee pain I was using multiple prescription naxoprofen and/or ibuprofen daily until I discovered, in October, an exercise program that is only practicable outdoors in non-freezing weather...and I'm starting to stiffen up again (It's cold!)...and I'm concerned about NSAID cardiac issues. Here's one alternative:

For example, cannabis has also been found useful in the treatment of osteoarthritis. Aspirin is believed to cause more than 1,000 deaths annually in the United States. More than 7,600 annual deaths and 70,000 hospitalizations caused by non-steroidal antiinflammatory drugs (NSAIDs) are reported. Gastrointestinal complications of NSAIDs are the most commonly reported serious adverse drug reaction.4 Long-term acetaminophen use is thought to be one of the most common causes of end-stage renal disease.5 Cannabis smoked several times a day is often as effective as NSAIDs or acetaminophen in osteoarthritis, and there have been no reports of death from cannabis.

39 posted on 12/08/2005 6:32:54 PM PST by MRMEAN (Suppose you were an idiot, and suppose you were a member of congress;but I repeat myself. Mark Twain)
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To: Forte Runningrock

I was just sarcastically referencing the article. I would never take more than what the dosage says on the bottle.


40 posted on 12/09/2005 5:56:05 AM PST by Crawdad (So the guy says to the doctor, "It hurts when I do this.")
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To: blam

I have learned to live without painkillers because of drug allergies. A hot bath or heating pad for some pain an ice pack for others.


41 posted on 12/09/2005 6:06:31 AM PST by Ditter
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