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Medicine Science

FDA Considers Banning Acetaminophen-Based Pain Killers 631

Posted by ScuttleMonkey
from the welcome-to-the-nanny-state dept.
Greg George writes "The FDA has determined that Tylenol enhancing pain killers are dangerous enough to potentially be pulled from the market. Drugs including Vicodin, Hydrocodone, Lortab, Maxidone, Norco, Zydone, Tylenol with codeine, Percocet, Endocet, and Darvocet may be permanently banned from the US market, even if the patient has a prescription from a doctor. The problem is the key ingredient — acetaminophen — can easily damage or destroy a patient's liver if more than 2000 mg are used per day. In many cases that means if you take a pain killer and then take two extra strength Tylenol, you may have gone over the maximum dosage per day."
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FDA Considers Banning Acetaminophen-Based Pain Killers

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  • not really a ban (Score:5, Informative)

    by mr100percent (57156) * on Thursday July 02, 2009 @12:59PM (#28559743) Homepage Journal

    Before everyone screams bloody murder, the fact remains that you'll still be able to buy the stuff, separately. Percocet, for example, is actually a mix of oxycodone and acetaminophen. You can buy them separately as Oxycontin and Tylenol (or paracetamol in the UK).

    It's the combination that causes problems; people wind up overdosing. Overdosing on the oxycodone portion is not all that dangerous (you could swallow 2 dozen of them at once though I would definitely not recommend it) compared to Tylenol, which can damage your liver. Thirty extra-strength tylenols at once can destroy your liver and you'll die within 72 hours. These medications have acetaminophen in them as an an anti-inflammatory to work with the painkiller, but they wind up being the deadlier part of the drug since people take too much. A few people think they can commit suicide by swallowing the whole prescription, but what happens is the codeine-based painkiller part wears off in hours and then the agonizing abdominal pain of liver failure begins until they're dead 3 days later.

    You'll still be able to buy the separate ingredients, hydrocodone is Vicodin and Norco, oxycodone is Percocet, etc. There are other formulations; Percodan is nearly the same as Percocet except it uses aspirin in place of acetaminophen (Tylenol)

  • by eldavojohn (898314) * <eldavojohn@@@gmail...com> on Thursday July 02, 2009 @01:02PM (#28559787) Journal

    The problem is the key ingredient - acetaminophen - can easily damage or destroy a patient's liver if more than 2000 mg are used per day.

    Disclaimer: Not a doctor or med student but my three sisters are nurses/researchers.

    My older sister warned me when I started college that if I was going to drink I should avoid acetaminophen at all costs. Luckily, I don't get headaches or have had a need for a painkiller in a very long time and I think it's been about six years since I've taken them. If you are a heavy drinker, avoid acetaminophen as your liver's already dealing with the alcohol and crap in the American diet and doesn't appreciate it. My sister told me that people who use acetaminophen during hangovers may be putting themselves at a much higher risk for liver diseases. I'm a little concerned these have been out for this long when there's safer alternatives. I'm sure the companies that stand to profit have tons of tricks up their sleeves yet.

  • Doctors orders (Score:4, Informative)

    by DerekLyons (302214) <<fairwater> <at> <gmail.com>> on Thursday July 02, 2009 @01:03PM (#28559823) Homepage

    Which is why my doctor tells me not to take any medication containing acetaminophen other than those prescribed, and the form I have to sign when I pick my prescriptions repeats that warning.

  • by mr100percent (57156) * on Thursday July 02, 2009 @01:04PM (#28559837) Homepage Journal

    This is true. Any pharmacist will tell you to take Motrin or Advil (Ibuprofen) instead, as it skips the liver and is not nearly as toxic

  • by Freetardo Jones (1574733) on Thursday July 02, 2009 @01:04PM (#28559857)

    All this ban is saying is that you can't buy the drugs as an all-in-one formulation. You can still buy them just the same as separate pills.

  • Re:not really a ban (Score:4, Informative)

    by ckthorp (1255134) on Thursday July 02, 2009 @01:05PM (#28559885)
    Except the article clearly states that Vicodin is actual hydrocodone+acetaminophen...
  • This is not a ban (Score:3, Informative)

    by wiredlogic (135348) on Thursday July 02, 2009 @01:08PM (#28559943)

    What is being proposed is not a wholesale ban on acetaminophen but a ban on *some* drug combinations that include it and a reduction in the maximum OTC dosage. The drug will still be available and you'll still be able to mix drugs yourself to get the old effect.

