The Same Pain Reliever Can Hide in Two Medicines

The FDA says over 600 prescription and nonprescription medicines contain acetaminophen. It advises reading the Drug Facts label before using two or more products at once, and not taking a prescription and an OTC medicine with acetaminophen unless a health care professional advises it. Not sure? Ask a pharmacist.

The FDA gives a familiar example: you have been taking a cough and flu medicine every few hours, then a headache hits late in the day and you reach for acetaminophen tablets. That is where the overlap happens. The agency says acetaminophen is a common ingredient in cold, cough and flu medicines, and 7 in 10 people use nonprescription medicines for those symptoms. It is also used in many prescription pain medicines combined with codeine, oxycodone or hydrocodone.

Taken carefully and correctly, the FDA says, these medicines can be safe and effective. But taking too much acetaminophen can lead to overdose and severe liver damage. The agency notes that symptoms of an overdose may take several days to appear and can look like a cold or flu at first, and some people have no symptoms at all.

Reading the label takes a little care. The FDA says the word acetaminophen is not always spelled out on a prescription container, and abbreviations such as APAP, Acetaminoph, Acetaminop, Acetamin and Acetam may be used instead. The agency suggests telling your pharmacist about every medicine and supplement you take, and talking with your health care professional if you have a history of liver disease, drink three or more alcoholic beverages a day, or still have pain and fever after treatment.