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FDA Considers Banning Acetaminophen-Based Pain Killers

ScuttleMonkey posted more than 5 years ago | from the welcome-to-the-nanny-state dept.

Medicine 631

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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Vicodin? (5, Funny)

Megaweapon (25185) | more than 5 years ago | (#28559725)

As long as it doesn't cause Lupus...

Re:Vicodin? (2, Funny)

clem (5683) | more than 5 years ago | (#28559733)

It's not Lupus.

Re:Vicodin? (1, Funny)

fridaynightsmoke (1589903) | more than 5 years ago | (#28560001)

It's not Lupus.

It's NEVER Lupus

Re:Vicodin? (1)

MikeKD (549924) | more than 5 years ago | (#28560109)

Except when [wikipedia.org] it is.

Re:Vicodin? (0)

Anonymous Coward | more than 5 years ago | (#28560371)

Ironically, the episode of House, MD that was on USA last night was the episode when it was Lupus...

Re:Vicodin? (1)

GameMaster (148118) | more than 5 years ago | (#28559795)

Yea, I've heard the damn vampire are tough to stomach in Santa Monica. The last thing they need is Werewolves too.

House, MD (1)

exes (853401) | more than 5 years ago | (#28559729)

So does House still have a working liver at this point?

Re:House, MD (5, Funny)

ae1294 (1547521) | more than 5 years ago | (#28559957)

So does House still have a working liver at this point?

The whole reason he got into medicine in the first place was to be near a supply of fresh new organs. It was ether THAT or start APPLE and he just couldn't stomach the idea of rampant fanboys.

not really a ban (5, Informative)

mr100percent (57156) | more than 5 years ago | (#28559743)

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)

Re:not really a ban (-1, Offtopic)

Freetardo Jones (1574733) | more than 5 years ago | (#28559831)

Before everyone screams bloody murder,

Don't expect anyone to read your post before blasting about nanny states and all the bullshit without realizing that you can still buy all this stuff just not as an all-in-one pill.

Re:not really a ban (2, Interesting)

jedidiah (1196) | more than 5 years ago | (#28560331)

Tylenol is nasty dangerous stuff. It's very easy to misuse it to a lethal degree.

Warning labels generally are not sufficiently dire assuming they are even detailed enough.

On the one hand, I am not really surprised. On the other hand, I wonder why they
took so bloody long. Tylenol by itself is dangerous enough, you don't really have
to mix it. So given how long it took for the Feds to take action, it doesn't
really seem to be that serious.

Successful diet pills get more diligence than the Feds are showing here.'

Who stands to gain here and who is greasing the relevant palms.

Re:not really a ban (4, Funny)

Anonymous Coward | more than 5 years ago | (#28559843)

Before everyone screams bloody murder, the fact remains that you'll still be able to buy the stuff, separately

Thank God! --- R. Limbaugh

Re:not really a ban (3, Informative)

ckthorp (1255134) | more than 5 years ago | (#28559885)

Except the article clearly states that Vicodin is actual hydrocodone+acetaminophen...

Re:not really a ban (2, Insightful)

brainboyz (114458) | more than 5 years ago | (#28559893)

Yes, let's protect people from their own stupidity. Next, we can make it illegal to sell desks without permanently attached foam on the corners to protect you in case you trip!

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.

Re:not really a ban (5, Informative)

BrokenHalo (565198) | more than 5 years ago | (#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:not really a ban (5, Informative)

Bitch-Face Jones (588723) | more than 5 years ago | (#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.

Re:not really a ban (1)

WilyCoder (736280) | more than 5 years ago | (#28560075)

I'd say its highly irresponsible to claim that 24 pills of 5mg Oxycodone will not kill an Opiate-naive individual.

Re:not really a ban (1)

nedlohs (1335013) | more than 5 years ago | (#28560301)

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.

So why the "but"? If they're dead 3 days later than they were right about the suicide idea.

Re:not really a ban (4, Interesting)

mcgrew (92797) | more than 5 years ago | (#28560303)

Drinking alcohol with it also will destroy your liver faster than either alone will. An over the counter cough medicine with both acetaminophen and alcohol in it is especially dangerous.

Tylenol has never worked for me, even Tylenol with codeine (percocet?). If I'm prescribed Tylenol with codeine, I have to take an aspirin with it to make it work. Perhaps they'll bring back Darvon (aspirin and codeine).

I don't see (aside from advertising and bribing doctors and hospitals) why acetomenaphine needs to be on the market at all, as there are a plethora of newer, more effective, and safer analgesics these days. Acetominaphine won't relieve swelling at all, while aspirin and other analgesics will.

Of course no drug is completely safe -- my friend Charlie had to be operated on for a perforated intestine that her doctor said was caused by taking too much naproxin. But that's far preferable to a liver transplant.

If You Drink Alcohol Avoid Acetaminophen (5, Informative)

eldavojohn (898314) | more than 5 years ago | (#28559787)

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.

Re:If You Drink Alcohol Avoid Acetaminophen (4, Informative)

mr100percent (57156) | more than 5 years ago | (#28559837)

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

Re:If You Drink Alcohol Avoid Acetaminophen (-1, Troll)

geekoid (135745) | more than 5 years ago | (#28559965)

well, your older sister needs to learn how to read studies and not repeat lies spread on the internet.