  • Re:not really a ban (Score:5, Informative)

    by BrokenHalo (565198) on Thursday July 02, 2009 @01:11PM (#28559997)
    Thirty extra-strength tylenols at once can destroy your liver and you'll die within 72 hours.

    If you're lucky. Things have a tendency to go wrong with this course of medication, resulting in a fucked liver and a death spread over several weeks. It happened to my sister-in-law, and it's not pretty.

    If you want to kill yourself, I'd suggest a nice clean OD on smack.
  • Re:I for one (Score:5, Informative)

    by Freetardo Jones (1574733) on Thursday July 02, 2009 @01:12PM (#28560027)

    Do not welcome our nannystate overlords.

    Seriously why do we have to keep legislating everything.

    When did the FDA become a legislative body? Did I miss that?

    Soon after Government run healthcare they are going to tell you want you can and can't eat.

    And yet in countries with publicly funded health care the government doesn't do that. It's almost as if your comment is just plain bullshit.

  • Re:not really a ban (Score:5, Informative)

    by Bitch-Face Jones (588723) on Thursday July 02, 2009 @01:12PM (#28560039)
    I'm not so sure about that. One of the reasons that drug companies put acetaminophen in things like hydrocodone and dextropropoxyphene in the first place is because they make it more difficult (ironically) to overdose on or use recreationally. If you try and just down 12 vicodin at once, all of the acetaminophen in it is going to make you pretty sick, so you have to jump through quite a few hoops (like using a cold water extraction) if you want to get the good stuff out without having to deal with the acetaminophen.
  • by Anonymous Coward on Thursday July 02, 2009 @01:18PM (#28560169)

    Even though I was concerned about taking the maximum daily limit of vicodin and then percocet, my doctors dismissed my concerns as all they really care about is treating my spine/nerve damage. Well now that my pre-surgery tests show that my enzyme levels were high, you would think that my neurologist and neurosurgen would care. Nope.

    After switching doctors, my new neurologist has the same careless attitude towards how many percocet that I take daily. My he proscribes up to 6-500 mg per day. According to this recommendation I feel bitter about towards the highly uneducated pimps that call themselves doctors. So not only was my spine surgery not successful I know have to deal with liver damage.

  • by Anonymous Coward on Thursday July 02, 2009 @01:28PM (#28560363)
    Everyone keeps saying 2000 mg limit. My doc said 4000 mg was the limit and to never take more than 8 vicodins a day. 5 mg hydrocodone and 500 mg APAP. I have taken that many in a day and never had a problem. Blood and urine tests show all systems functioning normally. Whatever. Just get the norcos. They are 10 mg hydro and 325 mg APAP. Then you can take like 15 a day and still be ok. That's a lot of hydro though.
  • Re:So wait... (Score:5, Informative)

    by phizix (1143711) on Thursday July 02, 2009 @01:31PM (#28560453)

    The FDA made the drug companies put acetaminophen into the narcotic painkillers to keep people from recreationally overdosing on them (same as they "denature" ethyl alcohol that you can buy at the hardware store by poisoning it with methyl alcohol)...

    This is not true at all. Acetaminophen and narcotics are mixed because the combination is a much more effective pain reliever than either alone.

  • by Dr_Barnowl (709838) on Thursday July 02, 2009 @01:33PM (#28560479)

    This is one case where it's counterintuitive.

    Your liver makes acetaminophen into some really nasty toxic shit, and that's what damages it. Fortunately, it has another metabolic pathway that detoxes the stuff before it reaches toxic concentrations.

    This pathway is powered by a limited stock of glutathione in the liver. When you run out, the toxic products start to accumulate rapidly and cause acute liver failure. Up until that point you are suffering no significant ill effects. Therefore you could take a therapeutic dose for extended periods with little ill effect, it only causes a problem when you overwhelm your capacity to produce glutathione.

    Acetaminophen is the number one cause of acute liver failure in the USA and UK, but is not noted for causing chronic damage (or it would certainly not be available over the counter).

  • Re:not really a ban (Score:5, Informative)

    by ae1294 (1547521) on Thursday July 02, 2009 @01:35PM (#28560509) Journal

    Anyone taking medicine should know they have to check for drug interactions and overdoses. The medical industry has been harping about it for years. If the product they offer is safe when following the directions, then it's not their problem if people do stupid things with it.

    What I think is funny is that the FDA is spending all this time over something that any half-way intelligent person should already know or at a minimal their doctor should have told them. What about all the drugs that they approve as safe that turn out to kill large numbers of people when they take the proper dose? eh? Maybe the makers of Tylenol are late on their hush money payment???

