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May 01, 2009 -- Tylenol and other acetaminophen products a health hazard?

Have you heard about the dangers that can result from taking acetaminophen after several days of fasting -- as you might if you had a particularly nasty flu?

Clark learned about this little-known threat when he was seated on a plane next to 2 lawyers from a firm named Toliver & Gainer. Both attorneys were actively involved in a pharmaceutical product liability case pertaining to acetaminophen.

For those of you who don't know, acetaminophen is the generic name of Tylenol. It's also an active ingredient in a variety of cold and cough medications.

Earlier this week, the FDA announced that it will now compel Tylenol to issue a stronger label warning about the possibility of severe liver damage resulting from acetaminophen.

Attorney William "Gil" Gainer called into the show while Clark was speaking on the topic. According to Gainer, the real problem is that when you haven't eaten for several days because of a stomach virus, a flu or even a dental operation, you're at risk of liver damage or failure even when taking recommended doses of acetaminophen.

It's important to note that his opinion differs from that of the FDA. But as Gainer explained, under normal conditions, you have enzymes in your liver that help remove toxins produced by the acetaminophen. However, once you go anywhere from 5 to 7 days without eating, those enzymes no longer work effectively.

Gainer also revealed that acetaminophen is now the No. 1 cause of liver failure in the United States. For more information on this topic, see his firm's blog.

As a safer alternative to acetaminophen, Gainer suggests either ibuprofen or aspirin. If you're prone to ulcers, you may need a buffered aspirin to protect your stomach.

Unfortunately, Clark won't be able to answer any questions submitted via commenting. If you have a question, please try posting it to our message boards.

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What others are saying

  • Tylenol
    Clark,I think your a little over the top on this one. The vast majority of people having problems are folks that are taking WAY over the prescribed or indicated dosage, many of them vicodan abusers. Saying you'll never take a tylenol is like saying that dringing a gallon of whiskey in an hour will kill you so I'm never having a beer again.
  • Tylenol warning to be heeded!
    Just before you posted this warning, a skinny, but not anorexic, co-worker had been eating less than her usual "birdfood diet" (I mean she had a strict, healthy eating regimen, unlike her gluttonous co-workers), and feeling "under the weather." She ate very little over one weekend and had been taking Tylenol for headaches (eating probably would have solved that issue). On the next Monday, she felt "out of it" and I noticed she tool Tyenol twice during the night. She never woke up the next day after going to bed. Her brother happened to come by and check on her that day and she went into the hospital in a coma. She was revived and put on a high caloric diet for a week and then sent home to recuperate. The doctor still has not released her to return to work.

