The infamous Paracetamol AKA Acetaminophen is still one of the most widely used over-the-counter medication to bring down a fever as well as reducing pain. It is highly effective to suit its purpose only if it is used in the PRESCRIBED DOSE and WITHIN A LIMITED TIMEFRAME!


Most users believe that Paracetamol is completely safe as it is available over-the-counter, but the opposite is actually true. It is interesting to note that at the beginning, Paracetamol was only available by prescription.

It is therefore not surprising to find that the United State Food and Drug Administration (FDA) has recently (June 2009) decided to limit the strength of Acetaminophen in prescription medications to prevent serious liver damage from an overdose. The FDA has called for a limit on the maximum adult daily dose to no more than 325mg. In addition, the FDA also wants to limit the tablet strength for children’s liquid formulas. This move clearly shows that the number of those overdosing themselves with Paracetamol has hit a worrying level despite the fact that Paracetamol has been accessible to the general public since 1956!

Paracetamol toxicity is one of the most common causes of poisoning worldwide. It is in fact, the leading cause of acute liver failure in the Western world, and accounts for most drug overdoses in the United States, United Kingdom, Australia and New Zealand. The numbers are also increasing in other countries too! A research showed that 30% of drug overdoses in emergency wards in the UK were Paracetamol-related.

Among the reasons why Paracetamol overdosing is of a big concern to the health community is the fact that symptoms are barely visible among overdosed users. It is that easy to get overdosed with Paracetamol! Many may not show any symptoms within the first 24 hours of Paracetamol ingestion. The rest will exhibit symptoms resulting from Paracetamol overuse such as gastrointestinal irritability with anorexia, nausea and vomiting, abdominal pain as well as pallor, malaise and increased sweating. Most people would normally overlook Paracetamol as the culprit of these symptoms.

Symptoms of an overdose usually present within a few hours after an overdose (0.5-24 hours). Patients may appear normal during this phase. In severe overdose cases however, the signs of progressive liver failure such as low blood sugar, low blood pH, hepatic encephalopathy and easy bleeding can develop within 3 to 5 days. At this point, lack of medical treatment can result in death!

A person with the intent of suicide may therefore choose to not disclose related information demanded by health practitioners. Therefore, Paracetamol should be suspected by those seeking to save them from Paracetamol poisoning should they see the above mentioned symptoms.

Generally, a daily intake exceeding 4g per day in an adult is considered to be an overdose. This is eight of the usual 500mg Paracetamol tablets. Note that I have used the world ‘generally’ because there are special cases of those who experienced Paracetamol poisoning even though they consumed the normal dose as specified above! Among the special cases include those whom consistently drink excessive amounts of alcohol, consistently use enzyme-inducing drugs (eg. Carbamazepine, Phenytoin, Phenobarbitone, Primidone, St. John’s wort and Rifampicin) and those with conditions predisposing them to Glutathione depletion (such as malnutrition, eating disorders, malabsorption states and HIV infection). The above mentioned may be at risk fo liver damage from lower plasma Paracetamol concentrations.

A single dose of 7.5-15g (15-30 of 500mg Paracetamol tablets) may cause severe liver damage if not treated immediately. Severe liver damage occurs if a person ingests more than 150mg Paracetamol/kg body weight, or in adults, more than 12g (24 standard tablets). Researchers have reported that the threshold for liver damage can start from asingle Paracetamol overdose of 12.5g.

If you are considering to use Paracetamol to control pain for long-term, a leading drug expert on pain management Prof Lombie Odendaal's view below may change your mind!:-

“Short-term use of pain medication containing Paracetamol will not cause liver damage. However, if it is used for longer than a year, there is no doubt that it will lead to liver problems.”

Scientific studies published in the American Journal of Respiratory and Critical Care Medicine have also reported that apart from liver damage, Paracetamol is also linked to the development of asthma and eczema among adolescents. The study found that the monthly use of Paracetamol can more than double the risk, while yearly use may increase the risk by 50%!

Recent research has shown that using Paracetamol as a baby increases your risk of developing asthma about five years later by about 46%. Other studies have also linked pregnant mothers taking Paracetamol to increased risks of child developing asthma early in childhood! This has led to some doctors using Paracetamol only as a last resort drug in pregnant ladies!

It is important to heed what the study leader Professor Richard Beasley from the University of Auckland said on Paracetamol use :

"Paracetamol is still the preferred agent, but the large amounts used around the world are unnecessary. Its use should be limited to treat high fevers (38.5C or above)."

Drugs like Paracetamol are dangerous if consumed beyond its usual doses and for long term use. Members of the public should strive to change the mindset that over- the-counter-drugs are safe and be more educated on the dangers of consuming drugs. Drugs are only heroes when consumed within the recommended doses and are notorious villains that may kill you if you take them in overdoses!

If you are contemplating suicide (be it with or without Paracetamol!), feel free to talk to us by contacting us. We are most willing to help you as we have done for others.



If you have enjoyed reading the article, please do leave a comment below. Share with us your thoughts. We appreciate your time and effort. Thank you and have a nice day!


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Author: Silambarasu Karuppiah
Copyright © 2012 Sandhya Maarga Holistic Living Resources
Holistic Living Annex (Volume 1, Issue 4 - MAY 2012 Edn)