This week an advisory committee voted to ban prescription pain medications Vicodin and Percocet, and to lower the amounts of Acetaminophen in products that we can currently purchase over the counter (Tylenol, several cold medicines, aspirin and Nyquil). The advisory committee wants restrictions placed on Acetaminophen-containing products to help prevent a possible severe side effect of the drug – liver toxicity and possible deaths due to overdoses. While the FDA doesn’t have to follow the advisory committee’s suggestions, they typically do.
According to the news released from WebMD:
Billions of doses of acetaminophen are used safely every year. But acetaminophen-related overdoses cause 56,000 emergency room visits, 26,000 hospitalizations, and 458 deaths annually, according to studies done between 1990 and 1998.
For chronic pain patients, Fibromyalgia patients, and ME/CFS patients who frequently suffer from pain, this news is causing some major concern because the advisory committee wants common prescription Acetaminophen containing drugs banned. Some of these include Vicodin, Percocet, Darvocet, & Tylenol with codeine to name just a few that contain both Acetaminophen and hydrocodone. The advisory committee voted 20 to 17 that prescription medications that combine acetaminophen with other medications should be eliminated.
The combination prescription products, which have rapidly increased in use in the last five years, are clearly the biggest cause of the acetaminophen overdose, said Marie Griffin, MD, professor of preventive medicine at Vanderbilt University. But she worried that people will simply turn to plain narcotics, if the combinations are eliminated. “We need a broader answer to chronic pain, because these drugs are being used extensively in the older population,” Griffin said during the meeting. “And I am not sure that practitioners feel like they have many other choices.”
Richard DeNisco, MD, MPH, medical officer at the National Institute of Drug Abuse and a panel member, said that so much acetaminophen is going out to people in hydrocodone/acetaminophen mixes that he is uncertain why there is not more liver damage. Prohibiting these combined products “would rock the system,” he said, but the two products should be prescribed separately, if necessary.
I have taken certain medications, particularly those for Interstitial Cystitis, where I had to have a blood test to check my liver twice a year but all of the years I’ve been on the Acetaminophen containing pain pills none of the doctors have had my liver checked once. In my opinion, I think instead of these drugs being banned, because many of us do need them, physicians should be held more responsible for making sure they are prescribing the medications properly and testing their patients’ liver functions. While there are now a couple of drugs FDA approved for Fibromyalgia, it is much cheaper to get drugs like Vicodin and Percocet than it is to get Cymbalta or Lyrica.
I also think that the FDA should put stronger warning labels on the drugs but it will be a major upset to ban them all completely. What will chronic pain patients do without these? Over the counter pain medications do not work and if they lower the amount of Acetaminophen in OCT drugs, pain patients will probably take several pills at once just to try and get a little relief.
The advisory committee is recommending to the FDA that the daily dosage for adults of acetaminophen should be no more than 650 mg. Currently two tablets of OCT medications contains approximately 1,000 mg. of acetaminophen.
What do you think is going to happen? Do you think the acetaminophen/hydrocodone drugs will be banned? What will be used to replace them or will they just be prescribed separately?