What to know when mixing prescription medication with over-the-counter drugs
By Fred Cicetti
Q: What is acetaminophen and why do I see it listed on so many products in my medicine cabinet?
A: Acetaminophen is the most widely used pain-reliever and fever-reducer in the world. It is contained in more than 100 products. Tylenol is the best-known over-the-counter (OTC) acetaminophen product. The drug is also a component of well-known prescription drugs such as Darvocet and Percocet. Acetaminophen also is known as paracetamol and N-acetyl-p-aminophenol (APAP).
Acetaminophen is available without a prescription. Follow the directions on the package label carefully. If your doctor prescribes it for you, the prescription label will tell you how often to take it.
Taking too much acetaminophen can lead to liver damage. The risk for liver damage may be increased if you drink three or more alcoholic drinks while using medicines that contain acetaminophen.
The maximum daily dose of acetaminophen is 4 grams in adults. The toxic dose of acetaminophen after a single acute ingestion is about 7 grams in adults. The at-risk dose may be lower in some susceptible populations, such as alcohol abusers. When dosing recommendations are followed, the risk of liver toxicity is extremely small.
Acetaminophen is one of the most common pharmaceutical agents involved in overdose, as reported to the American Association of Poison Control Centers.
One of the problems with acetaminophen is its widespread use. You have to check your medicine cabinet to see what products contain acetaminophen. Then, if you’re taking more than one medication, be sure you don’t exceed the maximum daily dose.
Adults should not take acetaminophen for pain for more than 10 days without talking to a doctor. Acetaminophen should not be taken for high fever, for a fever lasting more than three days or for a recurrent fever without a doctor’s supervision.
There are basically two types of over-the-counter pain relievers. Some contain acetaminophen and others contain non-
steroidal anti-inflammatory drugs, often called NSAIDs. Examples of over-the-counter types of these drugs are aspirin, ibuprofen (Advil), naproxen sodium (Aleve) and ketoprofen (Orudis).
NSAIDs are associated with stomach distress. You should talk to your doctor before using NSAIDS if you are older than 60, taking prescription blood thinners or if you have stomach ulcers or other bleeding problems.
NSAIDs can also cause reversible damage to the kidneys. The risk of kidney damage may increase in people who are older than 60, have high blood pressure, heart disease or pre-existing kidney disease, and people who are taking a diuretic.
You should talk with your healthcare professional if you have questions about using an over-the-counter medicine before using it in combination with other medicines—either other over-the-counter drugs or prescription medicine. Combining these two types of medicines can lead to problematic drug interactions.
All older adults should consult their doctors before taking any over-the-counter medication or herbal supplement.
Often, older adults use many drugs at the same time, including prescription and over-the-counter drugs. They also process drugs differently than younger adults. This is why older adults need to be especially careful about drug-drug interactions.
If you’re a senior, talk with your doctor about all of the drugs and herbal health products you take. He or she can tell you whether you are at risk for having a bad reaction from taking an over-the-counter drug.
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All Rights Reserved © 2010 by Fred Cicetti