    Also, I have nearly "instant" kidney problems if I take Aleeve... so there's 2 pain relievers to avoid taking on a regular basis Whether on a full stomach or not.
  • Naproxen Sodium
    I was admitted to the hospital after throwing up blood (coffee grounds) from taking Naproxen a.k.a Aleeve. Now granted I have been taking the drug for 10 years once a month following Dr's orders. I am now convinced that it might be better to live with the pain or look to other methods for aid than to take these OTC drugs, you are welcome to think what you would like.
  • Tylenol is the safest drug out there...
    1. All drugs have side effects. If it doesn't have a side effect, it probably doesn't have a benefit either. Yes, this applies to herbal remedies too--except they don't have FDA oversight, so no one is ever sure of what their side effects are.
    2. NOBODY gets liver failure from taking the recommended dose of tylenol--this "fasting" BS is purely conjecture. Even liver failure patients routinely get tylenol in the hospital.
    3. NSAIDS (ibuprofen, aspirin, naproxen) are much more dangerous than tylenol, even at recommended doses.
    4. Tylenol doesn't eat holes in intestines. Ibuprofen and other NSAIDs do.
    5. Tylenol doesn't exacerbate asthma attacks. NSAIDs do.
    6. Malpractice lawyers are out to scare the general public, and make money off of whoever they can. EVERY medical treatment has risks and benefits. Keep in mind that these LAWYERS are voicing their OPINIONS--there is no medical literature to bear their "facts" out.
  • I. M. Litigator, MD
    This sounds like it is more of a legal issue than a medical one. Very little medical facts, with lots of general warnings. Be afraid and suspect the drug companies of wanting to kill you.
  • Tylenol vs. Motrin
    I have been a nurse for 12 years and have to tell all of you that we use Tylenol far more than Advil in the hospital. Tylenol is the standard of care for fever and mild pain. I also must tell you that I have seen far more problems, such as kidney failure from Advil, Motrin abuse. All of the OTC drugs are safe if they are used in moderation. I have rarely seen anyone in liver failure related to Tylenol use.
  • Be careful with your advice Clark.
    I am grateful to hear of this information. I have been taking more Tylenol lately for headaches, cold, fever, etc and my toddler always takes Tylenol instead of Ibuprofen. I will reconsider before using it and giving it to him again. However, Clark, like the others I am surprised that you would have attorneys on your show talking about this without the full facts. I have heard for years now that NSAIDS like Ibuprofen can be much more of a danger, and aspirin even has its problems. So while I am grateful for the information, I think you should do more research and present the whole picture when reporting things that could seriously impact peoples' health.
  • Tylenol
    It's unfortunate the hospitals, doctors, and Drug companies cram this drug on us, and I agree with most of what others are saying. As for "Barb in Texas" please be cautious when taking Tylenol for arthritis pain, as my Mom took it for years until it "ate a hole in her upper intestines". She never was released from the hospital after that and finally died from other complications related to that incident.
    I don't know how many she 'actually' took each day, but do know it was as often as 3 times a day. Now that I'm on blood pressure drugs, I will ask my Doc to change the drug to allow me to go back to ibuprofen.
  • tylenol
    Clark.Best Pi;;s/Worst Pills a consumer Drug Alert has for more years than I can remeber WARNED folks about Tyenol and the liver damage it causes.......Once upon a time this pain killer was only avaiable by R/X.Like so many other R/x the became OTC.....And served up in Hospitals..........The elerly should be aware of the danger of this OCDThank goodness the warnings are going out.....Perhaps it will save lives

    This is a very bad pain releiver that NEVER should have worked it's way into the mainstream of products to reduce pain......The power of advertising!!!!!!
  • acetaminophen is not just in Tylenol
    Check the labels on your sinus pills and other pain relievers, too! There are better ways...turmeric (yes, the spice!) comes in capsule form that does wonders and doesn't hurt your liver.
  • acetaminophen requires a glass of water
    acetaminophen can be very dangerous, trouble is all NSAIDs (aspirin, ibuprofen, naproxin,etc) can be dangerous. Take acetaminophen with plenty of water. Believe it or not, your genetic makeup also determines how well acetaminophen is removed by your liver enzymes. Some folks have a genetic makeup that cannot remove even the normal dosage...as bad as it is, it remains a good alternative to other NSAIDs.
  • Where have you been ?
    Everyone knows that Tylenol causes liver damage in some people.
  • Acetaminophen vs Ibuprofen
    I take Ibuprofen! TG! I ned my liver, thank you!
  • Ibuprofen and Aspirin
    In a situation where dehydration is a possibility, taking ibuprofen may cause kidney failure. We also recommend against using aspirin in children due to Reye Syndrome. Tylenol, in moderation, is much safer
  • Acetaminophen
    I think no aspirin to children under 21 years of age because of Reyes Syndrome?
  • Acetominophen labeling change
    Clark gave valuable information. See the attached link to the FDA website. Manufacturers have until 4/28/10 to add the new warnings. http://www.fda.gov/bbs/topics/NEWS/2009/NEW02004.html
  • Common Sense
    I believe it's common sense that if you are going to not eat for 5 to 7 days that any medication you take will have some effect on your body. I'd even bet that after a week of not eating the first food you eat would effect your internal organs.

    When does the average American go 24 hours without eating? When we are ill we drink protein shakes, eat toast, yogurts and soups to keep us going. Our friends and families would never allow us to go 5 to 7 days with no food!

    I see no reason to change away from taking 2 acetaminophen each morning for my arthritis. When I'm in severe pain, I even take 2 at night. If you take care of yourself, eating something every day, and follow the directions on the bottle and not over dose, you will be fine.

