Migraine Patient Safety: Acetaminophen

I have no doubt a number of Migraine.com readers will question why I'm sharing information about acetaminophen risks and safety. After all, over-the-counter pain relievers are ineffective for many of us. But I'm doing so for two main reasons: (1) Many people living with Migraine do use over the counter pain relievers; and (2) It's not uncommon for Migraineurs to use combination medications that contain acetaminophen.

Before I delve into recommendations for safe use of acetaminophen and combination medications containing acetaminophen, I think it's important to provide a little toc032.jpgeducation about the potential dangers associated with acetaminophen use and misuse.

What are the possible dangers?

  • Liver damage: Like many other medications, acetaminophen is processed by the liver. If a patient takes more than the recommended maximum daily dose, acetaminophen can be quite hard on this organ because it acts as a toxin. Research has shown continual overuse can be as dangerous as a massive overdose.
  • Rare, but serious skin reactions: In early August 2013, the Food & Drug Administration (FDA) issued a warning about three serious, sometimes fatal, skin reactions that can result from acetaminophen use. Though these reactions are incredibly rare, it's essential to contact your doctor if you experience any out of the ordinary symptoms after taking acetaminophen. Please note these bad reactions can occur even if you've previously used acetaminophen with no problems.

Tips for safe use of acetaminophen:

  • Know the maximum recommended acetaminophen dose. And always follow it (unless your doctor directs otherwise). Stick with using no more than 650 mg total within a 4-6 hour period. Ingest no more than 4,000 mg within a 24 hour period. Tylenol, an OTC pain reliever containing acetaminophen, recommends a maximum of 3,000 mg within 24 hours.
  • Never take more than one medication containing acetaminophen at the same time (unless your doctor directs otherwise).
  • Read medication labels. It's important to familiarize yourself with the ingredients in each medication you take, both prescription and OTC, and the doses of acetaminophen contained in each one. Be aware that some prescription medication labels abbreviate acetaminophen by referring to it as APAP, acetam, etc.
  • Tell your doctor about every drug you take, including OTC medications. A medication called Fioricet or Butalbital, which contains acetaminophen, is sometimes prescribed to Migraine patients. Some Migraine patients are prescribed combination pain killers, such as Vicodin or Tramadol, for treatment of Migraine-related pain.
  • Don't forget to tell your doctor about medications you take for conditions or illnesses other than Migraine. Make sure you tell your doctor if you use acetaminophen-containing OTC cold or sleep medications or combination prescription pain medications for chronic or acute pain unrelated to Migraine.
  • Inform your doctor if you routinely consume alcoholic beverages. Consuming three or more drinks a day and with an otherwise safe dose of acetaminophen can lead to liver damage.
  • Take your medications as prescribed and/or as directed on the label. Never hesitate to refer back to the labels and do some quick math just to be sure you're taking a safe amount.
  • Only use as much as needed. Don't take the maximum dose just because you can.
  • Watch out for symptoms of adverse skin reactions: The symptoms to pay attention to include fever and muscle aches, followed by rash and then blistering.Call your doctor and seek medical attention as soon as you notice something is off. The sooner the better.
  • If you're ever in doubt, ask questions. Both your doctor and your pharmacist are great people to turn to with questions or confusion about any of these issues. Having trouble finding the acetaminophen dose on a label? Just ask. Always make sure you give them the full picture of what you're taking so they can give you accurate advice.

For more information about using acetaminophen safely, visit the Know Your Dose Acetaminophen Awareness Coalition website: http://www.knowyourdose.org/.1

Do you have questions about safe use of acetaminophen? Please share them in the comments.


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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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