Saturday, January 4, 2014

How to use acetaminophen safely, from the January 2014 Harvard Men's Health Watch

How to use acetaminophen safely in people with HCV

Hepatitis C Review - Acetaminophen -Tylenol
The maximum recommended dose of acetaminophen (Tylenol®) for patients with hepatitis C is two grams (four 500mg tablets) per day....

Evaluation, Staging, and Monitoring of Chronic Hepatitis C
Based on available information and recognition that many patients with chronic hepatitis C have limited pain treatment options, most experts believe that low dosages of acetaminophen can safely be used in most patients with chronic hepatitis C infection. Specifically, patients without cirrhosis can take acetaminophen if they limit their intake to two grams per day; those with cirrhosis should limit their intake of acetaminophen to one gram per day....


How to use acetaminophen safely from the January 2014 Harvard Men's Health Watch

Acetaminophen Safely - The Average Healthy Adult

January 2014

Cold, cough, and flu season is a good time to revisit the risks of acetaminophen, a medication found in many cold, cough, and flu remedies. Although billions of doses of acetaminophen are consumed safely every year, some people taking the drug end up in the emergency room or need hospitalization, and some die from acetaminophen overdose or interaction. In the January 2014 issue of the Harvard Men's Health Watch, Dr. Melisa Lai Becker, an instructor in medicine at Harvard Medical School, suggests some ways to avoid getting into trouble when taking acetaminophen.

Acetaminophen is the chemical name for the widely used pain and fever reliever in Tylenol and other over-the-counter medications. High doses of acetaminophen can inflame and damage the liver. Because acetaminophen is in more than 600 different medications, it can be easy to get more than is healthy.

"People don't realize that these doses all add up, and before you know it you've exceeded the recommended dose of acetaminophen," says Dr. Lai Becker, director of the Division of Medical Toxicology at Harvard-affiliated Cambridge Health Alliance.

For the average healthy adult, the generally recommended maximum daily dose is no more than 4,000 milligrams (mg) from all sources. But in some people, doses close to the 4,000 mg daily limit could still harm the liver. It's safest to take only what you need, and not to exceed 3,000 mg a day whenever possible.

Dr. Lai Becker suggests these guidelines for taking acetaminophen safely:

Stick to recommended doses. When taking acetaminophen, don't be tempted to add a little extra to the recommended dose. A small-bodied person should stay on the low end of the recommended dose range (3,000 mg).

Cold and flu remedies count. When you reach for an over-the-counter cough, cold, or flu product, take a look at the label. Does it contain acetaminophen? If so, add the dose to your daily total.

Know your pills. Over-the-counter acetaminophen pills may contain 325, 500, or 650 mg of the drug. Be extra cautious when taking the 500 or 650 mg pills.

Go easy on alcohol. Drinking alcohol causes the liver to convert more of the acetaminophen you take into toxic byproducts. Men should have no more than two standard drinks per day when taking acetaminophen, women no more than one.

Beware of medication interactions. Ask your doctor or pharmacist if any of your prescription medications could interact badly with acetaminophen.

Acetaminophen: How much can you take safely? 
325 mg 500 mg 650 mg extended release
Take how many pills at a time? 1 or 2 1 or 2 1 or 2
Take how often? Every 4 to 6 hours Every 4 to 6 hours Every 8 hours
Safest maximum daily dose
for most adults
8 pills 6 pills 4 pills
Never take more than this in a 24-hour period 12 pills (3900 mg) 8 pills (4000 mg) 6 pills (3900 mg)

The maximum daily dose for a healthy adult who weighs at least 150 pounds is 4,000 milligrams (mg). However, in some people, taking the maximum daily dose for extended periods can seriously damage the liver. It's best to take the lowest dose necessary and stay closer to 3,000 mg per day as your maximum dose. If you need to take high doses of acetaminophen for chronic pain, check with your doctor first.

Read the full-length article: "Acetaminophen safety: Be cautious but not afraid"

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