This week I received an e-mail from a member of my extended family detailing the tragic death of her friend from liver damage caused by taking extra-strength Tylenol pills for three weeks for a nagging toothache. The young woman was a healthy 19 year old college student on the dean's list who had no dental or health insurance who tried to deal with the pain herself using over the counter pain medication.

Apparently Mady was vomiting all day Saturday but refused her roommate's attempts to bring her to a hospital [I'm guessing because of lack of health insurance], so she wasn't taken until he found her the next day when she was delirious, didn't know who she was and was covered in vomit.

The reason I'm posting this story is that I think a lot of people don't realize that you can get liver toxicity and die from taking the recommended dosage of over the counter pain killers. The doctors estimate that she took 9 pills a day when the limit is 8, but say that the result would have been the same at 8 pills. People need to be aware that there is a cumulative effect of acetaminophen on the body, and it's not just about adhering to the daily limit.

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Parents say acetaminophen killed student

By Jeff Raymond

Madalyn Byrne had a nagging toothache. The over-the-counter pills she took to dull the pain killed her.
Byrne, a 19-year-old University of Oklahoma sophomore, died Monday from liver damage and cardiac arrest from taking too much acetaminophen, the active ingredient in Tylenol and many other commonly used medicines.

She had taken, her parents and physicians estimate, nine extra-strength Tylenol pills a day over three to four weeks. The recommended dose is no more than eight in a 24-hour period, and the label says it should not be taken for more than 10 days unless directed by a doctor.

Her roommate found her on the sofa Sunday morning, disoriented and covered in vomit.

Liver experts at Integris Baptist Medical Center, where the dean's list student died after her heart stopped, said acetaminophen should be taken cautiously. Byrne was taken first to Norman Regional Hospital and then to Baptist.

"It's pretty certain that acetaminophen is the cause of death,” said her mother, Evelyn.

Madalyn Byrne's father, Michael, her mother and Vicky Sims, her aunt, spoke Thursday at Baptist about her death.

Too much acetaminophen can cause liver failure. Although doctors can treat overdoses when they catch them early, damage can be fatal if left too long.

Dr. Harlan Wright, chief of hepatology at Nazih Zuhdi Transplant Institute at Baptist, said acetaminophen can harm people depending on how much they've taken, whether they've consumed alcohol and whether they have fatty liver disease.

Even a small amount of alcohol can be dangerous when combined with acetaminophen.

In dealing with a toothache or other chronic pain, many people keep taking pills when the pain doesn't go away.

Acetaminophen builds up and can poison the liver.

"The sicker your liver gets, the more Tylenol is not metabolized, and you get this whole process,” he said, estimating Byrne's liver likely was damaged several days before she was taken to the hospital.

"Is there a safe dose? Yes, acetaminophen is a safe drug,” he said.

Tylenol labels recommend taking no more than 4 grams a day, or eight pills.

However, Wright said the length of time a person takes acetaminophen is important in whether it becomes toxic.

Full Story

Another victim of the US drug policy.

Or of US society.

I still don't understand why anyone would take Tylenol....
It doesn't work except to reduce fever, and it's not an anti inflammatory...

Ibuprofen seems much safer?

Other over the counter medication containing acetaminophen:

NYQUIL
DAYQUIL
ALLEREST
SOMINEX
ANACIN-3
TEMPRA
DATRIL
ALKA SELTZER PLUS
MIDOL
PAMPRIN
DRISTAN
EXCEDRIN

Acetaminophen is also found (often in 375 mg strength or more) as a major ingredient in the following prescription medicines.
Therefore, they should not be taken in addition to over-the-counter Tylenol/Acetaminophen, as this will magnify the damaging effects.
TYLENOL 1, 2, 3, and 4: in combination with codeine
PERCOCET
ROXICET
ENDOCET
DARVOCET
LORCET
ULTRACET
OXYCODONE
HYDROCODONE
VICODIN
LORTAB

FOR A MORE COMPREHENSIVE LIST, GO TO THIS NATIONAL LIBRARY OF MEDICINE ARTICLE:
http://www.nlm.nih.gov/medlineplus/druginf...tml#brand-names

You would have to take a helluva lot in order to kill you..... Certainly more than the recommended dose for 3 weeks.....

