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Over the Counter Pain Medications – dangerous effects on more then the liver

by Tammera J. Karr, PhD

Open a medicine cabinet, first aid kit or a car glove box, and likely acetaminophen (brand name Tylenol ™), a pain reliever and fever reducer, will be there. It might be a store brand in a pill, gelcap, or liquid. Acetaminophen is found in a startling number of over-the-counter (OTC) products in the form of cold remedy, allergy medicine, anti-inflammatory, or prescription medication. The troubling part is experts are not quite sure how the drug works.

Researchers have guessed at how and why acetaminophen’s works for decades. Roughly it involves chemical messengers of inflammation and pain, and aspects of neurotransmission in the brain and spinal cord. As time moves on hopefully, we will learn more about how this drug works and on how many systems.  Each week about 23 percent of American adults (about 52 million people) use a medicine containing acetaminophen (Consumer Healthcare Products Association, a trade group). Acetaminophen has been used clinically for many decades, with more than 27 billion doses sold in 2009 alone. However, the drug’s established danger to the liver makes understanding its mechanism more than a minor detail. A recent study showed that people who took Tylenol® had increased risks of death, heart toxicity, gastrointestinal bleeding, and kidney damage. Importantly, individuals who received higher doses of Tylenol® suffered more damage to their liver, digestive tract, and other organs.

Common Over-the-Counter Brand Name Medicines Containing Acetaminophen

  • Actifed®
  • Alka-Seltzer Plus LiquidGels®
  • Anacin®
  • Benadryl®
  • Cepacol®
  • Contac®
  • Coricidin®
  • Dayquil®
  • Dimetapp®
  • Dristan®
  • Excedrin®
  • Feverall®
  • Formula 44®
  • Goody’s®
  • Powders Liquiprin®
  • Midol®
  • Nyquil®
  • Panadol®
  • Robitussin®
  • Saint Joseph®
  • Aspirin-Free Singlet®
  • Sinutab®
  • Sudafed®
  • Theraflu®
  • Triaminic®
  • TYLENOL® Brand Products
  • Vanquish®
  • Vicks®
  • Zicam®
  • *And store brands

Common Prescription Medicines Containing Acetaminophen

  • Endocet®
  • Fioricet®
  • Hycotab
  • Hydrocet®
  • Hydrocodone Bitartrate
  • Lortab®
  • Percocet®
  • Phenaphen®
  • Sedapap®
  • Tapanol®
  • Tylenol® with Codeine
  • Tylox®
  • Ultracet®
  • Vicodin®
  • Zydone®
  • *And generic medicines

 

A study published in May of 2011 voiced the concern over consumers lack of knowledge about the dangers of acetaminophen.  “Lack of knowledge about popular pain relievers plus unawareness of acetaminophen’s presence in more than 600 over-the-counter and prescription medicines could be a key reason acetaminophen overdose has become the leading cause of acute liver failure in the U.S.” said the study.  The solution proposed by the researchers is to develop a universal icon for acetaminophen that would appear on all medicine labels.

“It is incredibly alarming,” said Michael Wolf, an associate professor of medicine at Northwestern University Feinberg School of Medicine and senior author of the study published in the American Journal of Preventive Medicine. “People may unintentionally misuse these medicines to a point where they cause severe liver damage,” Wolf said. “It is easy to exceed the safe limit if people do not realize how much acetaminophen they are taking. Unlike prescription products, there is no gatekeeper, no one monitoring how it is taken.”

As with all drugs, nutrients are depleted, in the case of acetaminophen, the nutrients most affected are also central to reproduction, digestive and brain health: glutathione, phosphoadenosine, and N-acetylcysteine.

Researchers at The Ohio State University published findings in May of 2016, when individuals take acetaminophen to reduce pain, and may also be decreasing empathy for both the physical and social aches that other people experience. However, that is not all; the cognitive function has been found to decline also. Researchers from Indiana University School of Medicine, the Regenstrief Institute, and Wishard Health Services conducted a six-year observational study, evaluating 1,652 Americans over the age of 70 who had a normal cognitive function.

In addition to monitoring cognition, the investigators tracked all over-the-counter and prescription medications taken by study participants. Drugs regularly used for a variety of common medical conditions including insomnia, allergies, or incontinence negatively affects the brain causing long term cognitive impairment in older individuals.

Drugs termed anticholinergics, block acetylcholine, a nervous system neurotransmitter. Anticholinergics are Benadryl®, Dramamine®, Excedrin PM®, Nytol®, Sominex®, Tylenol PM®, and Unisom®. Other anticholinergic drugs, such as Paxil®, Detrol®, Demerol® and Elavil® are available only by prescription. Older adults most commonly use drugs with anticholinergic effects as sleep aids and to relieve bladder leakage problems.

“We found that taking one anticholinergic significantly increased an individual’s risk of developing mild cognitive impairment and taking two of these drugs doubled this risk,” said Noll Campbell, PharmD, first author of the study. Dr. Campbell is a clinical pharmacist with Wishard Health Services.

What else does acetaminophen affect? Fertility, research is also showing acetaminophen blocks progesterone production. Progesterone is the hormone that allows a mother to conceive and carry to term.

So before you grab for that bottle out of the medicine cabinet consider other options – stress reduction, clean up your diet, changing office furniture, change room lighting to halogen or incandescent, limit use of Wi-Fi and go hard wired internet, don’t carry cell phones in pockets or close to the body, use herbs Curcumin, Ginger, white willow bark, celery seed and my favorite Boswellia serrata sometimes labeled as frankincense.

Last but not least make sure your primary care provider knows just how much and what kinds of OTC products your using.

To your good health in 2017

 

Sources

http://cen.acs.org/articles/92/i29/Does-Acetaminophen-Work-Researchers-Still.html

http://www.mustforseniors.org/acetaminophen_facts_containing.jsp

http://www.northwestern.edu/newscenter/stories/2011/05/public-confused-about-pain-relievers.html

http://onlinelibrary.wiley.com/doi/10.1038/clpt.1987.50/abstract

http://ard.bmj.com/content/75/3/552.short

https://www.sciencedaily.com/releases/2015/06/150611082124.htm

https://www.ncbi.nlm.nih.gov/pubmed/15645405

https://www.sciencedaily.com/releases/2016/05/160510084257.htm

https://medicalxpress.com/news/2010-07-medications-term-cognitive-impairment-aging.html#jCp

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