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By itself and taken properly, Tylenol is considered by doctors a reliable, safe pain medication.
But people often don’t realize they are getting extra doses of Tylenol in cold medicine, said Dr. Deborah McMahan. Also called acetaminophen, it is in far more medications than the Allen County health commissioner could name.
When it is taken unknowingly, the chances of accidental overdose increase. Overdoses of acetaminophen are the leading cause of liver failure.
McMahan and other local health care professionals think an FDA panel’s recommendation Tuesday to curb the drug’s use will help raise awareness about its presence in many common medications. The expert panel called for reducing the maximum dose of Tylenol and eliminating combination prescription painkillers that contain acetaminophen such as Vicodin and Percocet. It opted not to recommend pulling over-the-counter cough and cold medicines containing acetaminophen.
"It’s good to bring awareness to this issue," McMahan said, but she sees the recommendations as inconsistent.
She believes the bigger part of the problem lies with over-the-counter medications, when people don’t consult with a doctor or physician and don’t know exactly what they’re taking.
Amy Hyduk, clinical pharmacy manager for Lutheran Health Network, agreed that when patients don’t know acetaminophen is in a medication it can increase risk.
"It’s a little bit easier to involuntarily overdose," she said.
But Hyduk said liver failure doesn’t occur when people stay within the current dosage limits, which will be reduced if the FDA follows panel recommendations. If Percocet and Vicodin are eliminated, "We would be severely limited with our pain medication options," Hyduk said.
From a safety standpoint, Nick Sloffer, pharmacy district manager for Kroger and Scott’s Food & Pharmacy, sees the panel recommendations as positive.
Sloffer liked its suggestion of limiting the maximum single dose of Tylenol to 650 milligrams, which he thinks would eliminate some confusion caused by varied dosages. But the biggest tool against taking too much acetaminophen is counseling patients about its presence in medications, he said.
Dr. Greg Johnson, associate chief medical officer at Parkview Hospital, saw the FDA panel’s recommendation as reflecting a general effort "making sure that patients know what they’re taking." He said an open patient-physician relationship is central to good medication management.
