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.

Just curious Slutty, why don’t you want to use opiates based pain relief?

Errr hear what you’re saying about paracetamol - but please don’t start popping ibuprofen like it’s the answer. Studies have shown that NSAIDS (ibuprofen falling into this category) can significantly increase the risk of having a heart attack or stroke.

walking I already take opiate based ones. My Gp gives me a generous monthly amount of codeine, 30 mg and enough for four doses of 60mg a day.
I'm very aware because I'm 50, some nhs trusts are reluctant to do joint replacements. Both my knees need doing so I'm trying to hold off on morphine until I really need it, and I know before long I will need it. Trust me I will ask for it. In the meantime I might speak to my Gp about dihydrocoedine to be used in place of some doses of codeine.

I do take biologic drugs that suppress the immune system further to the dmards I take. It's all a balancing act here.

There is controversy about quite how effective a painkiller it is - probably rubbish for chronic pain (but so are opiate, and they are even more dangerous, in different ways)

I've been on long term opioid therapy for 17 years, under the care of a pain consultant. He said many years ago when we reached the end of the road with exploring different pain meds and interventional pain procedures, and I was panicking about the effects of being on opioids long term, that he would be much more concerned about the long term effects of daily paracetamol or NSAIDs over a number of years on my liver or stomach, than opioids

Opioids give me the ability to function - when I was off all my meds during my (unsuccessful) pregnancies, I couldn't work, slept about 2h a night, I was curled up in pain, in utter misery. With my opioid regime I can work full time, go to the gym, do lots of activities - lead a normal life.

We'd exhausted every other avenue for analgesia - I don't have nerve pain (so gabapentin, pregabalin, amitrypitline and oxcarbazepine and topical lidocaine patches were ineffective) nor inflammation (so ibuprofen, naproxen and diclofenac didn't provide any relief, but left me with gastric issues, and Cox-2s Bexxtra and Vioxx were withdrawn from the market).

I have a full toolbox of pain management strategies, but the fact is that my nociceptive pain responds very well to a well managed opioid regime. Of course I've developed tolerance over the years, but by rotating the drugs used that helps. Unlike in the US I can be prescribed pure opioids without the paracetamol: my oxycodone MR as baseline may be available in the US as Oxycontin, but the oxycodone IR I take over here (as OxyNorm) isn't available in the US, only as percocet or percodan. The variable bio availability of dihydrocodeine and oral morphine mean the need for much higher doses to get the same analgesic effect as tramadol and oxycodone. My tolerance with fentanyl patches spiked incredibly quickly, so oral meds are better for taking less when I can (not so easy with transdermal)

Opioids when used judiciously and under careful supervision by a pain specialist, can be effective for chronic pain where appropriate, and as part of a multi pronged holistic approach to overall pain management in some patients

Can't believe some people are saying children's painkillers should be unpalatable - DS had to take paracetamol and ibuprofen for a couple of days after having stitches under general anaesthetic, he refused to take the children's Nurofen because he didn't like the taste and no amount of persuasion or bribery worked despite him being clearly in pain. Make it deliberately unpalatable and what do you do when your child needs it but won't take it?

He also tends to have an impressively high temperature when ill, again, make the paracetamol unpalatable, what do you do when the child won't take it?

(As an aside, when I was young there were two different strengths of Calpol, the prior one which was lovely and an (allegedly) orange flavoured one for older children. I had to have the baby one until I was old enough to take tablets as the orange one made me instantly sick.)

You don’t accidentally take an overdose of paracetamol.

Of course people do Ruby. Have you not read the thread ? It's going round in circles a bit now, but people have explained over and over various circumstances where people do.

As for your statement People need to take personal responsibility. are you really not aware that in so many cases we are talking about people who are taking pain killers are just not in a state where they can be thinking straight ? You can't be that naive surely. There are many people in the world / country / your local town / wherever you want to think about who are vulnerable, people who struggle with life a bit at the best of times, once you mix in some agonising pain, people aren't going to start being methodical and logical.

Paracetamol is an effective pain killer - I have been given it by drip in an ambulance when in pain.

Paracetamol is a killer - and worse still it kills slowly and horribly. I have seen a young man die after coming round from an OD, being glad he was alive, only to die slowly over the next few days.

Please be careful with it - and make sure that calpol is given precisely according to the instructions.

I take paracetamol for chronic pain but confine it to one dose in the morning and one at night.

One thing I will not have in the house is calprofen. The name is too similar to calpol, and with a dyslexic husband I don't want mix ups! Even the generics are referred to as calpol and nurofen when we are dosing the children.

I have seen a young man die after coming round from an OD, being glad he was alive, only to die slowly over the next few days.

That's horrible.

I once engaged in similarly risky behaviour.

But luckily didn't have any paracetamol available... (It had simply never worked for me.)

I have always followed the dosing guidelines and if course know about overdosing on paracetamol. What I didn't know was how little extra can cause problems and if what nature. There is a sense of it being an every day harmless drug. interesting thread. Thank you.

Very worrying how many posters are saying they didn't know of the dangers even WITH the restriction on sales and clear instructions on packets.

Personally I think paracetamol either singularly or in combo should be a Pom. AND TRACKED why poms aren't recorded in a way that the patient can't pharmacy hop I don't know! The attitude toward calpol as a panacea even being used by some parents for placebo effect terrifies me! I'm amazed there's not been an infant od epidemic! Too many either don't read packaging/info leaflets or dismiss the info as "arse covering" which some cautionary info is.

I also think codeine should be prescription only. Huge unacknowledged addiction issue in this country and its far too easy for addicts to pharmacy hop!

I've just done myself an injury (done similar before - stupid!) I'm allergic to NSAIDs, codeine, was taking tramadol when the pain very bad but I'm on new meds for something else which contraindicates the tramadol, and lots of other analgesics too so fuck knows where that leaves me!

