The Danger Of Mixing Candy And Poison
By Tim Davern, MD, a liver transplant specialist at the University of California, San Francisco San Francisco Chronicle, August 14, 2004

"First Do No Harm" is a cornerstone of modern medicine. "I think the practice of combining acetaminophen (Tylenol is one popular brand) and an opiate, such as hydrocodone bitartrate, together as a single drug (as Vicodin does) defies logic, if not common sense."

Acetaminophen is a "potent dose-dependent poison for the liver; simply stated, if you take too much, your liver dies."

Acetaminophen overdose is the "leading cause of acute liver failure in the United States today." On the other hand, opiates, such as hydrocodone bitartrate and codeine, while safe for the liver, are highly addictive. "Vicodin is currently the most popular prescription drug in the United States." Some patients become addicted to the opiate component of Vicodin and consume increasing amounts of acetaminophen, "ultimately leading to acute liver failure." "With overwhelming liver injury from acetaminophen, what follows is a particularly grisly death punctuated by bleeding, confusion, coma and, for still largely unclear reasons, brain swelling, damage and death."

"Patients typically take too much acetaminophen for fever or pain over several days, not realizing the potential for liver damage." "Many are unaware that acetaminophen is contained in dozens of over-the-counter cold and flu preparations."

"This situation is particularly tragic in young children accidentally overdosed with acetaminophen, typically in the setting of a flu-like illness, by well-intentioned but misinformed parents."

Acetaminophen packaging should have better warning labels, and should not be sold in 1,000 pill mega-bottles. Acetaminophen-opiate combinations [like Vicodin] should be removed from the market. "The prescription rules in California have made it far easier for physicians to prescribe an acetaminophen-opiate combination, such as Vicodin, than a pure opiate, such as codeine, although the former is far more dangerous."

The FDA banned Ephedra, which "contrasts with its puzzling, relatively meager efforts to prevent acetaminophen hepatotoxicity, which kills far more Americans each year than Ephedra."

Take This Painkiller Carefully Medical News That Matters Second Opinion
By Isadore Rosenfeld, MD Parade, February 19, 2006, pg. 6

"Acetaminophen, whose best know brand name is Tylenol, is one of the most widely used nonprescription painkillers is the US." "Overdosing with is the leading cause of serious poisoning in this country."

"Every year, too much acetaminophen accounts for 50,000 emergency room visits, 42% of liver failures, and an average of 458 deaths." "Never take more than 4,000mg a day—eight 500mg extra-strength capsules."

Numerous other drugs also contain acetaminophen, including Nyquil, Sudafed, Alka-Seltzer, Sinutab, Contac, Actifed, etc.

"If you have two or three alcoholic drinks or more a day, be sure to consult your doctor before taking Tylenol."

"The symptoms of acetaminophen overdose are nausea, vomiting, abdominal pain and lack of appetite."

"The specific antidote is N-acetylcysteine (NAC)."

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