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.

I was worried about prolonged use. I had notice the dosage change on bottles actually, I thought it was a new formula or something.

Since people are answering questions: with kids doses would weight by be a better guide than age? Or is to do with how old the liver etc is? There’s such a size difference between ds and nephew even though they are the same age.

Cross posted. But I don’t think saying people just need to read the label is fair. I spoke to a gp and wasn’t aware it was this dangerous.

Why isn't is fair to say read the label?

My kids don't often take painkillers so I always check the dose before giving it to them. Doesn't everyone do that? Or do you just guess?

I was sold 100 paracetamol at 16 years old, from a Lloyd’s pharmacy in 2004, so before the legal restriction came about. My raging bulmia saved my life, I was told shortly afterward.

It's essential for people to realise that there is a very real chance you will permanently damage or destroy your liver if you routinely take "minor" (say 3 or 4 instead x 500mg tabs, or taking 6-8 doses of 1g in a day). Furthermore in such cases of staggered overdose it is much more difficult to treat and prevent the damage than in one off (usually intentional) overdose.

If you do take a single, larger overdose then the timing of presentation makes a huge difference. Prognosis is much better when treatment starts within 8 hours.

If you want to die - don't choose paracetamol. Paracetamol doesn't cause sedation, it doesn't kill fast (more like you start to feel really ill about 2 days later when it is too late to rescue your liver), and liver failure isn't a good way to go - people are often very somnolent/confused and if not can be sedated at the end but the appearance of their body (bloated, yellow) and some of the ultimate mechanisms of death (eg massive haemorrhage) may be profoundly distressing to their loved ones.

If you don't die you may have to live with the serious life limiting health consequences of advanced liver disease for many years - yellow discolouration, nausea, abdominal swelling with needs to be repeatedly drained with a needle, repeated hospital admissions every time you get a simple infection or a cold, bleeding from the mouth and bowels, confusion during episodes of illness etc

Will not forget the woman we sent to King's liver unit with intiially unexplained fulminant liver failure that turned out to be taking around double the recommended allowance over the course of a few weeks for back pain. She either died or had to have had a transplant, I don't know.

Sayhellotothesun I have chronic conditions,Arthiritis,Rheumatoid Arthritis,Ulcerative Colitis and several others.

I take Dihydrocodeine,a strong anti inflammatory an immunosuppressant,buscopan and colpermin,a sleeping tablet and a couple of others.

Honestly they don't always work and I have to take 30 tablets a day,when they don't help with the pain or they're taking along time to help with the pain I use creams for the arthiritis,I have a heat pad(it's one you stick in the microwave and it has lavendar in it)my DH will help me stretch out my joints and muscles and will massage my legs and feet,if none of that works I have breathing exercises that can sometimes help,when all is lost I'll take my meds and stick on some cream and use the heating pad and go and have a nap.

JUST read the label isn’t fair to say, I said. Because people make judgment calls. And people in pain take 2 pills quickly and maybe don’t register the time exactly.
And, reiterating what pp’s have said, it’s really cheap, available in lots of places not just pharmacies so seems safe. Similar to alcohol which people underestimate the dangers of, over time or in large quantities.
Also, paracetamol comes in various forms, tablets, capsules, caplets under different brand names. My friend will not accept it’s all the same and insists the expensive stuff works better. I bet if she can’t get that she takes more of the cheap stuff to make up the difference. I’ll ask her tomorrow. That’s all marketing, designed to seem like some stuff works better than others, so just reading the label isn’t the only element in making decisions.

Taken within dosing recommendations paracetamol is one of the safest medications with no dependancy issues, no sedation, few side effects, doesn't damage the stomach lining or risk the kidneys, doesn't interact with other medications, effective for many different types of pain and for fever control. And is also off patent and incredibly cheap. Its a fantastic medicine, but overdose is not a laughing matter.

It's very clear on cold preparations such as Lemsip that they contain paracetamol.

I'm sorry, I really don't buy the excuse that when people are in pain they can't read the label. Some people can't, of course. But they are not the majority. Most people referred to and defended on this thread are choosing to ignore clear warnings.

I hope the OP was planning to alert people to the dangers of ignoring the warnings rather than bring out a load of people who agree it's not their fault if they don't read a label. Because they are in pain. Even when my life changing pain was being ignored for months by doctors I never thought of taking dangerous levels of OTC drugs. Are people so unable to tolerate a day of toothache?

I take cocodamol 4 times a day, (30/500) plus naproxen, cyclizine, gabapentin and buscopan for chronic pelvic pain and undiagnosed bladder problems. I've been on same dose for at least two years, been on regular codeine since I was 18 (now 27) for period pain.

I know I am dependant sadly, not allowed dihydrocodeine often due to this, but I didn't realise (as someone said earlier) you shouldn't have the full 4g if you're taking it long term. I'm a bit a lot concerned now, should I stop taking it ? Don't want liver failure..

I am a medical professional and completely agree with a PP that the amount of misinformation on this thread is staggering.

