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Top Pain Pills May Be Banned
July 7, 2009

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News Summary

A federal advisory panel has recommended that the U.S. Food and Drug Administration (FDA) ban the painkillers Percocet and Vicodin because of their damaging effects on the liver, the New York Times reported on July 1.

The two popular painkillers combine acetaminophen with a narcotic. High doses of acetaminophen are believed to cause liver damage. The panel noted that, over time, people who take Percocet or Vicodin need to take higher and higher doses of the drugs to receive the same effect.

At least seven other prescription drugs that combined acetaminophen with narcotics also would be banned if the FDA follows the panel's recommendations.

The FDA asked the advisory panel to meet to address problems arising from the high demand for acetaminophen, which can be found in over-the-counter medicines such as Tylenol and Excedrin. In 2005, Americans bought 28 billion doses of products containing acetaminophen.

Although the medicine treats headaches and relieves fevers, liver damage can be caused in some people even when taking the recommended doses.  More than 400 Americans die and 42,000 are hospitalized each year because of acetaminophen overdoses.

The committee also recommended that the FDA reduce the highest allowed dose of the ingredient in over-the-counter products such as Tylenol from 500 milligrams to 325 milligrams and to reduce the maximum daily dosage to no more than 4,000 milligrams.

Johnson & Johnson, the makers of Tylenol, said it "strongly disagrees" with the panel's recommendations. They said restricting the drugs would "lead to more serious adverse events as consumers shift to other over-the-counter products," such as aspirin and Advil.

"The FDA will make a final determination and Abbott will follow the agency's guidance," said Laureen Cassidy, an Abbott Laboratories' spokesperson. Abbott is the maker of Vicodin.

The panel also recommended limiting over-the-counter children's medicines containing acetaminophen to a single formulation to prevent doctors and parents from confusing the liquid and solid concentrations. 

COMMENTS ON THIS ARTICLE:

Posted by Tegan Mc Donough on 07 Jul 09 10:58 AM EDT
I stopped taking Acetaminophen, in the early 80's, when I discovered how many people die from taking it. If you read the Label, and are breathing, you won't take it either.

Posted by me on 07 Jul 09 10:58 AM EDT
am i the only one that thinks this is INSANE? how could you even hint at banning such essential pain meds as percocet and vicodin? add more warnings yes. lower the daily dose of acetaminophen to 3 grams per day, sure. EDUCATE PEOPLE, definitely! but banning such essential pain meds? are they crazy, seriously. should we all just suffer in pain for the rest of our lives? what will THE PANEL do next time they have surgery? just suffer through the post op? people need to wake up. i can understand taking a look at combination COLD remedies but pain meds too? this is the most ridiculous thing i've heard in a LONG time.

Posted by Joe on 07 Jul 09 11:08 AM EDT
Acetaminophen is like many drugs on the market, take too much and it can kill you. So don't take too much. Read the label and know what you are taking and with your doctors help, you should be fine. Acetaminophen is extremely safe when taken as directed but there are too many people out there that don't read labels and think everything over the counter is without any kind of risk and they can take unlimited amounts of anything. That is not the case. Read the labels and know what you are taking.

Posted by JAL on 07 Jul 09 11:10 AM EDT
"Johnson & Johnson, the makers of Tylenol, said it "strongly disagrees" with the panel's recommendations. They said restricting the drugs would "lead to more serious adverse events as consumers shift to other over-the-counter products," such as aspirin and Advil" Darn, people's safety interferes with their sales...but then again that is the way it has always been with pharmaceutical companies.

Posted by GMS on 07 Jul 09 11:10 AM EDT
So what is the replacement medication?

Posted by me on 07 Jul 09 11:14 AM EDT
there is no replacement medication GMS. the replacement is we all just SUFFER endlessly or move to canada or something, or maybe this is just their way of making the case to legalize marijuana.

Posted by John French on 07 Jul 09 11:23 AM EDT
This proposal is to ban drugs containing acetaminophen. It is NOT to ban codeine containing drugs. Chill :-)

Posted by me too on 07 Jul 09 11:28 AM EDT
Seriously, has anyone on this panel ever had a kidney stone? I mean, all banning vicodin is going to do is send everyone running to the ER for a morphine drip instead of treating a condition like that at home. Talk about over-taxing our health care system.