Re:If You Drink Alcohol Avoid Acetaminophen (-1, Troll)

Anonymous Coward | more than 5 years ago | (#28560147)

So instead of being a total douche, why not refute the statement with some cold hard facts?

You'll still be a douche, but not a total douche.

Douche.

Re:If You Drink Alcohol Avoid Acetaminophen (1)

snl2587 (1177409) | more than 5 years ago | (#28560385)

So name the studies. Alcohol damages the liver as it's broken down and so does acetaminophen, and it follows that taking both at the same time is even worse (not to mention possible interactions and metabolic interference caused by alcohol.

I fail to see how the sister was incorrect about the dangers of mixing the two drugs, though I do wonder how much the risk of liver disease is truly increased.

Re:If You Drink Alcohol Avoid Acetaminophen (0, Offtopic)

gandhi_2 (1108023) | more than 5 years ago | (#28560095)

three sisters are nurses

That's so hot.

Re:If You Drink Alcohol Avoid Acetaminophen (0)

Anonymous Coward | more than 5 years ago | (#28560273)

Unless they're the big fat ugly nurses that usually are in hospitals.

Re:If You Drink Alcohol Avoid Acetaminophen (0)

Anonymous Coward | more than 5 years ago | (#28560227)

Antonio Benedi, then a 37-year-old aide to George Bush, drank wine with dinner on a Saturday night in 1993 and over the next four days took ten extra strength Tylenol tablets, hospital records show. He went into a coma and was saved only by a liver transplant. He sued and won $8 million from J&J.
http://www.forbes.com/forbes/1998/0112/6101042a.html

Re:If You Drink Alcohol Avoid Acetaminophen (4, Insightful)

dunkelfalke (91624) | more than 5 years ago | (#28560433)

Maybe your sister should have told you not to drink that much alcohol in first place. Makes a lot of more sense that way.

more pointless prohibition (1, Insightful)

Utini420 (444935) | more than 5 years ago | (#28559799)

As someone who was prescribed Percocet after reconstructive surgery (my arm is full of plates and pins) the effect they might have on my liver was the furthest thing from my mind. Even had I known of this risk, I'd have not been at all hesitant about the drug.

Its also pretty hard to read that list and not assume the FDA is banning some of the more commonly abused pharmacuticals. Because, ya know, prohibition is totally what people want from their government.

Re:more pointless prohibition (2, Insightful)

njfuzzy (734116) | more than 5 years ago | (#28559923)

It's easier to live without one arm than without one liver. Food for thought.

Re:more pointless prohibition (3, Insightful)

Austerity Empowers (669817) | more than 5 years ago | (#28560125)

But if you take drugs as correctly prescribed, you can, and should, have both. In spite of the hysteria, people have taken vicodin for pain and not died from liver failure.

Re:more pointless prohibition (0)

Anonymous Coward | more than 5 years ago | (#28559959)

And you would still have gotten the drugs combo as two pills instead of one percocet. It's the combo that increases the risk of OD'ing on the acetaminophen, since it's so common. Basically making people know they're taking it by always requiring it's in a separate pill.

No it's not, read the FUCKING ARTICLE (1)

geekoid (135745) | more than 5 years ago | (#28560071)

They are considering banning them from being put in the same pill as other drugs. You will still be able to take them as separate pills.

This is actually seems to be a good thing.

"...prohibition is totally what people want from their government."
Some people do. I mean not what THEY enjoy, just what others seems to. F'n neo-cons.

Re:more pointless prohibition (1)

0100010001010011 (652467) | more than 5 years ago | (#28560279)

The problem is idiots that go "Oh damn, my arm really hurts. I'm going to take this Percocet AND this Tylenol, it's harmless.".

While we're at it we might as well ban Alcohol. I can't tell you the number of idiots I knew in college whose solution to a bad hangover was Tylenol.

The Linux Party (-1, Offtopic)

Anonymous Coward | more than 5 years ago | (#28559819)

First, there was a plan: how to bring together the two different development groups at work? My boss said there was a sort of tension he thought could be eased by some social interaction. Not easy. Both the different development groups despised one another, each thinking its "art" was more important and eloquent than the others'.

First there was the XML group. They worked on our website, documentation and formatting, and simple configuration apps and some front-ends to Java stuff. They also did our web sites. They used CSS, HTML, XSL, JavaScript, and a bit of Java. They typically dressed casually, drank coffee and tea, and liked to work straight from the spec: no "Learn XSL in 30 Days" books were to be found in their cubicle farm.

Then we had the Linux developers. They worked "special hours," coming in at one and staying late, supposedly, until seven or eight at night. They enjoyed Bawls and had a penchant for ThinkGeek t-shirts and cracking jokes about Win32 API calls and the dreaded Blue Screen of Death. They all had beards or mullets or long, unwashed hair. Some had penguin or C code tattoos. Their cubicle farm was known for the bleating laughter that exploded when one of them found a silly bug on someone else's code, and for the rotten, fetid stench that could only be compared to three-day-old shit reeking from inside a rotting corpse's abdominal cavity.

