Is Tylenol Damaging Your Liver?

July 01, 2009 06:00 PM
by findingDulcinea Staff
Due to the threat of liver damage, advisers to the FDA say Extra-Strength Tylenol should be sold by prescription only. But is the bigger problem our addiction to painkillers?

Acetaminophen Crackdown

An outside advisory panel to the Food and Drug Administration has recommended lowering the adult dosage of regular Tylenol to 650 milligrams, and making Extra-Strength Tylenol available only by prescription, Catherine Larkin reported via Bloomberg. The panel also suggested banning the prescription painkillers Percocet and Vicodin. All three painkillers contain acetaminophen, an ingredient that reduces fever and pain, and that "has been a leading cause of liver injury for more than a decade," according to the FDA.

Johnson & Johnson, the makers of Tylenol, fought back. The manufacturer's McNeil Consumer Healthcare unit suggested that "[l]imiting access to acetaminophen may inadvertently lead people to switch to ibuprofen," which presents other health risks. J&J recommended educational measures instead, such as icons alerting customers to the presence of acetaminophen, and changing Tylenol labels to suggest starting with one caplet and taking two only if necessary, reported Larkin.

Opinion & Analysis: Pain-free nation

But is the problem even bigger than acetaminophen? Have we become a society that's unable to deal with even the slightest pain?

Dr. W. Gifford-Jones thinks so. In a column for the Winnipeg Free Press, Gifford-Jones writes that some of his patients' reasons for taking Tylenol and other over-the-counter painkillers are "shocking," ranging from "'It lifts me up' or 'It helps to relax me' or 'I have a slight headache.'" According to Gifford-Jones, such excuses are the result of "TV ads assuring us that no one need ever suffer any pain, slight as it may be."

Although he tells readers that he has "no problem" with those who use painkillers for severe arthritis or other debilitating diseases, Gifford-Jones thinks our expectations of "total freedom from the slightest pain" have "become a dangerous addiction."

ABC News spoke with Dr. Jeffrey Punch, chief of the Division of Transplantation at the University of Michigan Transplant Center, who suggested that lowering recommended dosages of Tylenol would not have much of an effect on liver injury related to acetaminophen use.

Gifford-Jones concurs. "Tylenol is a safe medication if used properly," he writes. "The problem is there are too many unsafe people."

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Background: Acetaminophen and liver injury

WebMD lists the FDA's suggested steps for reducing the chances of liver injury for consumers who use acetaminophen, including limiting yourself to the suggested dosage only, and not mixing "acetaminophen-containing products."

But genes could also be to blame, according to a study spearheaded by Dr. David Threadgill of North Carolina State University and published in Genome Research. According to e! Science News, the researchers discovered, by way of mouse genetics, "a genetic marker linked to the risk of acetaminophen-induced liver injury."

The results of such injuries can be severe.

In 2005, ABC News reported on the case of Antonio Benedi, a former staffer for President George H.W. Bush, who experienced acute liver failure after Tylenol. Benedi, who took the painkiller for flu symptoms, used only the recommended dosage for three days and says he did not drink alcohol after taking it. He was forced to have a liver transplant, and later a kidney transplant due to complications from the liver operation. Benedi eventually won an $8 million settlement from Johnson & Johnson.

Reference: FDA suggestions

The U.S. Food and Drug Administration has an "Acetaminophen and Liver Injury: Q & A for Consumers," with a description of the drug, risks involved with taking it, including risks to children, and extensive safety advice.

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