Tylenol and the liver

The Food and Drug Administration's advisory panel has recommended that the agency reduce the maximum recommended dosage of acetaminophen, an over-the-counter pain killer more commonly known as Tylenol. The drug's potential risk of liver damage is the issue.

Here's the Associated Press story.

And, for a fuller explainer, here's this from MedicineNet: "How is acetaminophen processed (metabolized) in the body?"

"The liver is the primary site in the body where acetaminophen is metabolized. In the liver, acetaminophen first undergoes sulphation (binding to a sulphate molecule) and glucuronidation (binding to a glucuronide molecule) before being eliminated from the body by the liver. The parent compound, acetaminophen, and its sulphate and glucuronide compounds (metabolites) are themselves actually not harmful. An excessive amount of acetaminophen in the liver, however, can overwhelm (saturate) the sulphation and glucuronidation pathways. When this happens, the acetaminophen is processed through another pathway, the cytochrome P-450 system. From acetaminophen, the P-450 system forms an intermediate metabolite referred to as NAPQI, which turns out to be a toxic compound. Ordinarily, however, this toxic metabolite is rendered harmless (detoxified) by another pathway, the glutathione system."

If that's more than you want to know, there's always this from the FDA: "Acetaminophen and liver injury: Q & A for consumers."

It begins: "Acetaminophen is the generic name of a drug found in many common brand name OTC products such as Tylenol, as well as prescription products such as Vicodin and Percocet."

Most people, of course, don't take the more tightly controlled Vicodin and Percocet like candy -- as they sometimes do Tylenol.

-- Tami Dennis

Comments

[jdj]

The troubling thing about acetaminophen is its ubiquity in so many OTC medications. It is very easy to take much more than the recommended dosage without realizing it.

[ltc@gmail.com]

As a pharmacist at Medicine Shoppe, I remind my customers that besides the acetaminophen itself, so many of the other o-t-c medications are compounded with the drug that they could easily be taking it in unsafe amount. I am especially concerned for my older customers. More than other age groups, they will read the ingredients label, but often do not take into account that several of the prescription and o-t-c medications they are taking pose a serious threat to their health. I am glad the FDA is taking action.

[hb]

Is Advil dangerous, too?

[Tami]

Advil, or ibuprofen, has risks too. All drugs do. But they're different from those posed by acetaminophen. With ibuprofen, the risk seems to be concentrated in the kidneys. Again, MedicineNet.com has more complete information.

[Emorette Hinton]

I agree with this dianosis, my sister died in 2005 with, along with other vital parts that was damaged, panceras, heart, due to accessive use of Tylenol as well as Tylenol PM. She was only 58 years old.

[Fred]

I have been told that Norco is a drug with the same painkilling effect as Vicodin and the same narcotic level, without acetaminophen.

[Alan]

Percocet consists of oxycodone and acetaminophen. Note that oxycodone is not oxycontin (timed release oxycodone), although the main pain ingredient in both oxycontin and Percocet is oxycodone. Important for those using Percocet is that the medication oxycodone can be prescribed as a separate medication, in various dosages.

[megan totman]

Norco is the same as Lortab, or Vicodin it does have tylenol as well

[Cyn]

FDA Panel Votes to Eliminate Two Popular Pain Killers Due to Acetaminophen Concerns: http://www.newsinferno.com/archives/7603#more-7603