    Avandia - Glaxo SmithKline, Banned 03-2000 for; heart failure, hepatitis, and liver failure
    Baycol - Bayer AG, BANNED 08-2001 for fatal rhabdomyolysis
    Bextra - Pfizer, BANNED 04-2005 for; heart attack, stroke, skin diseases
    Dexatrim - Bayer, BANNED 11-2000 for fatal strokes
    Ephedra - Brayton Purcell, BANNED 04-2004 for; high blood pressure, heart rate irregularities, insomnia, nervousness, tremors, seizures, heart attacks, strokes, brain hemorrhages, and death
    Fen Phen - Wyeth, BANNED 09-1997 for; heart valve damage, primary pulmonary hypertension
    Lotronex - Glaxo SmithKline, BANNED 11-2000 for; ischemic colitis, abdominal pain, severe constipation
    Pondimin - Wyeth, BANNED 09-1997 for; heart valve damage, primary pulmonary hypertension
    Propulsid - Janssen, BANNED 03-2000 for; torsades de pointes, SIDS
    Redux - Wyeth, BANNED 09-1997 for; heart valve damage, primary pulmonary hypertension
    Rezulin - Warner-Lambert, BANNED 03-2000 for severe liver toxicity
    Vioxx - Merck, BANNED 09-2004 for; heart attack, stroke

    This is only the short list... Thank you FDA for protecting us and the children!

  • by phizix (1143711) on Thursday July 02, 2009 @01:39PM (#28560593)

    My prescription is 7.5mg hydrocodone, 500mg acetaminophen (standard - though there are a few variations on the amount of hydrocodone). The FDA has enforced that amount of acetaminophen, for two reasons. Hydrocodone is relatively addictive, and acetaminophen often induces a huge amount of nausea.

    Generally, it is the narcotic causing the nausea [wikipedia.org], not the acetaminophen.

  • Re:Doctors orders (Score:2, Informative)

    by Ioldanach (88584) on Thursday July 02, 2009 @01:40PM (#28560625)
    Aspirin is a risk factor for Reye's Syndrome and shouldn't be given to a child under 16. Ibuprofen, on the other hand, is fine as far as I know.
  • by Hatta (162192) on Thursday July 02, 2009 @01:43PM (#28560689) Journal

    Alcohol damages the liver as it's broken down and so does acetaminophen

    Not necessarily. Normal metabolism of either alcohol or acetaminophen isn't damaging, but it uses up reducing equivalents (such as those sulfhydryls on methionine and cystine). It's only when those reducing equivalents are used up that acetaminophen is shunted into another metabolic pathway that it produces toxic metabolites. In moderation drinking alcohol xor taking acetaminophen is safe.

  • Re:not really a ban (Score:5, Informative)

    by DurendalMac (736637) on Thursday July 02, 2009 @01:45PM (#28560731)
    Acetomenaphine is the only OTC painkiller that is safe for pregnant women to take AFAIK. Aspirin is a big no-no and Ibuprofen is iffy at best. It's always good to have options. You can burn a hole in your stomach with too much Ibuprofen. Should that be pulled from the market too?

    Bottom line: READ THE DAMN LABEL. Make sure you're not taking too much. Check with your doctor if you're not sure. A lot of medications will screw you up if you take too much. Equip yourself with knowledge and you'll be fine.
  • by Hatta (162192) on Thursday July 02, 2009 @01:47PM (#28560769) Journal

    Oh, I should have mentioned this. Aspirin and ibuprofen can damage the stomach lining, and drinking alcohol thins the blood which can increase the risk of stomach bleeding. Best thing to do for a hangover is to drink water and coffee and smoke some pot. If you absolutely must take an analgesic, use ibuprofen it doesn't thin the blood as much as aspirin does.

  • by Sangui5 (12317) on Thursday July 02, 2009 @01:54PM (#28560909)

    2000mg is not the daily limit for acetaminophen; 4000mg is. 2000-3000 is the limit for "at risk" populations (e.g. existing liver disease). The linked article doesn't even mention a dosage limit. You can take your 2 Percocets and 2 extra strength Tylenol and still be under the dose limit; that's only 2300 mg even with the high-dose Percocets.

    It's one thing to be concerned about an overdose and set a dose limit; it's a completely different thing to arbitrarily lop the max dose in half to cause hysteria.