So, in order to get the guys to get to know each other, my boss had asked me to organize a during-hours, alcohol-friendly party. My ideas ranged from a keg or two to live entertainment, AKA strippers. But as to what to get them to actually talk to each other in a human manner I had no clue. So I let it go til the last minute and decided to let my inherent creativity mull it over in the back of my head.

When the day of the party had arrived, the catering company brought in a few trays of lunch meat, chicken, pizza, and side dishes, I had picked up the four kegs from the local brewery, and the big-screen TV and DVD were set up ready to blast the Matrix into the eyes and ears of my co-workers. The eagerness in the the air was encouraging and I thought that loosening up and smiles going on even now were a good sign. I even saw some of the guys who'd known each other previously begin to bunch up, bringing along the co-workers they knew from everyday work.

The first thing everyone did was hit the food line, loading up their plates and grabbing a cup for beer to wash it down with. A few approached me and thanked me for the food; it seems appeasing the belly really did tame the beast. After a few minutes of silence and eating and a few second and third courses, they guys were ready to sit down and be entertained. After asking if anyone needed anything else before the movie started, the lights went out and the Matrix began playing. I heard a few enthusiastic comments and jokes being told.

About half-way through the movie I noticed a lot of the Linux guys getting up and presumably going to the restroom. No suprise, as the second keg was history by now and the third was probably half-way gone. I also noticed some of the guys bumping into things and stumbling. Alcohol's the social lubricant, eh? Well, not long after, my bladder beckoned and I answered. As I made my way to the restroom, I had a self-satisfied smile on my face: my little plan was working, my boss would be happy, and it might even a Christmas bonus or a promotion (even if in title only).

Well, as soon as I pushed the restroom door open, I knew something was wrong. The smell of vomit was pretty strong and I hoped that it'd only been the work of one guy. But the smell was so pungent! After standing at the urinal, waiting for the golden flow to commence, I stood in silence. It was then that I heard grunting. Listening intently for a few seconds, I hoped whoever was upchucking their beer and munchies wasn't leaving a huge mess for the cleanup crew. After pissing and still hearing the noise, I approached the stall the that moaning was coming from.

"Hey, you alright in there, man?" I asked cautiously.

I was met by silence for a moment. Then I heard a few grunts and concealed giggles. Something was up in there. It was then that I heard what sounded like crying and more moaning. What the fuck? I decided I needed to see what was going on. I didn't want this party to come crashing down around my ears. I pushed the door open hard and then gasped as I saw the most sordid, disgusting thing I'd ever seen in my life.

Standing on either side of the toilet were two of the Linux developers, their beards caked with vomit, their pants in puddles around ankles, with erect penises wagging in the air. Doubled over the toilet, his head nearly dunked in the swill, was one of the XML developers. His pants were also around his ankles and what appeared to be a combination of blood and semen were dripping from his torn, ragged anus. He was covered in vomit from head to toe, and he was crying hard into the toilet bowl, its echo an eerie accompaniment to the awful scene I was seeing but not believing.

They two Linux developers slowly turned and looked me straight in the eye, evil grins smeared across both of their bearded faces.

"What the fuck are you doing!?" was all I could force out of my mouth. I still wasn't believing I was seeing this.

Saying nothing, both of the Linux guys rushed me. Being in such a tense state, I threw both of them off and made a break for the door. And the fucking thing wouldn't open. In the following two seconds that seemed like an eternity, the door was pushed open my way and two more Linux coders came in. Upon seeing what was happening, they immediately grabbed me and were joined by the first two. I was trapped. Then the one guy, who was a dead-ringer for Rasputin, the mad Russian monk, gazed into my eyes and said in a feminine voice, "Looks like Mr. Party is gonna get a taste of the real action!" and cackled insanely.

Cold sweat spurted from the pores on my foreheads and cheeks as I was dragged by the four stinking, polluted hippies into the same stall their previous victim was in.

"Thanks for the pizza and beer," Rapsutin said, "now it's time for the weeners and buns!"

Immediately the first two slogged their pants off and got down on their knees. The other two put there knees in my back and held me on top of the first victim, who now appeared to be unconscious. I heard their belts coming off and their zippers coming down, and some rustling around told me that their pants were coming down also. Then the first two started sucking off the other two, in what I could only call the most enthusiastic blowjobs I'd ever seen in my life. The moaning and slurping sounds turned my stomach and I retched. I could see why the first guy might have vomited.

Eventually Rasputin and his cohort started moaning more loudly, and one of them said "fifteen seconds." This was followed by a series of rapid-fire belching and burping that shook me up and down on the guy underneath me. After about fifteen seconds, all Hell broke loose. The two guys behind me started vomiting on the two guys fellating them and I saw cumshot shoot and mix with the vomit all over the two cocksuckers' faces. It was then that I almost lost it. I finally did refund when the first two vile fluids were followed by streams of piss. I heard swallowing and dripping and I yacked all over their first victim's head.

Rasputin cried out like a little girl in ecstasy. "Oh god, I'd been waiting for that all night! This party fuckin' roxorz my coxor!"

Now it was my turn, it seemed, as all four started tearing my pants down. Chunks of vomit-piss-semen fell on my back and soaked through my t-shirt. It was revolting. I shuddered as I felt their cold, clammy hands in my ass-crack and a very indelicate reacharound on my ball-sack. At this point I had no idea who was doing what, and I was just praying that I'd wake up and realize I was drunk and dreaming.

