Tylenol Adds Up to Disaster

What happens when you take Tylenol Arthritis for joint pain, Excedrin for a headache, and NyQuil for a cold? Disaster happens; all of these products contain Tylenol (Acetaminophen, a.k.a. APAP) which is toxic in high quantities. The milligrams can add up over a 24 hour period of time. Those who do not read the labels and calculate their daily quantities may be taking a one-way trip to the hospital.
How can a ubiquitous substance like Acetaminophen cause death? Well, the answer requires a brief overview about the liver. As chemicals enter the body, they need to be broken down into different compounds which ultimately get eliminated from the body as waste. Two main players act as the street-sweepers for the body: the liver and the kidneys. Tylenol is one of the chemicals that go to the liver for this metabolic process. Unfortunately, the liver is only able to handle so much Tylenol. If the toxic, intermediate substances from Acetaminophen accumulate too rapidly, these nasty chemicals unleash their fury on the cells of the liver causing liver death (necrosis). You cannot survive long without a liver.

Who is most susceptible to the dangers of Tylenol? Young people who are unaware of the dangers from this over-the-counter medication will literally “pound” pills prior to an athletic event. Chronic pain patients who have daily hard-to-control pain will chronically overuse products containing Tylenol. Alcoholics who already have a weak liver are at great risk of a Tylenol overdose. Patients who take other medications that tax the liver (like the anticonvulsants) should also be careful about the amounts of Tylenol consumed. All of these scenarios can result in an accidental overdose and death.

Who should be responsible for protecting the public from these accidents? Lately, the Food and Drug Administration has been addressing this potential for disaster from Tylenol. One of the largest problems is the non-standard labeling practices of the over-the-counter products containing Tylenol. But, now the labels are becoming clearer and are actually highlighting the Acetaminophen amount. Recently, the FDA threatened to ban certain prescription drugs like Percocet and Vicodin. This recommendation by an FDA panel has caused an out roar amongst chronic pain patients. Ultimately, the responsibility lies with the consumer; just like drivers are responsible for their potential to cause a vehicle accident. However, we cannot hold people responsible if there has not been proper health education. We can start this process of protecting the public by bringing health education back into the curriculum at schools.

What products contain Tylenol? Here is just a short list of products that contain Acetaminophen. Do the math before you self medicate. An absolute maximum amount of Tylenol in a 24 hour period of time is 4000mg (2000mg for those with a weak liver). Chronic, daily users should not exceed 3000mg per day.

Tylenol Extra Strength 500mg
Excedrin PM 500mg
Vicodin 5/500 500mg
Tylenol PM 500mg
Excedrin Extra Strgth 250mg
Percocet 5/325 325mg
Tylenol Arthritis 650mg
Excedrin Back and Body 250mg
Lortab 500mg 7.5/500 Excedrin Tension Headache 500mg
Darvocet N100 650mg
Tylenol 8 hour 650mg
NyQuil (one dose) 1000mg
Tylenol #3 300mg

And remember, just because a medication is available without a prescription does not mean it is perfectly harmless. Talk to your doctor about all the chemical substances you consume or you could be heading towards a disaster. Don’t press your luck.

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Chronic Pain by drlasich