  • Re:not really a ban (Score:2, Informative)

    by anotheregomaniac (1439993) on Thursday July 02, 2009 @02:07PM (#28561157)
    There is a synergistic effect between the two drugs that enhances the pain relief from the narcotic and reduces the amount of narcotic needed to achieve relief. Separating them will require doctors to prescribe the two be taken together or more of the narcotic.

    http://en.wikipedia.org/wiki/Vicodin#Pharmacokinetics [wikipedia.org]

    I recently had surgery and was given clear instructions about avoiding anything with acetaminophen while taking Vicodin. If adding a little acetaminophen reduces the amount of narcotic needed, I think that is a good idea, as long as instructions are followed.

    I would think all the OTC remedies that mix acetaminophen in with every known variety of other drug would be a much greater problem w.r.t. acetaminophen overdose.
  • by Anonymous Coward on Thursday July 02, 2009 @02:07PM (#28561165)

    As a pharmacy student I can tell you that Acetaminophen is there mainly to prevent the abuse from the harder opiate drug. If patients try to abuse the acetaminophen containing drug they'll most likely get sick from the acetaminophen before they get too high off the painkiller, thus preventing abuse. If these drugs are pulled from the market, I can only see the separate drugs (oxycodone, hydromorphone) being prescribed with the doctor telling the patient to take it with Tylenol. This opens up the fact that patients are more likely just to take the opiate drug without the Tylenol, getting addicted, and causing even more problems.

    It's the responsibility of the pharmacist to tell the patient how much acetaminophen to take in a day. I've been taught and trained to counsel the patient that they can only take a maximum of 8 per day (based on if a tablet of Vicodin has 500mg of acetaminophen, for example) because of the liver problems that acetaminophen may cause. And last I checked, maximum daily dosing on acetaminophen was 4000mg per day, not 2000.

  • Re:not really a ban (Score:5, Informative)

    by businessnerd (1009815) on Thursday July 02, 2009 @02:07PM (#28561167)
    I really have to second this idea, but not just painkillers. Every medication has a label with extremely specific guidelines on how to take it (or not take it). Those labels go through painstaking copy review to make sure that the user has the tools to take the medication safely. But almost nobody reads them. For example, one day my wife missed two days of her birth control and didn't know what to do, so she was just going to come up with something on her own. I told her she should read the label and see what it says. She's been taking birth control for years and has never bother to read it. I read it and it said exactly what to do in every type of situation of missed pills at various points in the cycle and each situation had different instructions. It's a good thing I read it because she was planning on doing what was NOT recommended. While she wasn't in danger of overdose or anything like that, this type of drug messes around with your cycles which can cause a whole mess of uncomfortable issues or pregnancy (totally not ready for that). Everyone has been in a situation where they weren't sure what to do with their meds so they just guessed, but if they read the damn label it would tell them exactly what to do. Every time you get a new medication, sit down and read the label. It can be a surprisingly interesting read.
  • Re:not really a ban (Score:3, Informative)

    by Red Flayer (890720) on Thursday July 02, 2009 @02:16PM (#28561341) Journal
    I think perhaps the parent to your post is currently under the influence of one or more of those narcotics. Or he just made an regular casual mistake, but I prefer to be cynical.

    Hydrocodone is very mild compared to oxycodone. Oxycodone has something like 3000 (IIRC from medicinal chemistry well over a decade ago) times the affinity for the relevant receptor sites in the body as hydrocodone. Taking 30 oxycodone tablets is far from harmless... untreated, it would likely be fatal, as you'd stop breathing. Of course, it's illegal to take oxycodone in any manner other than as directed by a physician, so we don't have to worry about that, right? Right?

    Anyway, here's the deal:

    Ask your doctor before you take any medication in conjuction with a prescription medication. At the very minimum, ask your pharmacist (the pharmacist will have better knowledge of potential drug interactions, but poorer knowledge of your personal medical situation). I'd do both.
  • by xyphor (151066) on Thursday July 02, 2009 @02:18PM (#28561377)

    You can get a script for just hydrocodone or oxycodone, but doctors don't like to prescribe them because of DEA pressure. Oxycontin is oxycodone plus acetaminophen (like percocet) but is time released.