Just then I heard the door boom open and my boss's voice fill the air. The stall door was open and he saw right away the turgid scene transpiring in front of him. His voice was immediately followed by two others, XML developers I knew, and they flew into the stall as best they could and began a fight to save my asshole. The poor guy underneath me had just woken up and started struggling and the extra weight of eight other bodies in the stall must have been suffocating.

"It'll be all right, buddy," I said to him.

Within thirty seconds I was to my feet and was delivering the most heart-felt kicks to the guts of the rapist faggot Linux coders. Between me, my boss, and the two XML developers, we had the gang of four knocked out in a sloppy, excrement-filled pile of hairy body.

It's now been a month since this horrible incident and I am in regular therapy with a sexual abuse counselor. In response to the terrible outcome of this party, my boss toyed with the idea of selling the group off to another company, sans the four hippies who'd been fired and arrested. After considerable urging on my part, and very open ear from my boss, the whole group was dissolved and the Linux coders lost their jobs. Their product was delayed by a year as my boss began hiring a new development team. We'd found evidence that the whole group had been involved in the planning of the gang-bangs and that had it not been for us everyone would have had a turn in the stalls.

If there's one thing we learned from this tragedy it's that Linux developers, users, and advocates are desperate cock-lusting homosexual faggots that can't be trusted in any situation, let alone a restroom setting. You've been warned. On the positive side, though, the whole incident brought solidarity between the other groups in the company and I am now on schedule to get a huge Christmas package that not only includes a gigantic bonus but a month's worth of paid time off and a real promotion.

Doctors orders (3, Informative)

DerekLyons (302214) | more than 5 years ago | (#28559823)

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.

Re:Doctors orders (0)

Anonymous Coward | more than 5 years ago | (#28559979)

And then 80% of the population doesn't know or care what ''acetaminophen'' is

They're just gonna take their tylenol with it, as an extra assist.

Most people wouldn't say or know Tylenol contains acetaminophen if you asked them.

Re:Doctors orders (1)

zippthorne (748122) | more than 5 years ago | (#28560315)

I took a fair amount of tylenol as a youngster. It never worked, but my parents had been sold some kind of fear-mongering about aspirin and ibuprofen causing rickets or something. For years, I thought "pain relievers" were just supposed to reduce the pain by an unnoticeable amount and give you something to do when you had a headache to feel like you were doing something.

Anyway, the point is.. I couldn't say I knew Tylenol contains acetaminophen if you handed me the box with the word acetaminophen highlighted on the ingredients list.

Re:Doctors orders (1)

OrangeTide (124937) | more than 5 years ago | (#28560017)

If people want to destroy their liver after being warned, then so be it. I think it is overreacting for the FDA to ban something that has been used successfully for decades when no new side-effects have been discovered. We knew for a long time that acetaminophen is dangerous in large doses, so are a lot of things.

Re:Doctors orders (0)

Anonymous Coward | more than 5 years ago | (#28560377)

"You know why there's a Second Amendment? In case the government fails to follow the first one." -- Rush Limbaugh

that's rather ironic. Since according to his actions Rush doesn't believe in the First Amendment

What will kill pain then? (0)

Anonymous Coward | more than 5 years ago | (#28559829)

It seems to me that the majority of these pain killers are extensively used to treat pain. I took Percocet and Vicodin on occation after I was injured in the military.

What will replace these? I hope the FDA advisory panel which is recommending the FDA ban these has a backup plan to ease pain. The article says basically that doctors will have to explore other avenues of treatment, but wouldn't these acetaminophen based pills be the best already? So, then we have to go to a sub-standard method of pain relief? (maybe necessity will spur the development of safer pain killers?)

I for one, would rather risk damaging my liver over having incapacitating pain for weeks on end.

Re:What will kill pain then? (3, Informative)

Freetardo Jones (1574733) | more than 5 years ago | (#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:What will kill pain then? (1)

brian0918 (638904) | more than 5 years ago | (#28560177)

So some restrictions on freedoms are okay! .......

Re:What will kill pain then? (1)

pilgrim23 (716938) | more than 5 years ago | (#28560321)

the FDA is giving me a headache.

Re:What will kill pain then? (1)

Bobnova (1435535) | more than 5 years ago | (#28560443)

You can't buy them as seperate pills, they don't exist. The ranks of pure opiate painkillers are mighty thin, with oxycontin being the only pill one that i'm aware of. All the rest come bundled with acetaminophen or asprin.

Why? (4, Insightful)

muridae (966931) | more than 5 years ago | (#28559841)

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.

Would it not make more sense to educate the people taking the pills, instead of banning an effective pain reliever? Anyone taking a vicodin and then two Tylenol is either in serious pain that the hydrocodone is not treating, or is unaware of what is in vicodin. A little talk by the pharmacist or doctor can fix both. Lowering the dose of APAP in prescription pills makes sense too, I mean 650mg in Darvocets? Take that 4 times a day and you are already over the daily dose. All of that just to prevent some junkies from getting high?

Not that I will argue too much, since I can't take Aspirin or ibuprofen, it will be much easier to get a script for pure codeine.

