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Panel Recommends Ban on 2 Popular Painkillers

RightinNYC

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http://www.nytimes.com/2009/07/01/health/01fda.html?em

A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver.

The two drugs combine a narcotic with acetaminophen, the ingredient found in popular over-the-counter products like Tylenol and Excedrin. High doses of acetaminophen are a leading cause of liver damage, and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect.

Acetaminophen is combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of its experts. Vicodin and its generic equivalents alone are prescribed more than 100 million times a year in the United States.

Laureen Cassidy, a spokeswoman for Abbott Laboratories, which makes Vicodin, said, “The F.D.A. will make a final determination and Abbott will follow the agency’s guidance.”

The agency is not required to follow the recommendations of its advisory panels, but it usually does.

Wow.

One would think that the immediate result of such a ban would be a spike in the use of Oxy and Hydrocodone.
 
Hey this makes a lot of sense, it's the bull**** filler we've been putting in the pills to deter abuse that's actually failing to deter anyone that leading to all these deaths.
 
Hey this makes a lot of sense, it's the bull**** filler we've been putting in the pills to deter abuse that's actually failing to deter anyone that leading to all these deaths.

There are actual medical reasons for using acetaminophen in conjunction with those drugs other than to deter abuse.
 
There are actual medical reasons for using acetaminophen in conjunction with those drugs other than to deter abuse.

Acetaminophen is something you'd want for a fever not for pain. Take some tylenol the next time you break a bone and see how well it works.
 
This is a wee bit off topic, but anyone who, for whatever reason, is taking large doses of Tylenol or other medications with acetaminophen should be aware that there is some scientific evidence indicating that milk thistle can help protect against acetaminophen's hepatoxic effects.

Milk thistle

Milk thistle (Silybum marianum) has been used for 2,000 years as an herbal remedy for a variety of ailments, particularly liver problems. Several scientific studies suggest that substances in milk thistle (especially a flavonoid called silymarin) protects the liver from toxins, including certain drugs such as acetaminophen (Tylenol), which can cause liver damage in high doses. Silymarin has antioxidant and anti-inflammatory properties, and it may help the liver repair itself by growing new cells.
 
This is a wee bit off topic, but anyone who, for whatever reason, is taking large doses of Tylenol or other medications with acetaminophen should be aware that there is some scientific evidence indicating that milk thistle can help protect against acetaminophen's hepatoxic effects.

Milk thistle

This is actually a really good thing to point out. When I helping contribute to various harm reduction groups that's something that was brought up quite a bit for the opiate users. Acetaminophen is probably one of the most dangerous drugs commonly used, even by not non-recreational users/addicts.
 
Acetaminophen is something you'd want for a fever not for pain. Take some tylenol the next time you break a bone and see how well it works.

Acectominophen (paracetamol) most certainly serves as a pain reliever.

Paracetamol is a widely used over-the-counter analgesic (pain reliever) and antipyretic (fever reducer). It is commonly used for the relief of fever, headaches, and other minor aches and pains, and is a major ingredient in numerous cold and flu remedies. In combination with non-steroidal anti-inflammatory drugs (NSAIDs) and opioid analgesics, paracetamol is used also in the management of more severe pain (such as cancer or postoperative pain).

...

Paracetamol is usually classified along with nonsteroidal antiinflammatory drugs (NSAID), but is not considered one. