How Safe is Paracetamol?

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Paracetamol, Alabukun, Alcohol: A Deadly Combo

Paracetamol, otherwise known as acetaminophen, is one of the most commonly used analgesic/pain reliever in the country. This prescription and over-the-counter (OTC) drug is used by millions of people daily for pain, headache, toothache, fever, and a host of other ailments.

Lamentably, it is one of the most abused and misused drug as most consumers self-medicate with it. It is not uncommon to see an underage person walk into a medicine store to buy paracetamol. Some women crush the tablet, dissolve it in water and give to their children to drink even though the tablet is not recommended for children of a certain age. Some Nigerian men are fond of taking a combination of paracetamol, Alabukun (A Nigerian indigenous analgesic), and chilled beer or hot drink as an energy booster. Some consumers deliberately increase the recommended dosage, ostensibly for faster relief.

Millions of consumers consider paracetamol as a safe cure-all remedy and thus underestimate the danger it poses to their health when used inappropriately or for a prolonged period of time.

A young man in his mid-30s died recently and a post-mortem report attributed the cause of death to sustained liver damage due to his use of paracetamol as a pain killer. His liver was damaged due to toxic levels of paracetamol in his system. Many consumers erroneously believe that because the medicine is recommended by a doctor, dispensed by a pharmacist, cheap or readily available in small shops or supermarkets, they must be very safe. Indeed, when used appropriately, paracetamol is considered safe, but when abused, it could lead to a lot of health complications, and even death.

Okoli: Paracetamol overdose may lead to death

Toxicity from paracetamol has been found to be one of the top causes of acute liver failure in the world. Apart from damaging the liver, paracetamol can also cause kidney failure, cancer, low blood sugar, heart failure, stroke, low blood circulation in the brain, renal failure, loss of brain function, gastrointestinal bleeding, skin and other allergic reactions, etc.

Dr. Stella Okoli, Founder/Group Chief Executive Officer, Emzor Pharmaceutical Industries Limited, affirmed that overdose of paracetamol may lead to death. Okoli also cautioned consumers on the need to avoid taking paracetamol with other substances that contain acetaminophen, such as caffeine drinks, Panadol, etc., as this could lead to overdose on acetaminophen, which could be fatal.

It may be difficult to determine the extent of damage paracetamol abuse is causing consumers in the country due to the paucity of data. When people succumb to certain ailments, their loved ones are usually quick to attribute it to spiritual attack. But it has been established that paracetamol abuse is prevalent in the country and has been causing a lot of damage to the health of consumers.

There have been suggestions that the sale of paracetamol should be regulated as it is done in other climes. In the United Kingdom, legislation introduced in 1998 restricted the size of paracetamol packs to help reduce the incidence of liver toxicity from an overdose. Pharmacies could only sell 32 tablets while other retail outlets were limited to 16 tablets in any one transaction. Pharmacists and retailers thus have a responsibility to ensure consumers are limited to the required quantity in accordance with the law. But that is not the case in Nigeria where an individual, including the underage, can buy an entire carton of paracetamol without any question being asked.

There is need therefore to minimize potential risks of the drug to consumers through intensive consumer education and awareness creation on the safe use of paracetamol. Manufacturers, regulatory authorities, health institutions, and all concerned organizations should embark on a sustainable campaign to enlighten consumers on the danger of paracetamol abuse. It is also important for pharmacists to advise patients about the safe use of paracetamol. What happens in most health institutions in the country is that the pharmacists dispense the drugs based on doctors’ prescription but do little or nothing to caution the patients not to abuse the medicine.

Being a drug that is readily available in retail outlets other than pharmacies, its sale should bring added responsibility to the retailers because of the potential harm to consumers’ health if taken incorrectly. Unfortunately, most retailers place profit above consumers’ health, which is why the consumers are enjoined to be cautious in their use of the drug. Health experts say consumers should read and comply with doctors’ prescription or label warnings and directions for use, as well as avoid prolonged use of the drug in order to safeguard their health.

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