Re:Why? (1)

Aladrin (926209) | more than 5 years ago | (#28560079)

They aren't banning it, they are simply banning it premixed with other drugs. Doctors can still prescribe each individually and get the same effect, and then the patient knows how much they've taken, instead of guessing.

If you give someone one of the mixes, and warn them once that there's acetaminophen in it, they'll forget. If you give someone 2 pills, and 1 is acetaminophen, they -can't- forget.

I'm not usually for laws like this, and I'd much rather just see companies and doctors do this on their own, but... Well, greed and all that.

Re:Why? (1)

avandesande (143899) | more than 5 years ago | (#28560353)

That's fine but reformulating these drugs without tylenol and getting FDA approval will cost these companies millions or perhaps even billions of dollars.

Re:Why? (1)

avandesande (143899) | more than 5 years ago | (#28560103)

It is not effective. There are better OTC painkillers that last longer than tylenol with a smaller dose. It really should just be eliminated.

Re:Why? (1)

muridae (966931) | more than 5 years ago | (#28560297)

Name them, then tell me which can be taken by people with kidney or stomach problems.

Re:Why? (1)

DriedClexler (814907) | more than 5 years ago | (#28560183)

Lowering the dose of APAP in prescription pills makes sense too, I mean 650mg in Darvocets? Take that 4 times a day and you are already over the daily dose. All of that just to prevent some junkies from getting high?

Right on. When I was first prescribed Tramadol, the only medicine to make inroads on my back pain, the doctor felt he had to spike it with tylenol.

Hint: if Tylenol were effective, I wouldn't be coming to you, moron. Thanks for the poison.

Re:Why? (1)

Grishnakh (216268) | more than 5 years ago | (#28560193)

Wouldn't it also make sense to educate car drivers in this country so they drive better and cause fewer accidents, rather than just handing a driver's license to anyone who can pass a simple vision test with no regard to their driving skills?

The USA is firmly against educating car drivers; why would it want to educate medication users?

This is really a problem for Renal Patients (0)

Anonymous Coward | more than 5 years ago | (#28559845)

I'm borderline stage 3 and 4, and currently the only OTC pain killer I can use is Tylenol. If I receive my kidney, I would be receiving pain killers in the listed group for pain management. All the other pain killers I know of metabolize in the kidneys, so what exactly do they propose for people in this situation? Opiates that attack the liver and the kidneys perhaps?

Ah hell, I've got to read the article now. Damn it, I don't want to give up the AC cred. :)

Only because of stupid people. (3, Insightful)

Lumpy (12016) | more than 5 years ago | (#28559883)

The problem is with the idiots that take 1000mg and then cant wait for it to work so they take another 2-4 in an hour or so.

The people that are stupid and dont read the bottle that says" DO NOT TAKE MORE THAN XXX in a 24 hour period." It's clear as day on the fricking bottle.

So we ban something because the average person is too stupid to read the bottle?

Can we ban water as well? if you drink 6 gallons in an hour it will kill you!

Re:Only because of stupid people. (1)

geekoid (135745) | more than 5 years ago | (#28559939)

I think the point is that it is easy to misuse even if you are careful. That's becasue it's in so many products.
However, not letting a doctor prescribe it is just stupid.

People don't understand that drugs are dangerous (1)

b4dc0d3r (1268512) | more than 5 years ago | (#28560325)

People don't understand that drugs are dangerous.

If the doctor prescribed it, it must be safe right? And they intentionally recommend lower doses than would be lethal, so you have a little room, right? I mean, I'm not like the other people who die taking it, I'm only taking a little more than recommended. If it didn't work, I must have missed some. I took it with food, that slows down alcohol absorption, so I can take more because I ate and it will be slowly absorbed and it will be fine.

All of these thoughts make sense by themselves... but you take that extra bit and it suddenly goes from completely safe to dangerous.

I think the point here is people should be scared of drugs - but they are so common these days that fear is completely lost. If a few people die, the drugs get taken off the market. I'm currently taking something that killed 6 people - now the paperwork around taking it is incredible. It takes so much documentation and checking to make sure that I'm still supposed to be taking it - every month. Over 6 people, it was taken off the market and reevaluated and additional paperwork and process created.

So there are two sides to this. One, people see that drugs are carefully followed and should be safe. Two, people SHOULD see that drugs are scary and powerful and need to be respected, but all they see is the safe side, because of the logical fallacy that you won't be the one. Sure seat belts save lives, but I don't get in accidents. Sure cars get hot, but I can leave my dog or kid in it - I'll just be a FEW minutes, not like those people whose kids or pets died. Or sure other people need to pay attention when they drive, but I've got it under control.

People don't get it, and you can't make them get it. so you either have to accept that people will die, or make it impossible for them to die. In my old age, I'm inclined to agree with this. Take it with another pain killer and die, take it with alcohol and die, so people can't be trusted. Personally I'm all for Darwinian self de-selection for the gene pool, but as an enlightened society we have no choice but to make it difficult for people to kill themselves accidentally.

Re:Only because of stupid people. (5, Interesting)

jlechem (613317) | more than 5 years ago | (#28559995)

'The people that are stupid and dont read the bottle that says" DO NOT TAKE MORE THAN XXX in a 24 hour period." It's clear as day on the fricking bottle.'