  • Re:not really a ban (Score:3, Informative)

    by theydidnthavemyname (1258750) on Thursday July 02, 2009 @02:19PM (#28561381)
    This is not why acetaminophen (aka paracetamol in UK & other places) is combined with opiates in compound preparations. Acetaminophen is an effective painkiller and it works in a different way to opiate drugs meaning that you take a smaller dose of opiates to get the same effect on your pain. Opiates have more side-effects (e.g. constipation, nausea) and also the problems of addiction and tolerance. NSAID drugs like ibuprofen can also be combined with acetaminophen meaning you take a smaller dose of them (they can cause damage to the stomach lining and kidney amongst other things). Paracetamol (sorry so much easier for me to type) is very well tolerated, side-effects are much rarer than other analgesics - its only major downside is that its so damned unpleasant in overdose. Paracetamol is really commonly taken in attempted suicide and also overdose as a 'cry for help' in the UK. Its really heart-breaking how many patients i see who take an overdose, wake up and regret it only to have their liver slowly fail over the next few days and sometimes die a horrific death. Unintentional overdose with paracetamol is much, much rarer. Despite this, i will always prescribe paracetamol to people who are in MASSIVE amounts of pain (cancer, post-op, palliative, trauma) as a first line in combination with other painkillers. Yes on its own it will only help with mild pain but thats not the point. Some people here seem to think that their doctor is precribing them something ineffective or trying to con them. That just isnt true.
  • by Fieryphoenix (1161565) on Thursday July 02, 2009 @02:21PM (#28561419)
    They are not. They are considering banning combination drugs that include acetaminophen, because there have been fatal overdoses when people additionally took acetaminophen.
  • Re:not really a ban (Score:1, Informative)

    by Anonymous Coward on Thursday July 02, 2009 @02:35PM (#28561675)
    no, what you do is get if from mexico or an online pharmacy and then extract the hydrocodone or what have you yourself
  • Re:not really a ban (Score:4, Informative)

    by Zerth (26112) on Thursday July 02, 2009 @02:37PM (#28561703)

    The guaifenesin isn't really in there as an expectorant. It's in there because if you chug the whole bottle, the guaifenesin will make you throw up, discouraging you from using the dextromethorphan to get high.

    I'd rather take it with with theobromine [wikipedia.org] than dextromethorphan.

  • Re:not really a ban (Score:3, Informative)

    by Otto (17870) on Thursday July 02, 2009 @02:42PM (#28561783) Homepage Journal

    Acetaminophen has a lot of uses, actually. In recommended doses, it's perfectly safe and doesn't cause any liver damage. It's only when you combine it with other things or OD that it becomes problematic.

    Unlike aspirin, acetaminophen is safe for children as it doesn't cause Rhye's syndrome. It's safe for pregnant women. It doesn't irritate stomach lining and so is safe for those with gastric ulcers.

    It's method of operation is unlike other drugs (especially opiates) and the combination leads to less amount of both needed to produce the desired effects, which is why they combine it with those drugs. Hell, the stuff even works effectively in combination with aspirin (aka Excedrin), leading to a greater effect with less total dosage of either individually.

    The fact is that acetaminophen is practically a miracle drug. It works incredibly well with virtually no side effects. Unfortunately, the effective dose happens to be rather high when compared to the damaging dose (1/16th) which is unlike most other drugs (most other drugs fall into the 1/30th to 1/50th range).

    Anyway, I'm against the law banning any particular drug in general, because there may be an effective use of that drug in specific cases. My medicine should be between me and my doctor, not subject to government dictates.

  • Citation Provided (Score:5, Informative)

    by Tyler Durden (136036) on Thursday July 02, 2009 @02:50PM (#28561923)
    See here [drug-addiction.com]. It states in part that combining hydrocodone with other substances changes it from a Schedule II substance to a less restrictive Schedule III substance. The two example drugs they cite for this are Lortab and Vicodin - both containing acetaminophen.
  • Re:Doctors orders (Score:1, Informative)

    by Anonymous Coward on Thursday July 02, 2009 @02:54PM (#28561981)

    More children are hospitalized -- every year -- for Tylenol complications than ever contracted Reye's Syndrome in entire history of the disease.

  • OMG kill it! (Score:4, Informative)

    by Aphoxema (1088507) * on Thursday July 02, 2009 @03:12PM (#28562293) Homepage Journal

    "The FDA has determined that Tylenol enhancing pain killers are dangerous enough to potentially be pulled from the market. Drugs including Vicodin, Hydrocodone, Lortab, Maxidone, Norco, Zydone, Tylenol with codeine, Percocet, Endocet, and Darvocet"

    1. Vicodin is Hydrocodone

    2. None of these painkillers require APAP to function, the anti-inflammatory effects of acetaminophen are auxiliary. The primary reason APAP is added to these drugs is to make them difficult to take in doses addicts can appreciate.

