Navigation Links
If 2 Painkillers Are Banned, What Next?
Date:7/2/2009

Other options, available and in the pipeline, could plug a Percocet-Vicodin gap, experts say,,

THURSDAY, July 2 (HealthDay News) -- Banning the popular painkillers Percocet and Vicodin, which a U.S. health advisory panel has urged, would not be as drastic as it sounds, some medical experts contend.

The reason, they say, is that other options are available.

A U.S. Food and Drug Administration advisory panel made its recommendation Tuesday. It followed the release in May of an FDA report that found that many consumers aren't aware that severe liver damage, and even death, can result from overuse of acetaminophen, which is easier on the stomach than such painkillers as aspirin and ibuprofen.

Vicodin and Percocet combine acetaminophen with an opiate narcotic in one pill. Vicodin contains the narcotic hydrocodone, and Percocet contains oxycodone. Both drugs are prescribed to treat moderate to severe pain.

But acetaminophen is the active ingredient in such popular over-the-counter pain relievers as Tylenol and Excedrin. And consumers may also not know that acetaminophen is present in many other over-the-counter products, including remedies for colds, headaches and fevers, making it possible to exceed the recommended acetaminophen dose.

And that's what's prompting the FDA's concern.

"It really makes sense to do what the panel is suggesting," said Dr. Scott Fishman, chief of the pain medicine division and a professor of anesthesiology at the University of California, Davis, and president of the American Pain Foundation. "The key is that the public needs to understand that they [the FDA] are not voting to ban the drugs [contained in the pill: the opiate and acetaminophen]. The drugs are fine. It's the combination of the drugs in one pill. Each drug has its own problems but, used separately, can be used safely."

Narcotic painkillers such as hydrocodone and oxycodone run the risk of being abused. "We want to get tighter control," Fishman said.

Using two pills instead of one, if needed, would enable physicians to better fine-tune the amount of each drug that their patients would be getting, reducing the risk of an overdose of acetaminophen. An estimated 42,000 Americans are treated in hospitals each year for acetaminophen overdoses, half of which are accidental.

"I agree in theory with what they [the FDA advisers] are doing because ... even though experts say 4,000 milligrams [of acetaminophen] is a toxic dose, some people believe as little as 2,000 can cause liver problems," said Dr. Joseph Shurman, chairman of pain management at Scripps Memorial Hospital in La Jolla, Calif.

And some people can achieve pain relief from just one of the components in Percocet, he explained.

Oxycodone alone is "probably just as effective for pain," Shurman said. "Tylenol [acetaminophen] theoretically is for pain and fever, but some people question if it has an anti-inflammatory effect. We're not sure of the exact mechanism."

Currently there is no pill that contains hydrocodone alone, but Shurman said that a slow-release version is close to arriving on the market.

Patients and doctors do need to guard against using too much of either the narcotic or the acetaminophen if only one is being taken at a time, Shurman said.

But an even bigger concern, he said, is use of over-the-counter acetaminophen products, of which Tylenol and Excedrin are among the most popular.

"People can walk into [a store] and buy a bottle of Tylenol and take 10 pills of 500 milligrams each so it's over the toxic level," Shurman said. "We know that a significant number of patients don't follow doctor's directions, especially if they're in pain."

The FDA panel called for lowering the recommended maximum daily dose of nonprescription acetaminophen, which is currently 4 grams -- equal to eight 500-milligram pills of a drug such as Extra Strength Tylenol. The panel was not asked to recommend another maximum daily dose.

The panel also voted to limit the maximum single dose of acetaminophen to 650 milligrams (two pills of 325 milligrams each). The current single dose of Extra Strength Tylenol, for instance, is 1,000 milligrams (two 500-milligram pills). The 1,000-milligram dose should be available only by prescription, the panel said.

The FDA is not obligated to follow the recommendations of its advisory panels, but it typically does so, and Fishman predicted it would in this case as well.

"While it's very convenient to have them in one pill, safety trumps convenience," Fishman said.

