Percoset under review

[helen99]

Tylenol, Vycodin, and Percoset, are under review for a possible link to liver damage that could lead to eventual banning or dose reduction.
http://www.washingtonpost.com/wp-dyn/content/article/2009/06/30/AR2009063004228.html
http://www.washingtontimes.com/news/2009/jul/01/bans-advised-for-vicodin-and-percocet/
http://blogs.findlaw.com/injured/2009/07/vicodin-percocet-bans-could-be-on-the-way.html

I've noticed a trend wherein any over the counter or prescription drug containing the character string "phen" tends to be bad news. It's not the narcotic in Percoset they're concerned about - it's the Tylenol ingredient acetaminophen.

Separate issue: I think I'll avoid ibuprophen ibuprofen from now on just in case, not that I take it anyway. Cant take it now even if I wanted to -- my PT told me it impedes the healing process. Good to know Ibuprofen affects bones. http://www.newscientist.com/article/dn2364-painkillers-may-prevent-broken-bones-healing.html

Oddly, the ingredient acetaminophen is not under review, just three products that contain it, and other products with acetaminophen, for example Nyquil, were given the ok by the FDA.

If the ban went into effect, doctors could still prescribe the exact ingredients, just not the brand name.

Comments

[luludi]

It's a well-known fact that Tylenol can cause liver damage. That's not new information. It's a very dangerous drug if taken in high doses. Taken correctly, it's one of the safest drugs there is.

The problem with Tylenol is that it is in so many combination drugs (like cold medicines, Excedrin, etc.) and many times people don't realize that they're taking too much... people have died from taking Tylenol and cold medicines also containing Tylenol at the same time, never realizing they've overdosed until it is too late. Unlike ibuprofen and aspirin, acetaminophen (the active drug in Tylenol, Vicodin and many other drugs) does not produce any side effects upon overdose of the drug - in addition, there is a very, very small window in which you can reverse acetaminophen overdose (half hour to 45 minutes). In these cases, an enzyme is given at the hospital which prevents the liver from absorbing the drug, and the stomach is pumped (gastric lavage). This can save people's lives, depending on how much acetaminophen the body has already absorbed. An overdose of acetaminophen, if not promptly treated, is always fatal. The symptoms come 24-48 hours after (nausea, vomiting, diarrhea) which indicate that the liver is shutting down. At this point, there is nothing doctors can do for you ~ your liver is already shot.

Just so you are aware, acetaminophen and ibuprofen are two completely different drugs. Ibuprofen is an NSAID (non-steroidal anti-inflammatory drug) and acetaminophen is an analgesic (pain reliever with no anti-inflammatory properties). Your body uses inflammation to heal itself, hence the reason ibuprofen (marketed as Motrin and Advil in the states) and Naproxen Sodium (marketed as Aleve) aren't always the best choice for these types of situations. Aspirin is also an NSAID, of a different variety.

Every drug has side effects and potential long-term consequences. Tylenol is safe, if taken correctly, which means always checking labels to see if acetaminophen is listed before taking multiple drugs. Ibuprofen is also considered safe, and is much, MUCH safer if you overdose. An overdose of acetaminophen (over 5,000-7,000mg in 24 hours) is almost always fatal unless treated right away, whereas an overdose of ibuprofen will, at best, produce no symptoms (as your body only absorbs 800mg at a time - the equivalent of 4 over the counter 200mg pills), and at worst, give you massive digestive upset and/or an ulcer. Ibuprofen (like all NSAIDs) is hard on the stomach tissue, but will not damage your liver the way acetaminophen does.

Hope that all makes sense.

[helen99]

Yes, it does. I don't have faith that everyone will even be able to read the word "acetaminophen", though, let alone be able to read the small print on two pill bottles to alert them to the fact that they'd be taking too much if they take both medicines. I don't want them to ban these medicines, since they are very effective for a lot of people. Maybe just add big red warnings so people don't take with other things. or take too much.

I know ibuprophen is something entirely different (as were the Phentermine diet pills which also caused other kinds of damage), but all of them contain the syllable "phen".

[luludi]

Actually, ibuprofen is not spelled with a "ph".

I agree that a lot of people don't know that acetaminophen = Tylenol, especially since people have been taking the brand name "Tylenol" for so many years and been told it is safe. The warnings should read "Do not take with other drugs containing acetaminophen, the active ingredient in Tylenol" but McNeil (the maker of Tylenol) has been fighting this for years and years. They are now required by the FDA to have bolded warnings, but I don't think that is enough. Like I told husband, a person who's been taking Tylenol forever (say someone in their 60's or 70's) may end up taking a cold medicine that states "Do not take with other drugs containing acetaminophen" on the back and think "great, I didn't take any acetaminophen. I just took some Tylenol", and BAM, they're dead.

In 2001, McNeil was urged to add the enzyme which impedes absorption of acetaminophen by the liver to their over the counter Tylenol, so that an overdose (intentional or otherwise) would be less likely to be fatal, and they refused, based on the belief that this would make people think Tylenol was unsafe to begin with... O_o The enzyme itself can be purchased at most health food or supplement stores (like GNC), and is relatively inexpensive. Many people take it whenever they take Tylenol, as a precautionary measure.

From a logical standpoint, I agree with the drug company, in that people who can't be troubled to learn about the medications they take and what they put into their body (especially when it only entails taking 5 minutes to read a label or do a simple Google search) aren't doing their part, and it isn't McNeil's fault that people choose to be ignorant, or don't care enough about their own bodies to read one label on a pill bottle before they pop them into their mouths. On the other hand, though, from a realistic standpoint, Tylenol is a very well-known, worldwide brand that has been around forever and people will assume it's safe (or, like you've said, not recognize the actual drug name vs. the brand and make that connection), which leads to unnecessary suffering and death over what amounts to a simple misunderstanding.

McNeil has done well for themselves with the Tylenol brand... and because of that, they need to realize that their brand name is more recognizable than the actual drug name, so it should be included in all warnings pertaining to acetaminophen.

[helen99]

Oh dear, LOL! I'm one of the people who can't read medical labels... (I'll correct that after I finish responding here.)

These kinds of little battles among companies is what's given the whole medical profession a bad reputation lately. They have to start doing what they set out to do in the beginning - being interested in healing people.

[luludi]

I know, right? You would think that these companies would be proud to say that, "hey, we know we don't have to do A, B & C, but we want to because it's what's best (and safest) for the consumer", and what a great reputation they would have then! But, their fear that they might lose a few dollars (while simultaneously potentially saving many lives) overrides their logic, I think. It's very sad. I think is probably why I know so much about drugs and medications... after several bad experiences, I don't trust doctors or drug companies anymore so I feel like I have to be as educated as I can be about everything I take. It would be nice to feel like I could count on the drug companies and the doctors and the people who are in, you know, the business of healing people, but I don't feel that I can, and I don't feel that most people should.

[guardianjain]

Thank you for this. *takes mental notes*

Naproxin sodium is the only thing that works at all as intended on my body at the moment, but knowing this about acetaminophen helps, especially as I think I'll be looking for that enzyme to stock for guests.

[arcanetrivia]

If the ban went into effect, doctors could still prescribe the exact ingredients, just not the brand name.

Odd, since these drugs are (in my experience) nearly always prescribed in their generics anyway (random hydrocodone or oxycodone plus acetaminophen things).