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Common and dangerous: Acetaminophen overdose

Mar 14 2016
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Every year, overdoses of medicines containing acetaminophen send more than 78,000 people to emergency rooms. One third of those emergencies happened by accident, according to a Consumer Products Safety Commission study.  An estimated 150 people die each year from accidental acetaminophen overdoses, according to data from the Centers for Disease Control and Prevention. That’s more than the number who die from intentional overdoses of acetaminophen to commit suicide.

Acetaminophen is the active ingredient in one of the best-selling over-the-counter medicines in the U.S., Tylenol. (In many other countries it’s called paracetamol, and is part of the brand medicine Panadol.) It is also frequently combined with other drugs in many over-the-counter and prescription medications.

Taken correctly, acetaminophen safely reduces pain from headaches, body aches, muscle aches and menstrual cramps, and helps bring down fever. But if a patient takes two or more medicines containing acetaminophen (including over-the-counter medicines) it’s possible to get a dangerous amount by mistake. Too much acetaminophen can lead to liver failure and even death.

The pharmaceutical industry is responding to a request by the Food and Drug Administration to reduce the dosage of acetaminophen in prescription medicines when it’s combined with other drugs. To further decrease accidental overdoses, Aetna is helping pharmacists catch cases where patients are prescribed two or more medicines that together contain dangerous doses of acetaminophen. When these prescriptions are submitted for payment, Aetna alerts the pharmacist. The pharmacist then checks with the doctor or doctors who wrote the prescriptions, and will only fill the prescription if the doctor says the high acetaminophen dosage is appropriate for the patient.

Aetna’s pharmacy safety program was expanded in November 2014 to address all medications that include acetaminophen. The program provides real-time safety checks on prescriptions such as opiates and other medications that are in danger of being overused or abused.

“Pharmacists do a great job of flagging these dangerous drug combinations, too,” said Celynda Tadlock, vice president, Aetna Pharmacy Management. “But if the patient has filled prescriptions at more than one pharmacy, the pharmacist doesn’t have the whole picture. Aetna does. By using the data we have at hand, we can help prevent disastrous consequences and even save lives.”