I want my Tylenol!

This is just crazy talk.

According to that blurb, the FDA has voted to reduce the maximum amount of acetaminophen (Tylenol) that can be administered over-the-counter to 650 mg. For those that don’t know, “Extra Strength” falls around 1000 mg per dose. According to CNN, “a 2007 Centers for Disease Control and Prevention population-based report, that estimated that acetaminophen was the likely cause of most of the estimated 1,600 acute liver failures each year.” Also, “overdoses of acetaminophen have been linked to 56,000 emergency room visits, 26,000 hospitalizations and 458 deaths during the 1990s.”

Now, I’ve got mixed feelings about this… First of all, if I have a headache, I take the maximum dose (1000 mg) and it goes away. Simple as that. Done it for years. Regular strength usually doesn’t work as well, hence why Extra is kinda nice. Now, I’m just going to have to take three pills of Regular Strength (equaling 975 mg) to get the same efficacy.

Here’s the issue: people that have liver issues probably shouldn’t be taking acetaminophen. Alcoholics shouldn’t take acetaminophen. People that are drunk shouldn’t take acetaminophen. EVERYONE ELSE is probably okay (please correct me if I missed one there). The reason it’s a problem is because acetaminophen is metabolized in your liver by a specific enzyme, CYP2E1 (and others, but that’s the biggie here), and this enzyme also metabolizes alcohol. Problem is, it’ll take care of the alcohol first before going after the acetaminophen. Therefore, if you take acetaminophen while you have lots of alcohol in your system, it will hang around in your blood stream. If it stays in your blood too long without being metabolized by CYP2E1, it is converted to a “free radical,” which then goes on to wreak havoc to your liver, amongst other organs, causing acute organ failure. Chronic alcoholics also have less glutathione in their bodies, and that compound is very important for clearing the other dangerous metabolites of acetaminophen.

So yes, you don’t want acetaminophen hanging around all that long. And if you have liver problems, you shouldn’t take it. Or if you’re drinking, you shouldn’t take it (take naproxen or ibuprofen instead).

But making me take an extra pill, when I detest taking pills, is just dumb.

5 Replies to “I want my Tylenol!”

  1. I think part of the problem too is that us “little people” have no idea that percocet and vicoden (I don’t take these drugs so I cannot spell them!) contain tylenol. So people medicating for chronic pain may not always know all the sources of tylenol in their drug cocktail. Obviously, they should be educated – but maybe this doesn’t always happen. As with many, many things the people who abuse the system, end up costing the rest of us the ability to use the system appropriately. Too bad everyone isn’t perfect! Huh, son?? 😉

  2. I hear ya. There’s a reason they combine it with hydrocodone… it’s a good painkiller. I take it when I have severe non-inflammatory injures. But there’s the classic rule; you can’t fix stupid. They have so many warnings telling you the right way to take it and not to combine with other forms… and there’s a reason they tell you not to drink more than 3 alcohol beverages with it. And dude, do not take naproxen with alcohol, that will cause stomach bleeding, trust me, i found out the hard way… can happen with ibuprofen too. I think the only pain reliever to take with drinking is aspirin… don’t they call it the alcoholics friend or something?

  3. Yeah, apparently you’re right, Ryan. From Drugs.com: “Do not drink alcohol while taking naproxen. Alcohol can increase the risk of stomach bleeding caused by naproxen.” (http://www.drugs.com/naproxen.html)

    Really, though, you probably shouldn’t take _any_ drug while you’re drinking. I think, however, that the stomach bleeding is more likely if you still have alcohol in your stomach, as opposed to having it in your intestine.

    So far as aspirin goes, it’s an NSAID like naproxen (i.e. it works the same way), and Drugs.com says that you should also avoid it while drinking.

  4. I honestly can’t think of a single episode in my entire life where someone who had a beer or 10 then decided to take a pill of some sort. The next day is another story, though.

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