To not realise just how dangerous paracetamol is?

[HarshingMyMellow]

My friend is currently in hospital after taking an accidental overdose of paracetamol.

I say 'accidental', she was taking more than she should because she had a killer toothache but not huge amounts.
I think she took around 8 doses in a day instead of 4 and the repercussions aren't pretty.

I didn't realise a basic, widely available drug was so toxic.

Hi Xanadu -

Is there a reason why you need the liquid? In general I'd say don't buy Piriton® because you're paying for the brand name: generic chlorphenamine syrup costs £3.79 for 150 mL at Boots while the same amount of Piriton® costs £4.99 for exactly the same drug. That's not a huge difference, though, and you may have children who prefer the taste of Piriton®.

To answer your question, if you're using the medicine yourself you have to watch out for drowsiness. One of the reasons first-generation antihistamines are popular with parents of young children is that they help the child to sleep. Be aware, also, that there is a significant interaction between antihistamines and alcohol, so you risk becoming very sleepy and uncoordinated if you take them together. Like the decongestants mentioned in my previous message (phenylephrine, pseudoephedrine) they're best avoided in men with benign prostatic hyperplasia or anyone suffering from urinary retention for any reason. They should also be avoided in patients with epilepsy, obstruction of the opening of the stomach into the small intestine or a history of angle-closure glaucoma. Otherwise chlorphenamine is generally safe. There is a list of side-effects - as there is for absolutely all drugs of any kind - but they are mostly quite rare.

Adults would usually use non-sedating antihistamines like cetirizine or loratadine. These are available in liquid form but I think you'd have to go to a pharmacy to get them. The tablets are dirt-cheap at supermarkets. There is still the risk of interaction with alcohol, though.

I assumed it to be safe because it has a picture of a baby on the front

Sorry if I’m wrong, but is this sarcasm?

I think it was just honesty. That's how we all think on some level, and the companies know it. Packaging is researched and very carefully designed.

I just don’t believe it that a grown woman would take a cute photo on a bottle of medicine to mean it’s safe to consume in whatever quantities (with alcohol too!). It’s drugs not fruit shoots. I think she was trying to make a point about how ridiculous it sounds.

critique
I once spoke to a very well-respected cardiologist who said that an aspirin a day has huge health benefits in terms of both cancer, stroke and heart health for middle aged people
Indeed aspirin has been around for many years and I currently take a 75mg aspirin for angina - thins the blood.
That said I still (if needed) take painkillers containing aspirin rather than paracetamol. No problems with gastric bleeding - so I consider myself fortunate.

You don’t accidentally take an overdose of paracetamol. The instructions on the label are very clear, it shouldn’t need spelling out to grown adults that taking more than the box says is safe likely isn’t. They do’t put these labels on for the hell of it.

All this talk of how paracetamol needs to be banned etc are ridiculous. People need to take personal responsibility. If the instructions are there and you don’t read them then it’s not the manufacturer’s fault if you overdose.

I know someone who deliberately overdosed on paracetamol and she died a very slow agonising death. It’s not to be recommended.

@critique - Bear in mind that you take a low dose of aspirin (75 mg a day) because this selectively inhibits platelet aggregation and reduces the risk of thrombosis. At higher doses you start to also inhibit the production of a natural vasodilator and anti-platelet agent called prostacyclin, so you might be slightly undermining the protective effect of the low-dose aspirin. It's worth talking to a pharmacist about what you should take to relieve pain.

Paracetamol does nothing for me, pain wise. Never has done even when I was a kid who believed in magic medicine so the placebo effect should have done something at least! I've had it IV and it did nothing for my pain.

I'm also allergic to nsaids including ibuprofen. Almost died due to anaphylaxis last time. So they're out.

Which AFAIK leaves opiates/opoids. I have suffered with PGP and back problems for 13 years now. GPs are very twitchy about long term prescribing of these, and rightly so. I take codeine if in absolute agony only and it works like a miracle. Really sucks the rest of the time!

I'm surprised how many people don't know that paracetamol is so lethal tbh. I've known that since I was a kid - was told by my mother never to help myself as it was so toxic in slightly higher doses.

Have people stopped using clove oil for toothache?

I had to alternate painkillers of various kinds last year and you have to be so careful. My rule now is to write down when I take them and be that regimented about keeping to schedule if I need to take them more than once. Not sure why painkillers are not treated as serious medicines rather than sweets

Have people stopped using clove oil for toothache?

You're making me think of Dustin Hoffman & Laurence Olivier in Marathon Man. I'm going to have nightmares now.

I think it's only effective for pain originating in the tooth, rather than in the root, and the relief is quite short-lived.

