Over The Counter and Prescription Drugs Contain Acetaminophen

Perhaps you’ve always thought of acetaminophen as a benign but effective ingredient in Tylenol, cold remedies, sore-throat medications or back-ache pills. This is generally true when using acetaminophen occasionally and in small doses.

However, acetaminophen is a major ingredient in nearly 200 prescription and over-the-counter products. Some of the over-the-counter products containing acetaminophen are Tylenol, Children’s Tylenol, Tylenol PM, Excedrin, Excedrin PM, Alka Seltzer Plus Cold and Flu, and Sudafed Cold and Sinus. Prescription medications include Vicodin, Darvocet, Percocet, Endocet, Roxicet, Ultracet and Midrin.

Without realizing the potential danger, many people take a combination of medications containing acetaminophen. The combination of products can easily exceed the recommended dose. As you can imagine, many acetaminophen overdoses are accidental.

Acetaminophen overdose is significant. Recent research found that 50 percent of all acute liver failure in the United States is attributed to acetaminophen overdose.

Wondering how much is too much?  An American Chiropractic Association Journal article recently recommended the following guidelines:

• Do not take more than 1 gram (1,000 mg) of acetaminophen at once.
• Do not exceed 4,000 mg of acetaminophen in 24 hours. (The FDA is considering reducing the adult maximum daily dose to 3,250 mg and even further reducing the amount for chronic alcohol users.

• Always check to see if over-the-counter or prescription medications contain acetaminophen.
• For children, do not exceed 10-15 mg/kg/dose of acetaminophen, and do not exceed five doses or 2.6 grams in 24 hours.

These guidelines are guides, not absolute rules. Several conditions such as fasting, alcohol consumption, genetic predisposition or drug interaction may alter the optimum dose.

Remember, too, that acetaminophen is not your only option for pain relief. Ask your chiropractor to suggest drug-free pain relief options. Treatment plans may include spinal manipulation, mobilization, or massage, as well as procedures such as electric stimulation, rehabilitative exercises, advice on nutrition, and suggestions for posture modification.