paracetamol
- Note type: 🍂Fleeting Note
Paracetamol (acetaminophen) is a very popular painkiller, but its efficacy (compared to placebo) is unclear, while coming with worse side-effects than you would expect from a common over-the-counter drug.
References
Recent research suggests that Paracetamol does have a marginal effect for pain relief - but only in around 25% of individuals - and that its beneficial action in others is due to placeboeffects. However, the drug has significant side-effects (including stomach-lining damage) and overdoses each year run into 80,000 per year in the US alone.
Annette Reichel, a spokesperson for Tylenol, said the drug has over 60 years of use to show that it is safe.
"When used as directed at recommended doses, Tylenol does not cause acute liver failure," Reichel said. "However, per the Tylenol (over-the-counter) Drug Facts label, severe liver damage may occur if an individual takes more than 4000 mg of acetaminophen in 24 hours."
For Extra Strength Tylenol, that means liver damage may occur if someone took two 500-milligram caplets over the recommended dose within a single day. That’s not a lot of pills, a fact that has raised concerns that the dosage guidelines should be tighter. That doesn’t, however, change the data problems with this claim.
Many medications contain acetaminophen, however, meaning that Tylenol, by itself might not be the leading cause of acute liver failure.
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Dr. William Lee, a professor of internal medicine at the University of Texas Southwestern Medical School, has researched the connection between acetaminophen and acute liver failure for more than 20 years.
His research into acetaminophen and acute liver failure has continued to show that acetaminophen overdose, both accidental and intentional, is the "leading cause of acute liver injury and acute liver failure in the developed world."
"I think that’s a little specious to blame it on Tylenol, specifically, because (acetaminophen) is such a ubiquitous product," Lee said.
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Acetaminophen overdose is the leading cause of acute liver failure in the U.S., but the condition is rare — there are around 2,000 cases annually — and not always fatal.
About 450 deaths per year are related to acetaminophen-associated overdoses, according to the FDA. That number is nowhere near 100,000 deaths — and there is no reason to think that each of those deaths was due to Tylenol, specifically.
–Fact-check: No, using Tylenol isn't killing ‘at least 100,000’ people per year
Paracetamol’s broad spectrum of analgesic and other pharmacological actions is presented, along with its multiple postulated mechanism(s) of action. No one mechanism has been definitively shown to account for its analgesic activity.
There was no difference in analgesic effects or side effects observed using oral paracetamol, ibuprofen or a combination of both in patients with mild to moderate pain after soft tissue injuries attending the ED.
The use of paracetamol is ineffective in the treatment of low back pain. Minimal benefit is shown in patients with osteoarthritis of the hip or knee. Recommendations to use paracetamol should be reconsidered in patients with spinal pain and osteoarthritis.
Dozen of child deaths prompt Gambia to suspend paracetamol syrup sales.
The government of The Gambia is launching a probe into the recent deaths of dozens of young children from kidney failure and possible links to a paracetamol syrup, the country’s health director said.
“Dozens of children [under the age of five] have died in the last three months,” The Gambia’s director of health services, Mustapha Bittaye, told Reuters on Thursday. “Autopsies suggest the possibility of paracetamol.”