    3. Acetaminophen is STILL effective at what it does and despite the misuse of it from ignorant users it is less harmful to the lining of the stomach than aspirin, does not increase the risk of people taking lithium or have sodium sensitivity like naproxen, and is not as definitely fatal in case of overdose as ibuprofin.

    Acetaminophen is not perfect, but there's no perfect alternative and that is the very reason why we need to sustain as many options as possible for the diversity of medical needs people have.

  • by Hatta (162192) on Thursday July 02, 2009 @04:10PM (#28563493) Journal

    It's actually the 2nd step in alcohol metabolism, the aldehyde dehydrogenase that uses up reducing equivalents. Here's a nice summary [ceri.com] of what happens.

  • Re:I for one (Score:3, Informative)

    by fafalone (633739) on Thursday July 02, 2009 @04:24PM (#28563729)
    I normally wouldn't correct something like this, but this is /. so minor technicalities cannot go uncorrected. The DEA, not the FDA, determines which CSA schedule a drug is placed in.
  • Re:Alcohol (Score:3, Informative)

    by Empty Threats (543523) <ascii.letterNO@SPAMgmail.com> on Thursday July 02, 2009 @04:31PM (#28563835)
    Taking the daily recommended maximum dose of alcohol will not destroy your liver.
    Taking double the daily recommended maximum dose of alcohol will not destroy your liver.
    Taking triple the daily recommended maximum dose will not destroy your liver.

    Alcohol will cause acute CNS depression and kill you long before it causes acute liver damage. Only chronic abuse allows it to scar your liver. The same is not true of acetaminophen.
  • Re:not really a ban (Score:2, Informative)

    by mr100percent (57156) * on Thursday July 02, 2009 @04:56PM (#28564213) Homepage Journal

    Yes, any half-way intelligent person SHOULD know not to take tylenol, but there's many thousands of accidental overdoses every year in emergency rooms all over the country. Some of these people get all upset and blame the government for making it OTC and not warning them if eating the whole bottle can kill you. Yes, their logic is pretty bad, but the public can be stupid.

    Your list is inaccurate, the FDA did warn about many of these drugs, but they were not banned. Avandia is still on sale today, as well as in formulations like AvandiaMet. Vioxx was voluntarily pulled from the market by Merck and not the FDA, which probably would have been fine with it as long as it had some sort of black box warning on it.

  • by dickmerkin (867704) on Thursday July 02, 2009 @05:48PM (#28564969)
    I've worked in a liver transplant unit, which is where Tylenol poisoned patients land... The whole idea is to make drugs like vicodin toxic in high doses and lethal IV. These are called "Compounded" drugs. They have a maximum dose, over which it becomes toxic. Drugs like oxycontin have no maximum dose (if you are adequately physically tolerant to opiate drugs) It's like similar to the practice of adding an adulterant (e.g. isopropanol, methyl ethyl ketone, methanol, etc ) to ethanol to make it undrinkable. In addition to Tylenol, atropine and aspirin are used as adulterants. The theory is that they will have less value to opiate addicts and it works. Compounded drugs are worth less on the street than uncompounded drugs. Almost Invariably, people who OD (not counting suicide attempts) on the Tylenol portion of a compounded drugs are abusing it. Furthermore, they are usually malnourished alcoholics who already have underlying liver disease... Last of all, most people aren't as susceptible to Tylenol toxicity as the people who get into trouble. I've seen quite a few addicts who were downing 40 pills a day of percocet or vicodin, with no ill effects.
  • Re:not really a ban (Score:3, Informative)

    by gringer (252588) on Thursday July 02, 2009 @10:08PM (#28567457)

    Tylenol is no deadlier than any other drug on the market.

    From memory from a course I did at university, Tylenol (or Paracetamol, as we call it here) has a very low therapeutic index (ratio of lethal to effective dose), which is unusual for a drug which is commonly used by many people. It happens to be quite a big cause of liver damage worldwide. This wikipedia page [wikipedia.org] seems to agree with that, suggesting a toxic/effective ratio of about 10.

    Unfortunately, I can't find other web references for this, can anyone else help out by linking to a list of LD50/ED50 ratios for drugs (in particular, Tylenol)?

    FWIW, here's one [clusterbusters.com], which has the following ratios:
    psilocybin (psychadelic mushrooms): 641
    vitamin A: 9637
    LSD: 4816
    aspirin: 199
    nicotine: 21

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