"You don’t accidentally take an overdose of paracetamol. The instructions on the label are very clear, it shouldn’t need spelling out to grown adults that taking more than the box says is safe likely isn’t. They do’t put these labels on for the hell of it."

Just look at how many people here have said they often have "just one or two over the limit because the pain was bad". Then add in the people who don't scrutinise every label and realise that things like Lemsip ALSO have paracetamol in, or who take Paracetamol to the max dose for their headache but then also have cold&flu tablets without realising that they have it in as well.

If you've ever had a migraine then you'll know that focusing enough to read teeny tiny writing is almost impossible.

Yes opiates are essential, but need to be controlled.

I have to take opiates most days, as well as paracetamol, NSAIDs and amitriptyline, all for pain. Without the opiates I wouldn't have my career.

For those who are taking high doses of paracetamol for migraines, if you truly have a migraine (not just a bad headache) then please see your GP. In the last 15 years or so there have been lots of new drugs in the triptan group, which can stop a migraine in its tracks. If I take sumatriptan early enough in the migraine, I can often carry on working. Some of the side effects aren't pleasant, and sometimes the migraine comes back, but compared to the old days of 3 day in a dark room vomiting, it's bliss.

If the triptans don't work then there are preventative meds, or NICE has even recommended riboflavin (a vitamin you can buy on the high street) which medical trials have shown works well as a preventative.

www.nice.org.uk/guidance/cg150/chapter/Recommendations#management-2

Of course they should be controlled, I don’t even think that’s a ‘but’ point. Just an and. They’re essential and need to be controlled/monitored.

I wouldn’t have my career, and certainly my relationship.

sumatriptan is amazing for migraine. I’ve not had a single side effect from it!

If you've ever had a migraine then you'll know that focusing enough to read teeny tiny writing is almost impossible.

To be fair, when you have a migraine you’re even more likely to be reading the writing (it’s normal sized to my recollection?) as you’re desperate to find something with ingredients in that will work.

And most people with more than a couple migraines will have figured out pretty quickly a plan for the next time seeing as it’s so awful, you need to be prepared.

I agree, nobody unknowingly takes too much paracetamol: the packets of lemsip state even on the very front that they contain paracetamol! The normal dosage is well known (two tablets no more than every four hours). People may choose to break that if they’re okay with the risk but it’s certainly not accidental.

Sorry to hear about your friend, OP.

There have been a number of threads about this. I was incredulous that people didn’t know how dangerous paracetamol over use could be , until I found my (lawyer) husband had no clue (or care) that it was a main ingredient of Lemsip that he was copiously glugging for a bad cold.

He’s a giant so no real damage, but I was absolutely dumbfounded that an otherwise intelligent adult did not realise what the BOLD letters on the packet actually meant..

When people are talking about personal responsibility and "Just read the label", are they just assuming that everyone is as literate and intelligent as themselves?

Labels are great if you can read and understand them. There are plenty of adults living independently who can't.

Idk... I tend to stick with the recommended dosages quite religiously.

I take stimulant medication and ibuprofen when on my period...

One may not know how dangerous something is... But one should know to not take twice the recommended daily dosage... Especially without knowing anything about the medication one is taking / without doing research....

YANBU to not know how dangerous this specifically is.

Taking 8 instead of 4? Incredibly unreasonable.

WishITookLifeSeriously

You clearly need better pain management if this is the case

Please see GP to address

A friend's sister died from taking two forms of paracetamol when she had a cold. It happened so fast. ☹️ I'm always surprised that they sell massive bottles of the stuff in the US it makes so much more sense to sell it in little boxes like they do here.

I was serious about the picture of the baby. I assume that it if it is safe for babies and very young children, it must be generally safe. I don't mean exceeding doses. I sometimes take Piriton liquid to help me sleep and a friend of mine uses Night Nurse for the same purpose.

I hardly ever use painkillers though. If I ever do, one is usually enough .

I've tried an experiment today a very stupid one

I have inflammatory and osteo arthritis, I have long since accepted I'm always going to be in a degree of pain. I've already had surgery and am looking at joint replacements. I don't want to go to morphine based meds until I'm literally on my knees.

So today I haven't taken any paracetamol, ibuprofen or 30mg codeine to see what happens. I can now hardly walk so in a mo I'm going to be chugging my pain killers and going straight back to full doses.

People really don't know, I think most folk assume its safe as its on general sale everywhere for pennies.
I used to work in a ward where we got a lot of overdoses/poisonings. One night I clerked a young woman with abdo pain and she blithely told me "You can never have too much paracetamol", every other patient in the room was on a paracetamol antidote drip