| By :
Wendy Moyer
For a long time, when people wanted to take the safest pain reliever many of them went to their medicine cabinet and took out a bottle of Tylenol®. They took no more than the recommended dose and usually felt better. Acetaminophen is the active ingredient in Tylenol®. Many people tend to avoid aspirin because it can be tough on the stomach, as can other NSAIDs (nonsteroidal anti-inflammatory drugs) such as naproxen and ibuprofen. A number of years ago researchers initially believed that COX-2 inhibitors would offer pain relief while not damaging the stomach. However, after a number of studies linked them to heart attacks COX-2 fell into disrepute. And now it looks like acetaminophen is not as safe as it was once presumed to be. For quite awhile it has been known that liver failure can be caused by large doses of acetaminophen. Approximately 50,000 people per year go to emergency rooms in the United States because they have inadvertently taken an overdose of the drug. Approximately 500 people per year die of liver failure that was caused by such an overdose. But cases of clear cut overdoses are not the only challenge. Even doses that are close to the maximum recommendation of 4,000 milligrams per day could be very toxic to a number of people. A large liver failure study in addition to information found in the FDA's adverse event database has shown that the median dose related to liver injuries is actually between 5,000 and 7,500 mg per day. That is very close to what is currently the maximum recommended dose. One of the challenges people have is that acetaminophen can be found in a wide variety of drugs beside Tylenol®, such as TheraFlu®, NyQuil®, Execedrin® migraine relief products, some types of Alka-Seltzer®, Percocet®, Darvocet®, Vicodin®, and others. Therefore, whatever the Food and Drug Administration does recommend, doesn't it rationally make more sense that you should be more cautious about taking acetaminophen? In most instances acetaminophen does what the television commercials promise. Fast relief is quickly provided, and the medication quickly leaves the gastrointestinal tract. Within one of hour of taking an oral dose of the drug its concentration in the blood has peaked. However, if someone drinks excessively (three or more drinks per day) and takes a lot of acetaminophen over the span of several days, it could be quite dangerous. Although the amount was not specified, one of the FDA's working group recommendations was to lower the limit recommended for people who regularly drink three or more alcoholic beverages per day.
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