Acetaminophen is the most generally used pain relief medicine in the US and other parts of the world, and it is also regarded one of the safest medicine. But recently, its perceived safety has come into question.
Acetaminophen, also well-known as paracetamol or APAP, is a medicine generally used to relieve mild to moderate pain and decrease fever. It is available in over 500 over the counter and prescription medicines.
Generally people use acetaminophen for various conditions like headache, fever, acetaminophen and cold etc.
With respect to the Consumer Healthcare Products Association (CHPA), every week, about 23 % of adults in the United States use a medicine that contains acetaminophen.
At suggested doses, acetaminophen is regarded one of the safest OTC drugs.
Unlike other common pain medications, like non-steroidal anti-inflammatory drugs, acetaminophen does not increase the risk of stomach or heart issues, making it a go-to drugs for individuals who are not able to tolerate NSAIDs.
What is more, healthcare suppliers look at acetaminophen as one of the few pain relievers that is usually safe to use while in pregnancy; a 2010 study from the Centers for Disease Control and Prevention (CDC) identified the drug leads to no elevated risk of significant birth defects when used in the initial trimester of pregnancy.
But, as with all drugs, there are risks, and investigators are discovering that the hazards of acetaminophen use may be more serious than we understand.
Previous year, a review presented in Annals of the Rheumatic Diseases determined that the possible risks of acetaminophen have been “underestimated,” with some research indicating the drug could increase the risk of cardiovascular events and death rate.
In this spotlight, we check out a few of the well identified risks of acetaminophen use, along with some that may come as a surprise.
Association between acetaminophen overdose and liver damage
Liver damage is probably the very well known threat of acetaminophen use, and such harm can take place through overdosing on the medicine.
After taking acetaminophen, the majority of the drug is metabolized by the liver and excreted via urination. On the other hand, some of the drug is turned into a toxic metabolite that can damage liver cells. Obtaining too much acetaminophen increases the risk of liver damage, and in serious cases, it can result in death.
With respect to the Food and Drug Administration (FDA), in between 1998-2003, acetaminophen was the main trigger of acute liver failure in the U.S., and almost 50 percent of liver failure situations while in this time were an outcome of accidental overdose.
In addition, the FDA expresses that, while in the 1990s, unintended acetaminophen overdose was accountable for about 56,000 emergency department visits, 26,000 hospitalizations, and 458 deaths every year.
Because acetaminophen is existing in a wide range of OTC and prescription medicines at different doses, it can be fairly easy to unintentionally take too much, especially if using several acetaminophen-containing drugs at once.
Present guidelines suggest getting no more than 4,000 milligrams of acetaminophen every day. Thinking about a single Extra Strength Tylenol tablet contains 500 milligrams, it is simple to see how one may unintentionally overdose on the drug.
What is more, acetaminophen caused liver damage takes place slowly, usually going unseen until it is too late, so individuals may think that getting a little extra acetaminophen than suggested is posing no harm.
With this in mind, in 2011, the FDA requested prescription drug producers to voluntarily restrict the amount of acetaminophen in each tablet or capsule to no greater than 325 milligrams, to be able to decrease consumers’ risk of unintentional overdose.
As of 2014, the organization noted that just 50 percent of prescription drug producers had voluntarily complied with the request, prompting them to launch procedures to take out approval of prescription combination medicines that contains over 350 milligrams.
In addition, the FDA suggest that healthcare suppliers consider prescribing combination medicines containing under 350 milligrams of acetaminophen per dose.
Serious skin allergies and blood cancers
A number of research have related acetaminophen use with serious skin allergies, and the FDA Adverse Event Reporting System (FAERS) exposed that in between 1969-2012, 107 such conditions took place in the U.S., causing in 67 hospitalizations and 12 deaths.
As a result, in 2013, the FDA released a warning that acetaminophen use, in unusual cases, can lead to a number of possibly fatal skin reactions, which includes Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
Dr. Sharon Hertz, deputy director of FDA’s Division of Anesthesia, Analgesia and Addiction said,
“FDA’s actions must be viewed within the perspective of the millions who, over years, have helped from acetaminophen,”. “Nonetheless, given the seriousness of the threat, it is essential for sufferers and healthcare suppliers to be aware of it.”
In 2011, a study presented in the Journal of Clinical Oncology discovered a link between regular acetaminophen use and enhanced risk of specific blood cancers.
The research, which examined the painkiller use of over 64,000 men and women aged 50-76, identified that people who used acetaminophen 4 or more times a week for a minimum of 4 years were at a two fold risk of some types of blood cancers, which includes lymphoma and leukemia.
On the other hand, study co-author Emily White, mentioned that the possibility of such cancers was still small among regular, long-term acetaminophen consumers, at about 2 % over a 10-year period.
Autism, ADHD, and asthma
Despite acetaminophen use while in pregnancy being regarded usually safe, a number of researches have recommended this may not be the case.
In 2016 February, a research that identified expectant moms who used acetaminophen were more probably to have kids who developed asthma by the age of 3 years.
The investigators – which includes Dr. Maria Magnus says the results are of public health significance, discovering the possible adverse effects of acetaminophen use in pregnancy.
However, they say the outcomes do not guarantee changes to present acetaminophen recommendations for use during pregnancy, which state that pregnant women should seek advice from their doctor before using the drug.
Study co-author Jordi Julvez states that,
“I believe that the public does not think properly about the possible health hazards of acetaminophen use; only recently has this risk been proved by epidemiological studies. I think we have to re-think that paracetamol use is completely safe at all.”