Posted by Dr. Mel Pohl on 07 Jul 09 11:48 AM EDT
Just to clarify- they are proposing to eliminate COMBINATION preparations of hydrocodone and acetaminophen (Vicodin) and oxycodone + acetaminophen (Percocet) -there are other forms of these two drugs without additives- which could be combined with otc acet. if one desired - so if this goes, noone will be compelled to needlessly suffer, simply not accidently overdose on acet.

Posted by Bernard on 07 Jul 09 12:16 PM EDT
We need improved actions, on addiction prevention. We've leaned the mis-use/abuse of substances relates more to individuals inability to cope with life problems. More prevention therapy may be effective in lowing High risk behaviors in taking medications.Addiction is not the problem of the pharmaceutical companies.

Posted by Diane Kopperman on 07 Jul 09 12:35 PM EDT
Once again non-medical people are making decisions about pain management with NO experience with having to cope of chronic pain. I don't take either of these pain medications for my situation, but I understand that they work better for others than my pain regimen. Doctors should prescribe with side effects in mind and monitor for liver stress as they do for depakote. Patients should take medications as prescribed and not supplement them with OTC acetimenophen. Decisions like these are what encourage people to turn to smoking pot to relieve pain, a substance that has far worse social and behavioral side effects than vicoden. It is already hard enough to get sufficient pain medication for four crushed disks, two crushed vertebrae, and six pins in my back PLUS being treated like an addict at the doctor's office without more over-reactive government interference into medical issues.

Posted by fred carmack on 07 Jul 09 02:26 PM EDT
As John French said above CHILL, percodan is the same medicine as percocet. It is just codeine with aspirin instead of acetaminophen. nobody is recommending they ban codeine. I'm sure they can manufacture pills without either if they choose.

Posted by fred carmack on 07 Jul 09 02:32 PM EDT
Another thought, It would be hard to pass a kidney stone without painkillers, but it is still preferable to having a liver transplant which overdoses of acetaminophenh can lead to.

Posted by Steven on 07 Jul 09 02:35 PM EDT
The only Meds left for pain that do not have cetaminophen in it is Oxycontin and Roxy? However they are saying the Oxy and Roxy are killing people! What is next? Drink to much water can kill you! Last again in this great country a few bad will control the major good! I can see now the makers of Oxy Purdue Pharma in a back boardroom tossing hats in the air! I'm sure they are behind this!

Posted by me on 07 Jul 09 03:48 PM EDT
hey Fred, ALCOHOL causes more liver problems then acetaminophen, maybe they should ban that, know what i mean? :)

Posted by me on 07 Jul 09 03:55 PM EDT
the problem with taking JUST codeine or hydrocodone by itself is that it does not work as well for pain management when taken alone. that's the reason they combine these and have been doing so effectively for many many years. hydrocodone and acetaminophen work synergistically so it's not as simple as using just codeine or even codeine combined with ibuprofen or aspirin.

Posted by me on 07 Jul 09 04:23 PM EDT
Just what we need, ban pain relief and ignore the ravages of alcohol on the liver. Maybe the democratic party should change it's name to the Nazi Party.

Posted by Julian on 07 Jul 09 07:04 PM EDT
WOW! What part of 400 deaths and 42,000 hospitalizations don't you get? They are not banning acetaminophen. You can take hydrocodone and take a Tylenol pill with it. The problem is for people who become addicted and develop tolerance taking more and more Vicodin. I work with health professionals that have ready access and take Vicodin all day, reaching in their pockets for a "vicodin mint". This is a real problem people. Not a drug company or democratic party, or goverment "telling us what to do" issue.

Posted by Brinna Nanda on 08 Jul 09 02:22 AM EDT
I find it quite amusing that everyone is up in arms about banning Vicodin and Percocet which, when taken with OTC tylenol can lead to liver failure and death because "what if someone needs it" or "non-medical people shouldn't be making medical decisions". Don't you all see that the same argument can be made against the arbitrary prohibition of cannabis (which, by the way, kills no one), and which, added to opiates has the same synergistic analgesic affect as has the addition of acetaminophen. All I can say is, that soon we will run out of so called "safe" pharmaceuticals, and have to resort, once again, to cannabis. And that will suit me just fine.