Are you a Kevin Trudeau fan?

http://headaches.about.com/cs/medicationsu.../acet_death.htm

Have you personally tested that?

These neither contain acetaminophen nor are normally prescribed under these names.

Well I was sent this list, but in looking it up myself now it appears that both drugs are often prescribed in combination with acetaminophen, which must be why they were listed.

http://www.nlm.nih.gov/medlineplus/druginf...er/a601006.html
http://www.medicinenet.com/oxycodoneacetam...ral/article.htm

As for not being normally prescribed under these names, I can tell you that I was prescribed Hydrocodone under that very name last year, and that was also how the name appeared on the label on the bottle.

Basically yes, in fact one time I got a prescription for 800mg Motrins which are equivalent to 4 advils......

And my mother used to pop them like candy, and the only thing that happened was that her platelet count got too low and she started bruising. But as soon as she stopped it went away......

I took large amounts of advil after my car accident almost a year ago. My doctor said to take four advils at a time up to three times in a 24 hour period. I did this on and off for about two months. And yes I lived to tell the tale.

What is the US drug policy?

Ibuprofen overdoses can also be fatal.



20 is about enough.

You can overdose on anything. We're talking about normal or slightly more than normal use for an extended period.
There are few medications that won't do you damage if you take the entire bottle....

Exactly. This was not a case of someone overdosing, either intentionally or unintentionally. This was a case of a young woman taking a normal dose of Extra Strength Tylenol for 3-4 weeks straight thereby causing permanent damage to her liver which led to her death.

Just to put things in perspective, here is a paragraph from the e-mail I received:



To me at least, it's pretty scary to think that a healthy person can take Extra Strength Tylenol for 3 weeks and die as a result.

She must have had some alcohol while taking the meds or had previous liver damage for this to have happened. Something isn't adding up here.

Nine extra strength pills a day (and maybe more) for three weeks, for a person with a low body weight, was supposed to be acutely toxic. Vitamin A in such relative dosages would've long since killed her, as would've many other pharmaceuticals considered very safe. Problem isn't with Tylenol, it's with the fact that she couldn't get a normal anesthetic adequate for her pain because her doctor probably peddled his opiates quota to some drug dealer for extra cash. She was killed by Reagan, Rockfeller and the DEA.

That and the fact that she didn't HAVE a doctor, or at least no insurance to pay him....
But come on, she's on a college campus, no doctor is necessary to get even the strongest stuff.......

This girl had a toothache, not some other type of pain for which there is no cure. So had she had the money to go to a dentist in the first place to deal with the source of her pain, I'm sure she wouldn't have had to be on any type of painkiller for three weeks straight and she would be alive today.

They're combined with acetaminophen to make some other drugs on that list.
Oxycodone Acetaminophen is Percocet.
Hydrocodone Acetaminophen is manufactured under several brand names - Lorcet, Lortab, and Vicodin for some.

These are OTC drugs that contain acetaminophen.
http://www.nclnet.org/takewithcare/acetaminophen/otclist.htm


These are prescription drugs that contain acetaminophen.
http://www.nclnet.org/takewithcare/acetaminophen/rxlist.htm

For example;
Sudafed PE
Generic Name: acetaminophen, diphenhydramine, and phenylephrine (a see tah MIH no fen, dye fen HYE dra meen, and fen L ef fren)
Brand Names: Sudafed PE Severe Cold, Theraflu Warming Severe Cold Nighttime
http://www.drugs.com/sudafed_pe.html

Which is why I keep away from painkillers when possible. Tylonol can also be addictive btw.