Over the Counter Pain Relievers

October 6th, 2008 at 02:45pm Leslie Aalund

There are two very popular over the counter analgesics (pain relievers).  Acetaminophen, also known as Tylenol, and NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin and ibuprofen.  People assume these type of medications are very safe because they can be purchased withouth a prescription, but this is not true.  In this blog I will discuss acetaminophen.  I will discuss NSAID use in a future blog.

There is 325 mg in regular strength acetaminophen and 500 mg in each extra strength pill.    The maximum daily recommended dose for a short period of time is 4000 mg/day.  Acetaminophen is hard on your liver.  A study has shown taking 4000 mg of acetaminophen regularly, for a prolonged period of time, to cause an elevation in liver enzymes.  The American Liver Foundation issued a warning in July 2006 recommending people not to exceed 3000 mg of acetaminophen each day for a prolonged period of time.  This means if you take acetaminophen regularly for several weeks, the maximum dose per day should not be over 6 extra-strength tablets.  Pediatric dosing is determined by the child’s weight; it is important to follow label directions and/or check with your physician for infant and young child dosing.

Alcohol is also hard on your liver.  If you consume alcohol regularly, you should not use acetaminophen without speaking with your doctor.   Also, acetaminophen should not be used by persons with liver disease. 

A 2005 multicenter study indicated acetaminophen overdose to be the cause of 42% of acute liver failure.  Acetaminophen is included in over 200 over the counter combination medications; such as cold, allergy, flu and headache medications.  Acetaminophen is also included in combination pain medications such as vicodin, norco and percocet, to name a few.  It is the unintentional overuse of acetaminophen that accounts for most of acute liver failure.  Be aware of the content of pain medications you are taking and read labels when purchasing over the counter medications to avoid overuse of acetaminophen.   Acetaminophen can be an effective medication for mild pain if taken correctly.  It is the number one recommendation for pain in the American Geriatric Society guidelines.

Entry Filed under: Pain Management