Posted by me too on 08 Jul 09 11:05 AM EDT
Hydrocodone is not sold as a stand-alone drug, only in combination, so you cannot take that with a tylenol and get the same medicine. I agree the drug is over-used and abused by some people, but it's unfair to people like me who ended up in an ER with a kidney stone to have to do without and be in pain for a couple of weeks just because some idiots don't care to heed the warnings. They gave me really strong instructions about NO TYLENOL with that medicine and made sure I understood that before I left. Also I was given a limited amount of the drug and frankly, I didn't like the foggy feeling it gave me, so I used it sparingly only when I was dying in pain that OTC Advil wouldn't knock out.

Posted by Jim Mulcahy on 13 Jul 09 09:12 AM EDT
For my part, Tylenol has become a very dangerous drug in homes where suicide has been attempted through using them to overdose. Often the person attempting ends up with liver damage whereas with the previous generations where people used aspirin there were little permantent side effects. It would be good if some of these were banned.

Posted by mobo on 13 Jul 09 09:40 AM EDT
When I was suffering with a herniated disk in my lower back I thanked God for Vicodin. I can't imagine how I would have made it through my worst days without it. Several years ago my daughter burned her cornea with a curling iron that slipped. The pain was intolerable. The eye doctor told her to take Tylenol for the pain - what a joke! Our family doc prescribed a calculated regimen of vicodin to get her through the night - I worked perfectly and her eye was recovered 99% by the next morning with zero pain. Clinician screening, EDUCATION, follow up and management is needed not FDA banning. The majority of people use these meds as prescribed for the right reason - this is insane!

Posted by John on 13 Jul 09 09:53 AM EDT
One of the problems with these drugs is that they are class 3 and should be class two. The difference is that class two require a written presciption, can't be called on, and refills can't be written for class two. Dr.s, in my opinion write for these drugs way too easily. I ha ve told many Dr.s that I'm a recovering addict and they still ask me if i want a pain script as I leave!! Also they are already available with 325mg as a opposed to 500-Dr.s just don't write them that way, and BTW these drugs are hydrocodone not codeine.

Posted by Bluesman on 13 Jul 09 11:29 AM EDT
People use otc acetaminophen frequently, habitually and even daily for aches & pains. Then they drink socially or abusively binge alcohol without realizing the added danger to their liver. Codeine and codeine compounds will remain vailable for pain management. More people know not to drink with codeine, but because it is viewed as harmless, fewer heed that warning with acetominophen.

Posted by David on 13 Jul 09 12:13 PM EDT
This government's intrusion into healthcare is quite disturbing and the idea of banning such important medication absurd. I fear it is just the beginning.

Posted by qkruse on 13 Jul 09 03:43 PM EDT
I do not believe it! As a Hepatitis C survivor, I have liver studies done quite frequently - three or four times a year - and I often times take as much as 1500 mg of acetaminophen during the course of the day with it registering any adverse effects on my cirrhotic liver..... I have chronic pain, and I had to stop taking aspirin even though I think that it works better than acetaminophen....someone said that codeine and hydrocodone are not as effective as when combined with acetaminophen and that is my experience as well.

Posted by Barry Schecter on 13 Jul 09 08:04 PM EDT
Isn't it ironic that the legal drugs in America kill more people annually than the illegal ones. Tobacco is good for 440,000 death, and alcohol has its fair share. I was never a fan of acetaminophen, and frankly can;t figure out why it is mixed with opiates, which are less dangerous to all body parts.

Posted by Dot on 13 Jul 09 09:37 PM EDT
Hey Bluesman - I want to get the name(s) of your doctor(s). My 81 yr old mother, in Minnesota, can't get her physicians to prescribe anything for what has become a chronic pain condition. She has never had a history of abusing any drug. Similarly, she once or maybe twice a month (since my dad died 5 yrs ago)could use 2.5 mg Valium to sleep. Can't get that either in Minnesota. The system has become utterly absurd and dysfunctional.

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