I wonder if the pharmacists/pharmacology experts on thread agree with me that part of the problem is our obsession in the uk with oral meds. So many meds work better/are less dangerous if administered as pessary, suppository, via injection or skin absorption. Partially prudishness in the case of pessary/suppositories, squeamishness with injections and disbelief in efficacy of topical applications.

Littlebillie - more misinformation - that article you linked relates to opioid deaths. Paracetamol is not an opioid.

"Because like many people I seldom take aspirin, I was surprised that the age limit for taking it was 16. I suppose stomach bleeds in a small person are more significant." No it's because it relates to Reye's syndrome primarily. I suspect also because of triggering asthma, for several reasons it can be difficult to manage/control asthma in kids.

Also ibuprofen shouldn't be given to chickenpox sufferers as it can trigger necrotising fasciitis plus other problems.

Lemsip is a load of crap anyway! I'm sure the steam is what gives the most decongestant effect! And the paracetamol you can take separately if necessary (but bear in mind a fever - which is the main reason people take paracetamol for a cold - is the body naturally defending itself by creating an inhospitable environment for the virus so actually you're better tolerating the fever if you can or controlling it with natural methods if not.) all the claims of lemsip are easily achieved naturally by use of steam inhalations, natural fever management methods and homemade hot lemon and honey drinks (to which for adults a wee tot of rum or whiskey can also be beneficial 😉).

"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, and the only reason it's not recommended as health advice is that a small number of people end up with a gastric bleed." Low dose aspirin could also prevent a significant number of mc. Treatment for APLS and can prevent pre-eclampsia that is unlikely to cause harm to non-sufferers unless other medical history contraindicates (as in my case).

Regarding the MANY cries of "just read the label" - don't forget the literal 'can't read' factor - users with visual disturbance, sight impairment (the size of the writing is RIDICULOUSLY small I have slight short sightedness and I struggle), illiterate, non-English speakers - not everyone CAN read.

Also the assumption people have the cognitive skills to understand the info. Or that they're not also experiencing a cognitive impairment eg short term memory issues.

"what do you do when your child needs it but won't take it?" Personally I don't take no for an answer! There are methods to get children to take medicine. But again - why the fixation on oral administration?

Can you buy paracetamol pessaries in the UK?

I've thought about using these for DD. I also wonder whether we should be following the example of our European neighbours and be taking young children's temperatures rectally. Isn't it far more reliable (and quicker) than trying to keep a thermometer under the armpit of a wriggly irritated toddler?

Pom is prescription only P is pharmacy only.

I work behind the counter and every box I sell I have to point out the maximum dose and the fact that you cannot take it with co-codamol or cold remedies that contain paracetamol.

And maybe 4 or 5 times out of 10 people say - "oh, so I can't take it with Lemsip?" or "it's only paracetamol" or "I'll take as much as I bloody like"

For us mere mortals, what's POM?

Oops I said Pom when I meant pharm only

POM is prescription only medicine

My gran OD'd accidentally (dementia) no long term damage thank god but I caught on at lunchtime when I checked the packet and noticed them missing or it could have been worse.

I work in care, everything prescribed is monitored, given out, signed off apart from off the shelf stuff.

I think it's going to get worse as there is new restrictions on it being prescribed due to costs.

The amount of vulnerable people who need help managing medication hoarding huge amounts is ridiculous.

Paracetamol including calpol is locked up our house, I consider it just as dangerous as any prescription only medication.

POM is Prescription Only Medication. You can only get it from a pharmacy with a script from your gp/nurse practitioner/other healthcare professional.

P is Pharmacy only - you don't need a prescription but you can only buy it from the pharmacy.

OTC is Over The Counter - like with paracetamol or cetirizine, you can pick up a box off the shelf and pay for it with the self scan machines or general checkout counters.

Personally I think anything containing paracetamol should only be available from the pharmacy counter.

Personally I don't take no for an answer! There are methods to get children to take medicine.

Interesting. What do you do? Hold them down and force their mouth open, then hold it closed until they swallow? I have to do that to my cat, I really don't want to do it to my child. And what do you do if if the taste makes your child vomit - should my DM have just continued to force the orange flavoured Calpol into me?

But again - why the fixation on oral administration?

As far as I know that's the only way to buy it.

mirime with my eldest yes I’ve made him have antibiotics that way. He had pneumonia and needed them. My daughter was a vomiter and we had to resort to suppositories .

You can buy suppositories of paracetamol but they are crazily expensive.

JumpJockey I saw that Casualty episode and I've been super-careful with paracetomol ever since! I've forgotten nearly everything about Casualty but that episode really stayed with me.

Glad to see your friend is doing OK Harshing.

When BBC1 broadcast the episode of Casualty in 1999 that featured someone dying horribly from a paracetamol overdose, 20% of the people who turned up in A&E over the following week having taken overdoses and having seen the programme said the programme had influenced their decision (www.theguardian.com/uk/1999/apr/09/timradford). In other words, showing someone dying horribly - but dramatically - from a paracetamol overdose makes people more likely to take paracetamol overdoses. People are strange. However, the study did also find that people were twice as likely to know that paracetamol is dangerous if they had seen the programme, even 7 months after it was broadcast.

Different date and storyline Skiiltan but interesting results. Who would have thought it?

Because like many people I seldom take aspirin, I was surprised that the age limit for taking it was 16. I suppose stomach bleeds in a small person are more significant.

It has nothing to do with that, it is because of Reye's syndrome. No one knows that exact cause but 90% of children with it had taken aspirin. Stopping giving aspirin to children has reduced it by 90% in the UK.

INeedNewShoes

Get a digital thermometer that takes the temperature from the ear or forehead.