Questions and answers about pain medicine dangers
A Food and Drug Administration panel has recommended limits on Tylenol and other drugs containing acetaminophen because of risks for liver failure. Maximum recommended doses for over-the-counter Tylenol would be reduced. Percocet and Vicodin, two narcotic prescription drugs containing acetaminophen, would be banned.
Q: What's the reason?
A: It's easy to get too much acetaminophen because the drug is in many medicines and a few extra doses a day can cause liver problems.
Q: I've taken Tylenol at recommended doses for years. Could I be damaging my liver and should I get tested?
A: Doctors say recommended doses are safe and they aren't recommending routine tests; possible liver damage can be detected with blood tests.
Q: Would I know if I have liver damage?
A: Liver damage from excess acetaminophen tends to cause sudden symptoms, within a few days of taking too much. These may include nausea, vomiting and jaundice -- yellowing of the skin or whites of the eyes.
Q: What should I do if I've taken extra doses and develop these symptoms?
A: Seek immediate medical care. Quick treatment with antidote medicine can prevent permanent liver damage; waiting too long can be fatal.
Q: How can I avoid getting too much acetaminophen?
A: Carefully read drug labels; don't exceed recommended doses and don't take more than one medicine containing acetaminophen. Also, avoid drinking alcohol while using acetaminophen-containing drugs.
Q: Are the proposed limits likely to be adopted?
A: The full FDA has not taken any action but will likely consider the recommendations separately. Its decisions are months away.
Source: The Associated Press
For Barbara Weaver, a 59-year-old Chattanooga resident suffering from chronic back pain, a possible ban on Vicodin is cause for alarm.
"They are thinking about banning it?" she asked. "I take it at night so I can sleep. Without it, I can't even get up for work in the morning."
On June 30, a Federal Drug Administration advisory board announced a proposal for further regulation of acetaminophen, the main ingredient in Tylenol. The proposal also would affect the painkillers Vicodin, whose main ingredients include acetaminophen and hydrocodone, as well as Percocet, which combines acetaminophen and oxycodone.
If adopted by the FDA, the changes would lower the maximum over-the-counter acetaminophen dose and would ban Vicodin and Percocet, The Associated Press reported.
The panel's proposal was prompted by concerns over acetaminophen overdoses, which are the leading cause of liver failure, sickening more than 50,000 people and causing at least 200 deaths each year nationwide, according to the AP.
Patients now on Vicodin or Percocet shouldn't panic, said Dr. Joseph Cofer, a professor of surgery at the University of Tennessee College of Medicine in Chattanooga.
Doctors can prescribe oxycodone on its own, he said.
"I prescribe Percocet on a regular basis. It the most common drug that I prescribe for post-surgical pain," Dr. Cofer said. "People just need to be aware of what they are taking, stick to the recommended dose, and report any prior liver problems to doctors."
Dr. Peter Rawlings, a physician with Pediatric Diagnostic Associates, said many people don't realize when they are taking excessive amounts of medicine, especially when it comes in the form of over-the-counter medications such as Tylenol.
"Tylenol comes in different strengths and can be mixed with other meds," he explained. "Parents and patients need to read the labels and look at the ingredients."
However, some doctors worry about the consequences if acetaminophen medications are banned or harder to get.
"Our big concern, and something that I have seen already, is people switching from acetaminophen to drugs that are much more hazardous for them," said Dr. Wayne Scott, an internist with Galen Medical Group in Chattanooga.
"For some patients, Tylenol is a much healthier alternative than other pain medications such as ibuprofen or Aleve," he said.
"People need to talk to physicians to know what is best for them," he said. "Our worry is that people will hear the news and run out to get medicine that is unhealthy for them to do so."
While the FDA may not change anything, Dr. Julia Finley, an internist with Beacon Medical Group, said the dangers of acetaminophen are real.
"It's good that the FDA is making it clear that it isn't safe to use as much medicine as you want," she said. "Doctors have known about the possibility of this problem for a while, and it's good that the FDA is shedding light on the issue."
But for people such as Ms. Weaver, the threat of losing her pain medication still is upsetting.
"When you hear them say they are going to ban it, it does bother you because you finally find something that works, and then you have to go through the trouble and extra cost of talking to doctors to find something new," she said.
"I feel like people should be able to take the medication if they are responsible," she said. "If I can't sleep, I can't work, and if I can't work, I'll find myself living off the state."
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