Child Safety When Taking Over-the-Counter Drugs
OTC Drug Dosing May Be Different Than Adult or a Bad Idea Altogether
Nov 12, 2009
The AARP website Health Tools pages list more than 20 separate types of prescription medications containing acetaminophen, and seven forms of prescription ibuprofen. These ingredients are in many over-the-counter (OTC) drugs available nearly everywhere.
Adults in pain who double up on doses of OTC medications for more pain relief, may suffer the consequences. Symptoms generally occur within 24 hours and can include nausea or vomiting, flushing, heavy perspiration, lack of appetite, and diarrhea. After 24 hours, the initial symptoms may disappear, but then liver damage is imminent. This is exacerbated if aspirin, acetaminophen, or ibuprofen are taken with prescription or street drugs, or with alcohol, and can be fatal. A 17-year old Oklahoma girl died of liver failure in 2003 from a Tylenol overdose for a migraine, four days after ingesting it.
Symptoms and Dangers of Acetaminophen Overdosing
Acetaminophen is the generic for the brand name Tylenol, which exists in multiple OTC products. Generic acetaminophen may be labeled as such, or just as “non-aspirin.” According to the article Tylenol Poisoning at arthritis.emedtv.com, Tylenol is one of the most common causes of poisonings worldwide. The maximum safe Tylenol dosage is 4000 mg for an adult, including acetaminophen from any other sources.
One Extra-strength Tylenol contains 500 mg of acetaminophen, and the recommended dose is two tablets every four to six hours, but should not exceed eight tablets daily. When pain is a factor and instructions haven’t been read, or have been disregarded, taking two tablets every four hours for an entire day would result in an acetaminophen intake of 6000 mg. When it comes to children, standard acetaminophen dosing can be problematic. According to a pediatric study listed on PubMed, “Although children appear to tolerate single, high-dose ingestions well, the literature is replete with reports of significant morbidity and mortality after repeated supra-therapeutic dosing.”
The September 2008 issue of the medical journal The Lancet found that infants dosed with acetaminophen (paracetamol) from one to 12 months of age to reduce fever, were found more likely to develop asthma later on, and also to develop rhinoconjunctivitis and eczema at ages six to seven (The Lancet, Vol. 372 No. 9643 pp 1011-1012).
Symptoms and Dangers of Ibuprofen Overdosing
Ibuprofen treats conditions related to pain, inflammation, fever, and stiffness, some forms of arthritis, and menstrual pains. It is thought to block inflammation by inhibiting prostaglandins. It is sold alone and combined with other medications to treat cold, flu, sinus, and migraine symptoms.
Studies using ibuprofen (in Motrin, Advil, Genpril, Midol, Medipren, Nuprin, PediaProfen, Pamprin IB, Rufen, et. al) in children have shown that it may be more effective than acetaminophen, but that it also has more potential side effects. Dr. Karl E. Miller, M.D., in an article for the American Academy of Family Physicians, says that while both acetaminophen and ibuprofen may be relatively safe and effective for adults, “results cannot be extrapolated to children” (aafp.org, article 20050301, 22.html).
In information listings at one medical reference web site regarding all NSAIDs except ibuprofen, weight gain is never mentioned as a side effect. In the listings regarding ibuprofen, specific mentions state that users listed some or very little weight gain (arthritis.emedtv.com, ibuprofen-and-weight-gain-p2.html), but that all NSAIDs (Non-Steroidal Anti-inflammatory Drugs) may cause congestive heart failure and a side effect of that is weight gain, implicating all NSAIDs. In a strangely suspicious statement at the end of that description, it says “Make sure to contact your healthcare provider if you notice unexplained weight gain or swelling,” and “If the weight gain continues, he/she may also recommend other lifestyle choices or possibly switching to another pain relief medication.”
Prescription Drug Information That Won’t Be Told
The United States undoubtedly owes some of its national prosperity to the pharmaceutical industry. A term the industry uses for any drug that produces more than $1 billion in sales is a “blockbuster.” Less than 30 blockbuster drugs brought in over $52 billion for several of the large pharmaceutical companies back in 2001 (citizen.org, article ID=7416). The figures increase annually so a lot rides on how drugs are advertised, and also depend on what is not mentioned.
The FDA has relaxed certain restrictions on drug companies in response to pressure to fast-track drugs to the market. Many drugs can now be approved for sale with far less pre-testing and the understanding that they will be "tracked" for adverse side effects by the doctors who prescribe them. Since this is hardly a scientific approach, this strategy has kept a low profile to maintain the public trust; and has also resulted in a considerable number of recalls within a few years of release of dangerous drugs, but only after many consumers have suffered injuries and death (coreynahman.com, vioxx_lawsuit.html).
It is clear that with big profits at stake, even adult consumers can expect little quarter to be given by drug manufacturers. This is a hint to go the extra mile to protect infants and children from the many undisclosed side effects even of so-called "safe" FDA-approved drugs. Public Citizen, a government watchdog organization, had long recommended that consumers not use any drug that hadn’t been on the market for at least five years. Two years ago, it raised its recommendation to seven years.
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