To think paracetamol overdose is just too easy sometimes

[Soubriquet]

Asked Dh to pick me up some decongestants today as I have a terrible head cold

He gave me some paracetamol before he went out in the mean time

He brought home some sudafed and luckily handed me the box instead of the pills themselves with a drink

Just as I was about to open the box, I quickly spotted one of the added ingredients was paracetamol which meant I couldn't take the pills until now which is 4 hours after my initial dose of paracetamol

Dh didn't notice it at all

Now I know common sense would say to read the box carefully to make sure you know exactly what was in it but hands up honestly who does that? I do because I'm paranoid but I know many who don't.

So AIBU to think that paracetamol overdose is too easy sometimes with it being added to a lot of medications

It's very easy to double dose but you'd really have to be chugging it back to take enough to do yourself serious harm.

Sadly that's not true. Liver damage can occur at doses as low as 75mg per kg of body weight, although it's more common at doses of 150mg per kg of body weight. Those doses could be taken over a period of 24 hours and still result in liver damage.

As an example, a person weighing 50kg (just under 8 stone so slim but not unusual) could sustain liver damage from taking 7500mg (15 tablets) in a 24 hour period. If that person had other risk factors then a smaller dose could also cause liver damage.

The normal maximum dose of paracetamol is 1000mg (2 tablets) every 4-6 hours. It would only take someone accidentally taking two paracetamol containing products at that dose to be at enough risk of liver damage to require evaluation in hospital.

It's so important that people don't underestimate the risks of a paracetamol overdose. Just because it's easily available doesn't mean it can't cause serious harm.

coco - It's amazing isn't it - some of those drugs knock you sideways. Worst thing is, that you can think you are 'with it' and not be at all. I once insisted to DH that I needed to go to the local shop, because I was high on post-op codeine and still had anaesthetic in my system. I got half way down the road and he had to carry me back! Illness and drugs do strange things to your judgement.

Persian - totally agree.

I try to avoid buying stuff which combines drugs, so sudafed with paracetamol, paracetamol with caffeine, etc etc. Then it's easier to choose what you want to mix and match, so to speak, and harder to overdose by accident.

Fortunately my friend who regularly chomps her way through a few packets with a litre of vodka is fairly robust. She gets a few nights in while they flush her out, but so far her liver is ticketyboo. The paramedics are never too concerned. Just roll their eyes as we pick up the packets and point out that if she really wants to kill herself, she might want to try something else. Presumably that's why paracetamol is her go-to.

I'm a bit confused your DH bought actual sudofed? I buy those now and again and they just contain pseudoephidrine no paracetamol (in fact I've just checked a box I have upstairs).

I think a lot of cold medicines do contain decongestants and paracetamol though.

Persian, the way to tell whether you've got a cold or flu is to get a blood test done and see whether it's rhinovirus or influenza. Anything else is guess work. If you're hallucinating in ICU it's probably flu, but there are loads of people struggling on with their everyday life, (feeling dreadful but still getting on with it) with mild flu. Flu can be deadly serious yes, but that doesn't mean that if it isn't deadly serious it isn't flu.

Agree with pp - when I was on codeine for pneumonia I had to get DH to dose me up because I was too poorly to know what day it was, let alone what medicine I'd taken.

One of the useful bars to deliberate paracetamol overdose is that they taste disgusting so you'd struggle to swallow enough.

When I was triaged at A&E for an emergency recently I told them I had taken 16+ paracetamol over about 12 hours, they told me it was considered an overdose by the NHS. The immediately took me to majors, took blood and put me on a drip.

I shouldn't have taken that amount but I had run out of oramorph and found my self in horrific pain. Nothing happened with the paracetamol and it wasn't mentioned again once I made it to a ward but I "appear" as a healthy adult but a relatively small amount was treated very seriously.

Apparently even a small amount of the recommended amount can do serious damage.

What KnitsBakesAndReads says - even if an overdose isn't fatal it can be very serious.

Also, paracetamol is fatally toxic to cats even in very small doses. It's not some gentle placebo.

And wipe up Calpol when you spill it.

It is true both that most people will be absolutely fine with a serious paracetomol overdose and that some people will suffer lethal or life changing consequences from a minor overdose. The thing is that you just can't tell in advance which group you personally fall into. You can guess from height and weight and previous liver abuse, but you can't know for certain so you really do have to act paranoid.

I'm on long-term medication to manage pain and my GP Practice keeps an eye on the combination I'm taking due to the build up effect of paracetamol
This is interesting because I am concerned about this issue too.

I broke a vertebrae in my back 7 years ago and although at first it got better it is now starting to get more and more painful, probably due to arthritis at the site of the old injury.

I take 8 co-codamol tablets a day (30mg/500mg) and they are not as effective as they used to be but what concerns me the most is not the codeine in them but the paracetamol in them.

Somewhere up thread a PP said that 4g of paracetamol was considered dangerous and this is what concerns me because I take that everyday.

The GP seems super reluctant to prescribe anything stronger or without paracetamol as I think that their logic is that due to the paracetamol content people are less inclined to take more than the recommended dose.

However TBH I would much rather just take the codeine and not this amount of paracetamol every day.

there are loads of people struggling on with their everyday life, (feeling dreadful but still getting on with it) with mild flu
Sorry to disagree but if you are well enough to "struggle on with everyday life" then it probably is not flu.

I would generally assume that most flu remedies contain paracetamol so yabu.

Might be flu, might not be. During the swine flu epidemic when people were actually getting tested a fair few of them came back positive after being "a bit under the weather".

Yes most people who are feeling poorly and sniffly but basically able to cope "probably" have a cold rather than flu, but that's not the same as saying "if you'd get up to pick up a fifty pound note off the doorstep then it's not flu".

One (totally in-scientific) test I heard of once for telling the difference between a cold and the flu is that if there was a £20 note in the middle of your garden, a person with cold would go and pick it up and a person with flu would be so ill that they would leave it there.

Unfortunately this must isn't true. Not everyone who has the flu will be really ill with it.

I wonder just how many are lethal... I personally don't think it's as dangerous as made out

A few years ago when I was a bit younger I read on the internet that a slight overdose would kill you, never use paracetamol as a cry for help as once you swallow and it dissolves there is nothing you can do so I went and bought I think it was two 30 boxes and ate most or all of them. I got drowsy, fell asleep, woke up throwing up and then again in a car. I was then pretty out of it in hospital for a while. It does FEEL horrible but lethal?

I'd just trust what they tell me, chances are nothing will happen but why take the risk. :)

Oops didn't see we were now talking about flu lol

This is one of the reasons why they discontinued sudafed for under 6s.

I think you need to take a lot of paracetamol to overdose TBH. But I do remember when I was about 14 or 15 I was feeling ill at my dad's house, took a lemsip and was going to go to bed a couple of hours later, he insisted I took another one. I reasoned that it hadn't yet been four hours. "It's only like taking a max strength one!" he reckoned. Well they were both max strength, so it turned out it wasn't, I threw up all night and felt horrible! Haven't been able to stomach lemsip since.

Growing up we were given paracetamol for the slightest thing, and not surprisingly, my mother has liver damage. So yes, regular doses within the limits can cause damage if taken regularly enough.

Personally, I don't find paracetamol touches the majority of pain. It helps reduce a fever but not pain. My GP annoyed me recently by encouraging me to take it for a pregnancy related pain, despite me saying repeatedly it hadn't touched the pain. Instead on relying on hot water bottles that are much more effective.

That's why they put the info on box and leaflet and you should check it. My DM has double strength ibuprofen (400mg instead of 200?) she handed me them once and I took my usual two so accidentally had a double dose. I always check what I'm taking now and it was lesson learned through my own stupidity. I texted a GP friend in a panic when I realised!

I honestly though do was sensible enough to check the boxes - apparently I was wrong.

Bugger - that was meant to say I thought dh was sensible enough - must proof read before posting.

Although the majority of paracetamol ods that attend a&e don't reach a blood-level that needs treatment a significant number do. Of those treated the majority survive with no long term problems. However given variation in body weight, how tablets are taken (staggered or not) and the general health of individuals it is not a drug to be messed with. I've seen many people die in the years since I qualified but by far the most distressing was watching the slow painful death of a man who accidentally overdosed on paracetamol.

I work in a hospital lab and I've only ever seen one paracetamol overdose. I've seen overdoses for other drugs and alcohol more though. It's not very common to be affected by taking a high dose of paracetamol unless you have a weak liver or kidneys, or you are a child.

I thought sudafed was banned here? Or is that just America?