Health And Safety

27 March, 2010- Paracetamol Tablets that are known as acetaminophen in the United States, Canada, Hong Kong, Iran, Colombia and other Latin American countries and as paracetamol elsewhere is a widely used over-the-counter (OTC) analgesic (pain relieving) and antipyretic (fever reducing) drug. The paracetamol tablets are used to cure minor aches and pain related to common cold, flu, toothaches, arthritis, menstrual cramps and other conditions. It is generally used by people who are sensitive or allergic to aspirin. However, Paracetamol tablets used in excess (overdose or continuous use) can prove fatal due to its many side effects some of which are very dangerous leading to failure of liver and kidney and ultimately death.

Side Effects of Paracetamol Tablets

Paracetamol is derived from coal tar. It belongs to the class of drugs known as "aniline analgesics." The gravity of the side effects can be understood by the fact that it is the only such drug still in use today. In June 2009, an advisory committee of FDA recommended that new restrictions should be placed on paracetamol to help protect people from the potential toxic effects. However, as till March 2010, the FDA has not implemented these recommendations.

• High dose-usage (greater than 2,000 mg per day) of paracetamol increases the risk of upper gastrointestinal complications like stomach bleeding.
• Heavy use of paracetamol (300 grams a year or 1 g per day on average) has been linked to a condition known as 'Small Indented and Calcified Kidneys' (SICK).
• A study in 2008 on long term side effects of paracetamol tablets in children found that administering paracetamol for fever in the first year of life was linked with an increase in the incidence of asthmatic symptoms at 6–7 years. It also stated that use of paracetamol (both in the first year of life and in children aged 6–7 years) was associated with an increased incidence of rhinoconjunctivitis and eczema.
• Paracetamol used excessively damages multiple organs, particularly the liver and kidney where toxicity from paracetamol is not from the drug itself but from one of its metabolites, N-acetyl-p-benzoquinoneimine (NAPQI).
• Paracetamol hepatotoxicity is the most common cause of acute liver failure- one of the most dangerous side effects of paracetamol.
• Habitual use of paracetamol leads to decrease in threshold for pain in a person. This means that the endurance level for pain reduces in that person.

Paracetamol Toxicity

Overdose of paracetamol leads to 'paracetamol toxicity,' which mainly results into liver injury but is also one of the most common causes of poisoning all over world. Many people who develop paracetamol toxicity may feel no symptoms at all in the first 24 hours that follow overdose of paracetamol. Others may initially experience nonspecific complaints like vague abdominal pain and nausea. As the paracetamol toxicity increases, signs of liver failure like low blood sugar, low blood pH, easy bleeding, and hepatic encephalopathymay may develop. Timely treatment can cure the condition of the patient but untreated cases may result in death. Often a liver transplant is needed if damage to the liver gets severe. The risk of paracetamol toxicity increases with excessive alcohol intake, fasting or anorexia nervosa, and also with the use of certain drugs like isoniazid.

Paracetamol Caution

People who already face liver problems, kidney problems should not take Paracetamol tablets. Paracetamol should not be taken when alcohol is consumed as this increases the risk of liver toxicity. Pregnant women and nursing mothers should consult doctor before taking Paracetamol. Consultation with doctor is also required if someone needs to combine Paracetamol with any nonsteroidal anti-inflammatory drug like aspirin, ibuprofen etc, blood thinner drugs, and oral contraceptives.