For posters to acknowledge that they are not medical professionals, yet still make numerous advisory posts, is breathtaking.

Please please do not speak factually about medical matters if you are not trained to do so.

Paracetamol is awful, it's often a drug people overdose on as a cry for help and then end up dying several weeks later.

On the tv programme along the lines of 'Doctor who ditched medicine' it said Calpol should not be used for a fever, but only as a pain reliever.
One poster has said the opposite

*DS 1 was rushed to hospital with a suspected paracetamol overdose. he'd gone into my bedroom and managesd to get the lid of the Calpol and drank it. ( He was about 18 months old). Luckily we lived close to the A&E unit and when we got there we were rushed into treatment where he was given something to make him sick. He was then admitted and monitored over night. It was only because we got him to treatment so quickly, less than 10 minutes from ingestion to hospital that he was fine in the end.

It's scary how easy an overdose can be*

It’s actually also very scary how uninformed even medics are on current treatment protocols for paracetamol and poisoning in general.

I know how easy it is to overdose on paracetamol after Mandy’s brother died a slow painful death in Hollyoaks about 20 years ago.

How’s your friend doing OP?

Florence, that's worried me too. I've been on cocodamol for years now for a chronic condition. I never exceed the 8 tablets a day but didn't realise that for long term you should only take 2.7mg. if that's true why haven't my doctors flagged this - they all seem very happy with the amount I take and happily presrcibe 200 tablets for a month (ish).

I'm allergic to anti inflammatories, so my options are limited. Tramadol gives me horrible headaches. I can take morphine but I don't really want to be on that long term either.

The cocodamol does help a lot with the daily pain but I do worry about long term damage. My GP told me not to worry, said it was improving things for me now and of I didn't overdose there was nothing to worry about.

there are warnings on the pack, in the package leaflet, sale is restricted to safe amounts per purchase, it on the news frequently...
at some point people have to take resposibility

It’s an exception drug in that the gap between the effective dose and a dose that can do you serious harm or kill is so narrow. And that it’s so readily available. And that it’s seen as an easy remedy for so many things.

Those things together mean that accidental overdoses are far too likely (deliberate overdoses have been reduced since the pack size restrictions came in a few years back.)

There really does need to be more awareness of things like double dosing - taking a lemsip for example then a dose of paracetamol. It is written on the lemsip pack but I think this needs a bigger warning akin to a black box one (would it qualify under that though?)

I’d like to see public health ads on TV about double dosing/amounts to take. I’m also uncomfortable with how it’s dished out as a long term painkiller - when you take it long term things like body mass and comorbidities are important.

It’d NEVER be licensed for use nowadays- research shows that a significant proportion of people dont even react to it very well and the dose gap for effective-lethal is too narrow.

What it exposes is the lack of safe effective painkillers available in the market. There are some in the pipeline based on venoms and toxins but they’re a way off....

It is a killer, my SIL seems young people coming in after a "cry for help" attempt only to see them gain consciousness and then die a few weeks later a terrible death. I am completely paranoid about painkiller poisoning.

In the US is a real problem, it kills more women than cervical cancer

www.nbcnews.com/healthmain/opiate-overdose-deaths-skyrocketed-women-cdc-finds-6C10509026

The opiate crisis in America is dreadful. Again, not enough safe painkiller options, but a lot of the opiate issues can be laid at the door of pharma marketing pressure and the way the US health system works.

Opiates are much harder to get here. And rightly so.

*is a killer, my SIL seems young people coming in after a "cry for help" attempt only to see them gain consciousness and then die a few weeks later a terrible death. I am completely paranoid about painkiller poisoning.

In the US is a real problem, it kills more women than cervical cancer*

Your link is to opioid deaths. Yes also a painkiller, but a completely different beast to paracetamol. It is much more accessible in the us than in the uk.

Bloody hell, I can't believe how many of you have admitted to being so casual about exceeding safe doses. My parents are both doctors and I had it drummed into me from childhood that paracetamol is safe in the recommended dosage, but very, very dangerous in OD. Medics really haaaaaate seeing teenagers who have taken impulsive paracetamol ODs, because they come into hospital sitting up and chatting at a point at which it is already too late to save their livers and everyone but them knows a painful, drawn-out death lies ahead.

Btw: when a DC is sick I create a WhatsApp group called "DC medicine log" and add anyone who might conceivably be administering meds. Everyone then send a msg every time they give a dose with "Calpol 5ml" or whatever, which also gives it a time stamp.

I once told my doctor I was worried about how often I had to take paracetamol for my headaches (always sticking to the correct dose) and he told me that paracetamol is such a safe drug that I could take it every day for the rest of my life with no ill effects.

he told me that paracetamol is such a safe drug that I could take it every day for the rest of my life with no ill effects.

As far as I understand it, that's true, as long as you rigorously stay under the safe dose.

For severe pain like toothache it is better to alternate doses of ibuprofen & paracetamol as they are different drugs that work in different ways.

Yep, that's the way to do it if one or the other doesn't numb the pain - take something different with different active ingredients rather than exceed the recommended dosage.