Not really look at a tylenol bottle. Yeah it says no more then 6 or 12 in a day but it's incredibly tiny and hard to read. And nowhere does it talk about using it with other drugs of that type other then a generic consult your doctor blah blah blah. And who talks about tylenol with your doctor? I means it's been on the market a while and is 100% safe right? I agree there is a lot of stupid shit out there but I feel this case isn't one of them.

Re:Only because of stupid people. (0, Troll)

Spy Handler (822350) | more than 5 years ago | (#28560019)

Well considering you and I will be paying for the liver transplants (if Obama gets his way) of all these stupid people who can't understand the label on the bottle, yes I think a ban is not unreasonable.

About 50% of the population has BELOW AVERAGE I.Q. - lower than 100.

Re:Only because of stupid people. (1)

twidarkling (1537077) | more than 5 years ago | (#28560221)

No. That would only be true if it was a median IQ. Averages are thrown by outliers. Someone with a 120 IQ requires an 80 to average to 100. Or two 90s. And 90 is already pretty far off, but it isn't *that* much stupider than 100.

Re:Only because of stupid people. (0)

Anonymous Coward | more than 5 years ago | (#28560061)

The bottle doesn't say "do not take more than XXX in 24 hour period - or YOU WILL DIE", yet that is exactly what can happen from taking just 10 pills over 4 days:
http://www.forbes.com/forbes/1998/0112/6101042a.html

Re:Only because of stupid people. (2, Insightful)

geekoid (135745) | more than 5 years ago | (#28560133)

"So we ban something because the average person is too stupid to read the bottle?"

Perhaps if ti's the average person, then there is an issue.

Anyways, this is just a ban from putting two specific medication together in the same pill. There reason are good and are not "because the average person is stupid".

Of course, one if the most stupidest things someone can do is post about an article they clearly didn't read. Of course, the most stupiest thing, bar none, is having a land war in Asia.

I for one (0, Flamebait)

Icegryphon (715550) | more than 5 years ago | (#28559899)

Do not welcome our nannystate overlords.
Seriously why do we have to keep legislating everything.
Soon after Government run healthcare they are going to tell you want you can and can't eat.
Hope you Enjoy cardboard for the rest of your life


Elections have Consequences.

Re:I for one (4, Informative)

Freetardo Jones (1574733) | more than 5 years ago | (#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:I for one (1, Flamebait)

Icegryphon (715550) | more than 5 years ago | (#28560117)

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.

I know I am really just completely crazy huh [bio-medicine.org] Government would never ever go to far.

Re:I for one (1)

twidarkling (1537077) | more than 5 years ago | (#28560243)

Hmm. Hasn't happened in Canada.

You fail it.

So wait... (4, Insightful)

moosehooey (953907) | more than 5 years ago | (#28559901)

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), and then when druggies take large doses anyway and cause liver damage and death, the FDA is *surprised*?

Re:So wait... (5, Informative)

phizix (1143711) | more than 5 years ago | (#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.

Well (2, Insightful)

geekoid (135745) | more than 5 years ago | (#28559909)

If this is an issue with miss use, then pulling it from the shelf seems ok; however not letting a doctor prescribe it is just stupid.

Re:Well (0)

Anonymous Coward | more than 5 years ago | (#28560441)

Not an issue. Doctors can prescribe the prescription-only (the good stuff) and paracetamol on the same piece of paper or just tell the patient to buy paracetamol also.

This is not a ban (2, Informative)

wiredlogic (135348) | more than 5 years ago | (#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.

As someone with a lortab prescription... (4, Interesting)

ScytheBlade1 (772156) | more than 5 years ago | (#28559951)

... good.

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. This acts as a deterrent for anyone trying to "get high" off of the hydrocodone. Second, acetaminophen is a pretty decent pain killer, which hey, if you're taking lortab, that is the whole point.

My problem is the raw nausea induced. It's not uncommon for me to need to take one, and then develop a severe stomach, erm, 'problem' to the point where I can't do anything until a couple minutes after I've emptied my stomach into the nearby toilet. That is solely a side effect of the acetaminophen.

The "hey my liver is going to live" is a bonus effect from the removal of acetaminophen as far as I'm concerned.

The problem of course - is what they'd replace the acetaminophen with, should they want to continue shipping lortab (and friends). I somehow doubt it'd be any better in terms of side effects.

But I can hope.

Re:As someone with a lortab prescription... (1)

value_added (719364) | more than 5 years ago | (#28560431)

My problem is the raw nausea induced ... That is solely a side effect of the acetaminophen.

If that's true, then it's likely that folks who take (chew, inhale, inject, etc.) these drugs recreationally would benefit from the proposed changes. Not trying to funny, just making an observation.

So too much acetaminophen can kill you? (1)

jayme0227 (1558821) | more than 5 years ago | (#28559969)

Well, the same can be said for alcohol, let's ban that. Wait, we tried? And failed? Damn.

We should probably ban water, too, then. After all, if you're holding your wee for a Wii, too much water has proven deadly.

Truth be told, in moderation, most things are fine. If you're too stupid to follow the directions given by your doctor/pharmacy, you deserve a little bit of liver damage. Since the liver is your only organ that regenerates, you probably won't even die.

