paracetamol - the dangers true or false

[Guest reville]

QDoes paracetamol cause irreversible liver damage in overdose?

AIn large, untreated overdoses paracetamol may cause liver damage, but theliver recovers completely within a matter of months with no permanent damage (12,13).If the overdose is large enough to completely overwhelm the liver it cannot recover and death will follow. This is what is meant by the term 'irreversible liver damage.'

12Proudfoot, A. T. and Wright, N., 1970, Acute paracetamol poisoning, BMJ,3, 557-558.

13Prescott, L. F., 1983, Paracetamol overdosage: pharmacologicalconsiderations and clinical management, Drugs, 25, 290-314.

http://www.pharmweb.net/pwmirror/pwy/parac...bpichealth.html

[This message has been edited by reville (edited 01 October 2001).]

[Guest FatherPaul]

Paracetamol does not cause irrversable liver damage in overdoses unless used with whiskey or strong alchohol. It may cause diarrhoea and bad headaches, but does not effect the liver in an irrevesable manner.

I love you all.

[Guest ziebonka]

So are you saying if silly teenagers like me use paracetemol to get drunk faster they will get irreversible liver damage?...Oh Shit!!!

[Guest NOB]

There have been plenty of teenage girls who have eaten a box of 20 paracetamols in a misguided attempt to kill themselves and resulted in permanent liver damage. I get the impression they get this information from movies and books where a character overdoses on painkillers, though they sure as hell weren't panadols.

Paracetamol liver damage that causes fibrous tissue to form(cirrhosis) is permanent, the scaring doens't heal, the organ can't repair it's self. Liver damage involving inflamation without scaring is reversable.

[This message has been edited by NOB (edited 02 October 2001).]

[MrBumpy]

ziebonka : taking panadol with alcohol will get you drunk quicker? lol, c'mon, you can't be serious.

I've had friends tell me this before but I've dismissed it because I've never seen any drug interaction between the two, can anyone bring any light on the subject?

[Guest NOB]

What about if the paracetamol was causing the liver to work so hard that it's abilities to metabolise the alcohol are greatly inhibited.

This would get you drunk quicker and stay drunk longer.

[MrBumpy]

NOB : for that to happen you'd have to take a large amount of paracetamol anyway...which is why depressed teenage girls get liver damage...not by jsut taking two Panadols

[Guest reville]

so...

some say it does others say it doesnt.

what im looking for is medical evidence to suggest that it does..

as iv efound two papers that reportedly suggest it doesnt..

Hearsay or the advice of GP's (lol) are not admissable.

I know someone who took 38 panadol in one go ( obviously their intention wasnt to be around anymore - and they reprted a feeling like glass in the stomach for several days after regaining conciousness)

any ideas on that. BTW they seem quite healthy now

[Guest ziebonka]

Mr Bumby,

I'm pretty sure paracetemol thins out your blood and that's why it gets you drunk of smaller amounts of alchohol. I have freinds who do it regularly and my brother used to do it. Aspirin works a bit better I find and so does Pseudoephedrine,60-120mg + 2 beers=drunk.

The strange thing is when I tried to do this with paracetemol my body behaved very strangely.

[Guest NOB]

Well the thing is permanent liver damage doesn't mean you'll show any symptoms, depends on the extent of damage. A 14yo female neighbour has permanent liver damage from an overdose of panadols, though she looks perfectly healthy and probably is. But her liver enzyme count(or something like that) blood tests shows she has liver damage.

This girl had cramping in the stomach, but defiantly wasn't too ill as her mother took her to the GP the next day rather than the hospital. 2 displays of ignorance, the mother not realising how dangerous a paracetamol overdose is and the girl believing eating a box was like cyanide poisoning.

[somnif]

While I can see the point which reville is trying to make, I cannot emphasise enough that Paracetamol(==Acetaminophen) is nasty stuff - in particular subjecting yourself to the substance over and over again in overdose mode will tempt fate.

To not seek medical treatment after overdose on the ground you think you'll get better is probably an act of stupidity.

Interestingly, I read in one of the below URLs that ethanol actually decreases the liver toxicity in overdose of paracetamol. This, as usual, should be taken as a grain of salt and not used as a reason to mix the two :-)

A close friend of mine (ironically a pharmacist) had the unfortunate luck to find an elderly neighbor who had died of paracetamol overdose who hadn't seeked treatment.

FWIW, in mice orally, the LD50 for paracetamol is 338mg/kg - though LD50 are only indicators (and not much fun for the animals)

Anyhow, have a quick look at

http://www.icondata.com/health/pedbase/fil...es/ACETAMIN.HTM

http://www.mc.vanderbilt.edu/peds/pidl/acu...te/acetamin.htm

http://www.lef.org/protocols/prtcl-001.shtml

[This message has been edited by somnif (edited 03 October 2001).]

[This message has been edited by somnif (edited 03 October 2001).]

[This message has been edited by somnif (edited 03 October 2001).]

[Hopping Eagle]

If memory serves me correctly a fatal doaeage if you want it to be effective is ~ 24g.

If you want to knock yourself off there are far less painful methods - the medieval rack for one.

[Guest Ramon]

Panadol overdoses are treated as very serious in Hospital. They put you on some a drip full of something designed to reduce or prevent the liver damage.

Whilst I can not say with any authority that it does cause irriversible liver damage I do know that the medical profession treat it as if it did.

[Guest Trichus]

From personal experience, Im pretty sure that high doses of parecetamol _do_ tax your liver. I guess the amount that causes cirrhosis is dependant on the state of your liver (as well as kidneys etc).

Maybe there's other usually benign substances that have dodgy liver synergy.

IMO, a stressed liver is something to avoid _especially_ in this day and age.

[Torsten]

The main fatality reasons with paracetamol are not related to the liver, but to the kidneys. Taking large amounts of panadol can cause renal failure. Either way, I think taking it for anything other than as a painkiller is stupid.

[spaced]

Originally posted by Torsten:

Either way, I think taking it [paracetamol] for anything other than as a painkiller is stupid.

How about for reducing temperature? On the one hand I would be inclined to agree. Letting the fever run its course theoretically allows the immune system to function optimally to overcome an infection. But then on the other hand if someone had a REALLY high temperature, particular if (s)he was a younger patient then they may have febrile convulsions. There are always natural alternatives for the febrile patient - eg sponge baths and fanning which are effective.

I think paracetamol is a by-product from the petroleum industry. Its parent compound phenacetin was shown to be nephrotoxic and is no longer available in Australia (at least not over the counter). Personally I don't believe, at all, that paracetamol does anything for me personally to help reduce pain but I still take it for the placebo effect.

One thing you may also like to consider is the impact of taking paracetamol in higher than recommended doses for long periods. I can understand introducing wierd xenobiotics from the petroleum industry into the body for the treatment of short term pain but it is really only pain relief - ie it's not going to cure anything.

[Torsten]

Originally posted by spaced:

How about for reducing temperature?

I phrased that poorly. I meant that paracetamol is a useful tool for healing (or at least masking symptoms) but has no credibility or desirability as a recreational substance. I put it right up there with butane.....

[gomaos]

I think they should write in big letters on panadol packets, just as they do on cigarette packs:

Doses of more than 4 panadol tablets taken at the same time may be fatal.

The pill companies would lose a lot of business.