Common drug can be lethal: study

The most common call to Australian poisons centres in the past 10 years related to an everyday pain reliever that most of us have taken without thinking twice.

Yet this medication is responsible for a tidal wave of poisonings and 200 deaths over 10 years.

The surprising revelation that paracetamol is causing widespread and increasing harm was revealed in a study published in the Medical Journal of Australia on Monday.

Lead researcher Dr Rose Cairns, from the University of Sydney, says the study found a 44 per cent increase in the number of Australians who had overdosed on the drug in the past decade.

As a result, she is urging health authorities to insist that packet sizes be reduced.

“In Australia, you can get 20 tablets in supermarkets, and in pharmacies, you can get 100. There are no legal restrictions on how many packets you can buy,” Dr Cairns said.

She said Australia’s lack of regulation on paracetamol was out of step compared to many other countries.

“In the UK, over 20 years ago, they took action on paracetamol because they were seeing a lot of overdoses and increases in deaths,” she said.

As a result, the UK restricted packs to 32 tablets in pharmacies and 16 outside of pharmacies in 1998. This resulted in a long-term reduction in paracetamol poisonings, liver injury and deaths.

In Denmark, paracetamol sales are permitted only to those aged 18 and over.

Dr Cairns explained that the research team analysed data from national hospital admissions, poisons centre calls and coroners’ records to examine poisonings, liver injuries and deaths.

The study found that the annual number of cases of paracetamol poisoning had increased by 44 per cent from 2007-2008 to 2016-2017. In that time, more than 95,000 paracetamol-related hospitalisations were recorded.

Writing in The Conversation, Dr Cairns said that liver injury from paracetamol had doubled over the same period and that paracetamol was the leading cause of acute liver failure in the western world.

She said the likely cause was because people were taking more tablets when they overdosed – either intentionally or accidentally – than in previous years, increasing the risk of liver failure.

“Paracetamol itself is not toxic,” Dr Cairns explained, “but in large amounts it overwhelms the body’s ability to process it safely. This can lead to build-up of a toxic metabolite (or break-down product), which binds to liver cells, causing these cells to die.

“The quantity that constitutes a toxic dose depends on circumstances, including the time period in which the paracetamol is taken, and the person’s weight. But any adult ingesting more than four grams in a day could be at risk.”

Dr Cairns emphasised that paracetamol was safe if used correctly.

“It is just when people take too much for whatever reason we see this toxicity, and it can be really, really harmful.”

She said it was important to be aware of the many brands of products that contained paracetamol, including cold and flu products, to avoid doubling up.

“People should also read the pack and ensure they follow the dosing instructions,” she advised.

Symptoms of paracetamol poisoning included nausea, vomiting and stomach pain.

Are you cautious about your use of paracetamol? Are you aware of the various products that contain the drug?

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Written by Janelle Ward

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