Re:So too much acetaminophen can kill you? (2, Interesting)

EastCoastSurfer (310758) | more than 5 years ago | (#28560293)

Well, the same can be said for alcohol, let's ban that. Wait, we tried? And failed? Damn.

Are you sure they failed? Alcohol laws continue to get stricter and stricter. The prohibitionists realized that you can't take it all away overnight, instead you have to slowly take it away.

Re:So too much acetaminophen can kill you? (1, Interesting)

Anonymous Coward | more than 5 years ago | (#28560323)

And if I said that three beers a day will kill you within 5 years? Well, having been prescribed a standard prescription of vicodin which contains 500 mg of ace., 6 tables a day. You can do the math.

And this has been for 2 years for nerve damage. And yes, I have liver damage. I'm not a make believe TV doctor and I don't pretend to be one.

Well then don't do that (1)

Paul Carver (4555) | more than 5 years ago | (#28559989)

Also, if you take any of these pills and then drive your car into a telephone pole or across the median of a highway you could die. Also, if you don't take any of these pills and then drive your car into a telephone pole or across the median of a highway you could die. I think this is a classic case of "don't do that, stupid"

Logic fail (2, Insightful)

forgottenusername (1495209) | more than 5 years ago | (#28560003)

Hydrocodone has 0 requirements to be "cut" with acetaminophen. Neither does oxycodone. It's just done as a way of limiting a patient's intake of the various painkillers that are mixed with acetaminophen. Look at the dosing for Vicodin for instance (I had neck surgery a while ago for a herniated neck disc & did a bit of research);

- 5mg hydrocodone for 500mg acetaminophen
- 7.5 for 750
etc

Similar ratios with oxycodone.

So you really end up being limited by the amount of (unecessary) acetaminophen which has _nothing_ to do with the RX painkillers in question. The fact that liver damage etc is so prevalent with acetaminophen simply means they need to remove that component of it, and people consume that as as seperate pill.

Such silliness. Don't force people to take acetaminophen if they don't need it - damage from that is a very real problem with these painkillers. It makes no sense - "let's prevent people from overdosing on the painkiller by adding in something that will cause liver failure if they take too much of it!" "omgz grate idea I just happen to have a great deal worked out with this acetaminophen provider. We'll all get rich!"

Just in time (1)

digitalsushi (137809) | more than 5 years ago | (#28560023)

For some fresh drama on an aging "House, MD"

Some more harmful things they should ban: (1, Insightful)

Anonymous Coward | more than 5 years ago | (#28560031)

-Pointy sticks
-Firearms
-Automobiles
-Anything harder than nerf

'Cos you know, you could kill yourself if you used those things improperly.

Alcohol (5, Insightful)

sexconker (1179573) | more than 5 years ago | (#28560053)

So when will the FDA ban alcohol for destroying people's livers?

Why BAN and not WARN? (5, Insightful)

Fallen Kell (165468) | more than 5 years ago | (#28560059)

Seriously here. Why not make sure that there are STRONG WARNINGS on these drugs and require that they also place the warnings on TV Ads (not just in the small print, but actually required spoken warning about exceeding the 2000mg limit, and mention that other drugs like prescription pain killers may also contain this substance and to check with your doctor). I mean, if people know that over-dosing on this WILL seriously damage and potentially kill your liver, they will pay a little more attention to how much they are taking...

As it currently is, with the current ads and warnings, more people think that something like Tylenol with Codeine is pretty safe to take. I mean, its Tylenol, safe for your stomach (too bad just not necessarily safe for your liver).

Re:Why BAN and not WARN? (1, Informative)

Anonymous Coward | more than 5 years ago | (#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.

Should have done it long time ago (1)

zymano (581466) | more than 5 years ago | (#28560069)

Seems like a lot of people having problems overdosing on this stuff.

news: government outlaws natural selection... (1)

pointbeing (701902) | more than 5 years ago | (#28560077)

JMO, but...

I think people who want to use a hair dryer in the bathtub should be encouraged to.

If you're old enough to read and you want to eat those little silica gel packets marked "Do Not Eat" the government shouldn't stand in your way.

And last, I think "hold my beer and watch this" events should be televised.

In short, the gummint is pissing in my gene pool.

My iPhone burned my hand (0)

Anonymous Coward | more than 5 years ago | (#28560107)

I guess I had better stock up on some of this shit

Hey this is good. (0, Flamebait)

ae1294 (1547521) | more than 5 years ago | (#28560119)

I have a bottle of 1000 acetaminophen sitting right here... Maybe it's time to stock up as I love the black market in my nanny state of America.

If you can't be bothered with the fact that taking more of a drug than perscribed can hurt you than one of the following is true.

1. You are in such pain that you don't give a fuck (your doctor should have gave you better drugs but the DEA would kill him)
2. You really are just taking the shit to get high and are dumb and thus should die.
3. ???
4. Profit!

Time to hoard what I've got... (1)

Iphtashu Fitz (263795) | more than 5 years ago | (#28560159)

I just got a bottle of Vicodin for a root canal last week. My girlfriend has an even bigger bottle of Valium for back problems she's having. Luckily neither of us are in as much pain as was anticipated so we're not using it up very much. I guess we'll have to milk them both for as long as we can.

Thanks, but it's too late for me. (3, Informative)

Anonymous Coward | more than 5 years ago | (#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.