    Why should we take medical advise from an Attorney? Isn't he just angry because a person stopped eating for 5 to 7 days and not take care of their bodies? Who told the person to stop eating for 5 to 7 days? Shouldn't they be responsible for what they've done to themselves?
  • Statin Drug Side Effects
    I heard your comments on the dangers of acetominephen and think you should also look into the side effects of of the statin drugs, widely prescribed for cholesterol. Please read the following:

    Excerpt from ‘The Better Brain Book,’ by Dr. David Perlmutter, Page 44.


    ‘Statin medicines to lower high cholesterol levels, including Lipitor, Mevacor, Pravacol and Zocor, also deplete cells of Co-Q10. They are among the most widely prescribed drugs in the world. In my opinion, doctors are too quick to write prescriptions for these drugs, ignoring their potential downside. I’m not saying that these drugs are all bad; they’re not. They can help prevent heart attacks, particularly for people who are resistant to making changes in diet and lifestyle. I do believe, however, that these drugs are terribly overused.

    ‘Statin drugs have another particularly nasty side effect: according to a recent study in the journal Neurology, patients using statin drugs had a stunning 1,600 percent increase in peripheral neuropathy.’ (His emphasis)

    I took Lipitor, Zocor, and Pravachol for about 10 years and I have severe peripheral neuropathy. I never associated it with the statins until I read in CONSUMER REPORTS that fish oil was as effective as the statins in reducing cholesterol.

    Also, please read, 'STATIN DRUGS: SIDE EFFECTS AND THE MISGUIDED WAR ON CHOLESTEROL,' by Duane Graveline, M.D. His book goes way beyond peripheral neuropathy.

    Regards,

    ROBERT H. WATHEN
  • Lawyer or not...
    Under the circumstance of fasting for several days (which is the subject of this piece,) how can you argue that ibuprofen or aspirin are NOT safer alternatives than acetaminophen? Given individual circumstances, there are potential severe complications from any pain relief medication. This particular investigation is quite narrowly focused and as such the advice is good. If you think someone here is recommending ibuprofen or aspirin over acetaminophen in every case where pain relief is needed, then you're reading way too much into this.
  • acetamonophen
    Thanks for the warning. Ibuprofen for me from now on.
  • Substituting NSAIDS for Tylenol.
    A dangerous recommendation from a lawyer who ought to be aware that there are also severe complications from Motrin, Alleve and aspirin. Since when is the law profession qualified to make medical recommendations? Clark, are you out of your mind to allow this? As an ER physician who trained at Grady, I have seen more severe complications from non-steroidals (especially uncontrolled bleeding) than from Tylenol. The risk from Tylenol is real. Educating the public is great. To allow lawyers to come on your show is like letting insurance companies tell me how to practice medicine. Conflict of interest, and practicing medicine without a license! Even if it was not a physician, adding some type of medical professional to the discussion would have been prudent.
  • Want an aspirin
    The humble Aspirin is all I deal with and it was around before I was. The rest don't have a track record and aspirin I believe is from willow bark, think I read this a long time ago somewhere. Drink too much beer to fool with acetaminophen, Nothing like a cold beer after a hard day, and if you drink more than one, stay away from acetaminophen, it will rot you liver quicker than a thousand beers. This also applies to wine and hard liquor so beware my friends.
  • Acetaminophen
    Dear, Clark; I lost a son in 1994 do to liver failure the hospital where he was at in St.louis Mo. a liver specialist there told me they don't use any acetaminophen products anywhere in the hospital because it does destory liver cells no matter what it is in or the strengh. Another warning is if you are a asthma person like me with cronic Bronchitis it is a death sentence to use it because it can and does set up a reaction with in the lungs in these people i know becuase i have been in the hospital several times do to this. It doen't matter the strength. I have been warned several times by my doctor the lung specialist to which i see every four months, warned me if people with asthma would quit using this tpye of medication almost all asthma attacks would be stop right in there tracks I have never used this med since my last go around a year ago when i spent 3 days in th ehopital because of this medication. Watching a person die of liver failure is not a pretty site. It is worse than a heart attack or stroke
  • Medical advice from a malpractice attorney? Really Clark?
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