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Acetaminophen overdoses still send over 78,000 to the ER every year

The ‘safest pain reliever you can buy’ keeps right on killing

One day, out of the blue, Sarah Erush got a call from the FDA.

She’s a pharmacist, and in charge of the drug information center at the University of Pennsylvania hospital. Her job is to send the FDA reports about drug reactions.

The FDA, she was told, is looking at your reports about acetaminophen overdoses. She was asked if she had ever collected all that data and reviewed it.

“No,” Erush said. She would just send her reports along to the FDA as they came in, one at a time.

The caller then told her she might want to start pulling them all out to see how many there were.

So she did.

And the results “set off a light bulb.” What patients thought was the “safest pain reliever you can buy,” she said, had landed them in the hospital. Some were so sick they needed a liver transplant.

That’s what can happen when someone “takes just a little bit too much acetaminophen.”

For years I’ve been warning you about the dangers of acetaminophen.

And for years the FDA has been, well, basically collecting data. And doing practically nothing with that data to protect us.

That’s why this drug still lands over 78,000 people in the ER every year in the U.S.

And hundreds of them die.

So when Erush gathered all those reports in one place as the FDA has asked, she found a lot of “odd cases” where people took “just a little extra” of the drug and ended up in big trouble.

Only now, it doesn’t look quite so “odd” to her.

She said that when these patients were told they were in the hospital because of acetaminophen having damaged their liver, “they would be aghast.”

They would say, “From Tylenol? This is from Tylenol?” They would tell her how they thought it was “so safe,” that this “couldn’t possibly happen.”

And there’s another thing they would almost always say:

“I didn’t take that much.”

That’s how easy it can be to overdose on acetaminophen. Just a little bit too much can do it.

In April the FDA finally warned about prescription drugs that contain more than 325 mg of acetaminophen. Such meds were reported to be “no longer considered safe by FDA.”

The agency is now asking doctors not to prescribe anything above that amount. And asking pharmacists to be on the lookout for any prescriptions that are — and to send them back if they find any.

But that does nothing to protect us from all the other drugs, the OTC versions you can get most anywhere. Some have very high amounts of acetaminophen to begin with — as high as 650 mg in a single Tylenol Arthritis Pain pill.

That’s TWICE the amount the FDA now calls “no longer safe.”

Even if you’re taking a drug with a lower dose of acetaminophen, it’s in so many products it can add up…fast.

And you can’t always count on your doctor to keep you safe from a deadly overdose.

Erush said that she’s “stunned and amazed” at the way doctors will “almost routinely throw in Tylenol when they’re treating pain.”

Many of them still think, “It’s only Tylenol. It’s fine. It’s safe.”

Believe it or not, that call the FDA made to Erush was 2002. You can see how much progress they’ve made in the last 12 years.

So while the FDA continues to do lots of busy work collecting more data, we’re still waiting for the day it will actually do something.

Because there’s just too fine a line between that deadly dose and what they call a “generally safe” one.


“Use only as directed” This American Life, September 20, 2013,