But for what durration? (1)

jbarr (2233) | more than 5 years ago | (#28560171)

"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.'

Maybe taking 2000 mg in a day long-term could be dangerous (you could probably extend that theory to many drugs both prescription and non-prescription) but what about for the occasional headache or body ache? You know, what most people use these drugs for? Yet another example of the government legislating something away because a small percentage of people will or could abuse it.

Therapeutic Index (3, Insightful)

Dr_Barnowl (709838) | more than 5 years ago | (#28560229)

One problem with the substance is that the doses in which it's effective are so close to the doses in which it's toxic, as mentioned.

The other problem is that you can take a fatal overdose, and you'll be fine for three days. Then you die very horribly indeed.

A lot of the time a suicide attempt is the proverbial "cry for help". Someone overdosing on acetaminophen might take their overdose and fall asleep in a tearful puddle, feel emotionally purged and a lot better in the morning. And then discover a few days later that they are the walking dead.

Most other drugs have the virtue of making you feel ill enough to seek (or attract) medical attention. Some of them you can just literally "sleep off", with enough support.

That said, it's an excellent drug. Safe, when taken as prescribed, very few side effects, and effective, as evidenced by the enormous number of combination preparations containing it - it reduces the overall dose of opiates that need to be taken and that's a good thing.

The downside of this profligate mixing with other drugs of course, is that if you're not 100% clued up on which preparations you are taking, you might take an overdose.

I'm an ex-doctor. I had no idea that Vicodin contained it until I read TFS. I've never prescribed the stuff though. If I was living in blissful ignorance every time Greg House popped a little blue pill, imagine what the general level of knowledge is amongst Joe Public.

The tinfoil-hatted part of me thinks that they only mix acetaminophen with opiates to stop junkies abusing them anyway. Who'd be stupid enough to take a fatal overdose of something that doesn't even get you high ... oh , wait, the general public, after we spent so much time and effort dumbing them down...

Incorrect/Imprecise summary (1)

93 Escort Wagon (326346) | more than 5 years ago | (#28560245)

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.

This is only a problem if that initial pain killer also contains acetaminophen. Alternating Tylenol with an NSAID (e.g. ibuprofen, aspirin) is a commonly recommended way to deal with short-term acute pain.

The basic problem, which has been known for decades, is that the level of acetaminophen required to effectively treat pain is unfortunately fairly close to the level that does harm.

Good lesson for everyone (0)

Anonymous Coward | more than 5 years ago | (#28560265)

Acetaminophen is quite toxic, and some individuals are particularly susceptible. Matters are made far worse by the fact that usually by the time toxic symptoms are recognized, it's too late to save the patient.

Over-dosing might not be good? (0)

Anonymous Coward | more than 5 years ago | (#28560305)

hold the presses - late braking news: over-dosing on a drug could cause harm? Seriously - do we need to ban everything where taking too much could result in harm?

Acetaminophen (1)

Physician (861339) | more than 5 years ago | (#28560339)

As those who prescribe narcotics already know, opioids when combined with acetaminophen are considered Schedule III where as those without (like oxycodone, oxycontin, morphine, dilaudid, etc.) are considered Schedule II. Many physicians are uncomfortable with prescribing Schedule II medications. Schedule II medications, as per the Controlled Substances Act are considered to have a higher abuse potential. Prescriptions are limited to a 30 day supply and any refill (given 1 month at a time) requires a doctor's appointment. Schedule III drugs such as Norco and Vicodin may be refilled up to five times within a six month period.

Where is this 2,000 mg number coming from? (2, Interesting)

Anonymous Coward | more than 5 years ago | (#28560351)

As a nurse, I know that the current FDA limit is no more than 6,000 mg per day for up to ten days. Where is this new number from?

Effective dose very close to the toxic dose (1)

kenevel (921288) | more than 5 years ago | (#28560365)

Paracetamol's problem (acetaminophen) is that it's effective dose is quite close to its toxic dose. I have often wondered why the tablets aren't sold with the antidote, acetylcysteine, mixed together and usually concluded it was down to the additional costs involved - which of course invites a comparison of those costs against those of treating overdose patients.

Thanks a lot (1)

DoktorSeven (628331) | more than 5 years ago | (#28560399)

As someone that is allergic and/or hypersensitive to everything except Tylenol, I guess I'm screwed if I need one of those types of drugs then, huh?

Wonder how long it will take them to ban Tylenol itself.

Thanks a lot for treating me like an idiot.

These FDA morons are going to get a letter from me. Not that it'll do any good, since modern government doesn't listen to the people anymore. Not really.

To put it another way... (1)

Alzheimers (467217) | more than 5 years ago | (#28560405)

You can also drown in just three inches of water.

OH MY GOD, BAN WATER!

TWO grams?! (1)

erroneus (253617) | more than 5 years ago | (#28560421)

Who could take two grams of acetaminophen?!? My god, that is a lot of stuff! While we're at it, let's ban water, because if you drink like 1/4 gallon or more at one time, you could die!

I think nearly any any drug is dangerous when taken in such large amounts.

cigarettes (2, Insightful)

CyBrett (697472) | more than 5 years ago | (#28560435)

Yet we still allow cigarettes to be legal even though we know for sure that they cause lung cancer.
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