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Sunday, November, 22, 2009
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FDA Acetaminophen Recommendations

Will Rowe
Will Rowe
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Executive Director - American Pain Foundation

Will has been the Executive Director of the American Pain ...

Will Rowe

Friday, September 11, 2009
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An FDA Advisory Committee recently recommended some changes regarding the use and availability of the very common pain medicine acetaminophen.  The Advisory Committee was acting on concerns over the incidence of acetaminophen overdosing that have resulted in serious harm to the liver and sometim...
  1. FDA Recommendations on Acetaminophen
    Denise Coleman
    Tuesday, September 15, 2009 at 02:31 PM

    Dear Dr. Rowe,

    Thank you for bringing this important issue to our attention. I agree that there should be an extensive education and public awareness program to inform the public about how Acetaminophen is used in conjunction with their other medications, what amount they are ingesting, and why they need to be careful.  I believe it is counter-productive, however, to begin removing Acetaminophen from the shelves or banning or severely limiting its use together with another medication, specifically pain medication, before taking other steps.  You correctly state that many people believe that because something can be bought "over the counter," or OTC, there is little to no danger associated with it, which is completely wrong.  

     

    There are several effective pain medications on the market today that contain Acetaminophen and to remove these would be a disservice to those of us who live our lives with pain.  Many non-pain medications can have a negative impact on a person's liver, in fact there are some medications that require periodic blood tests to assess a person's liver function before a new prescription can be written.  These medicines have not appeared on any list that I have seen of medicines that are in danger of being removed from use.  Is this another effort to increase the barriers that people in pain already face in their efforts to receive effective   pain medications?  If not, then why isn't the first approach one of education and awareness building?

     

    For the past several years pharmaceutical companies market an every increasing variety of medicines and medical procedures, such as joint replacements and surgery for  weight loss, through television commercials.  I am personally appalled by these commercials as I believe medical professionals should be the target of medical marketing efforts, with a strong education element included, instead of the consumer who many times does not even hear what illness or condition the medicine on the commercial is for.  What these commercials do demonstrate, however, is the number of potential risks each of these medicines carry, some very serious and life-threatening risks.  In one case a second commercial had to be run by the pharmaceutical because the FDA did not feel the risks associated with taking it were highlighted strongly enough in the initial commercial; the product was never removed from the shelves, however. 

     

    I apologize for the length of this comment, however after living with pain for over 40 years and knowing that there are finally some effective medications for chronic pain, it is distressing to learn that the FDA is considering the removal of an essential element of these medications even before it attempts to increase the doctor and patient education programs that could remove or reduce the risk significantly, or at least to the same degree that many other medications risk damaging the liver.  Most people who watch TV commercials or read patient information booklets that accompany prescriptions know that there is risk associated with taking any medication, and it is the doctor and the patient's responsibility to be aware of what they are and to take necessary steps to prevent or treat them, should they appear.

     

    I will definitely write to the FDA, again, and request that they first try to limit the risk through education and building awareness among medical professionals, including pharmacists, and patients.  My previous letter to the FDA discussed the proposed Risk Evaluation and Mitigation Strategies (REMS) and how they might affect people living with pain.  We must all stay aware of current and new policies and legislation on the federal and state level, and when possible speak out for or against those that could impact our health and our lives.

     

    Thank you for the opportunity to comment.

    Reply
  2. Acetaminophen
    FlaGuy954
    Thursday, September 17, 2009 at 09:47 PM

    I think that limiting the amount of milligrams of acetaminophen to 325 per pill is probably a good thing.  The makers of Tylenol continuously advertise how safe it is, that it is better for you to take than ibuprophen or aspirin, etc.  It would be a good thing if a black box warning on acetaminophen containing products warning of potential liver damage with consuming high dosages was mandated.

    Reply
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