Dr. Sandra L. Kweder, deputy director of the FDA's Office of New Drugs at the Center for Drug Evaluation and Research, gave a strong hint Tuesday of what the agency might do with the advisory panel's recommendations.

"I think the top recommendation of this committee was that the agency needs to do something to address and decrease the usual dose of acetaminophen, both for over-the-counter products and also prescription combination products," Kweder said during a press conference.

She added, "There was a clear message that there is a high likelihood of overdose from prescription narcotic/acetaminophen combination products. If we don't eliminate these combination products, we should certainly at least lower the usual acetaminophen dose patients receive in those prescription combination products."

At the very least the FDA should require new warning labels on these prescription combinations that alert patients to the potential of liver damage if they take too much acetaminophen, she said.

More information

The U.S. National Library of Medicine has more on acetaminophen.



SOURCES: Joseph Shurman, M.D., chairman of pain management, Scripps Memorial Hospital, La Jolla, Calif.; Scott Fishman, M.D., chief, division of pain medicine, professor, anesthesiology, University of California, Davis, and president and chairman, American Pain Foundation


'/>"/>
Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Why dont painkillers work for people with fibromyalgia?
2. Antidepressants and painkillers - a dangerous combination
3. Morphine Painkillers Wont Impair Driving
4. Acupuncture Cuts Need for Post-Op Painkillers
5. Vioxx Settlement Puts Painkillers Back in the Spotlight
6. Minorities Less Likely to Get Powerful Painkillers in ER
7. NSAIDs: Painkillers, inflammation inhibitors, anti-cancer drugs and new de-methylating agents
8. Painkillers Boost Muscle Mass Among Weight-Training Elderly
9. Study shows doctors offices can help stem abuse of Oxycontin, other narcotic painkillers
10. Common painkillers lower levels of prostate cancer biomarker
11. Study Sheds Light on Painkillers Heart Risk
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
If 2 Painkillers Are Banned, What Next?
(Date:5/5/2016)... ... May 05, 2016 , ... In the midst of making plans ... most important arrangement — planning a safe way of getting home after the festivities. ... Unfortunately, these celebrations often lead to drunk drivers on the roads who become involved ...
(Date:5/5/2016)... , ... May 05, 2016 , ... Is the part ... Mother’s Day just a few days away, it’s a good opportunity to raise awareness ... to the American Academy of Dermatology, 40% of women experience hair loss or ‘thinning’ ...
(Date:5/5/2016)... ... May 05, 2016 , ... ... for blood and service orders. Blood suppliers and their hospitals use BloodHub ... “BloodHub serves 13,000 active users across 2,100 hospitals who use our platform to ...
(Date:5/5/2016)... Wisconsin (PRWEB) , ... May 05, 2016 , ... ... proud to announce that Dr. Julie Lombardo, PT, DPT, MA, OCS, WCS, has ... of the WPTA Private Practice Award. The WPTA Private Practice Award is awarded ...
(Date:5/4/2016)... ... May 05, 2016 , ... The talus is the part ankle ... falls, or traffic accidents can cause the talus bone to be fractured, and a ... In a first-of-its-kind procedure using 3D printing technology, internationally renowned orthopedic surgeon Dr. ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... CITY, Mo. , May 3, 2016 /PRNewswire/ ... Kansas Medical Center,s Institute for Advancing Medical Innovation ... and commercialize new drugs, diagnostics and medical devices. ... provides BioNovus Innovations with rights to license, develop ... "This partnership represents ...
(Date:5/3/2016)... 2016  Axiogenesis has acquired a major investment from Sino-German High-Tech Fund to further expand product development, strengthen its ... http://photos.prnewswire.com/prnh/20160503/362921 ... ... ... ...
(Date:5/3/2016)... 2016 ACME Markets, ... Delaware County Councilman Dave White ... all ACME pharmacies across Delaware ... and Prevention (CDC), naloxone has saved 26,463 lives nationwide over the ... Delaware County were authorized to administer naloxone to ...
Breaking Medicine Technology: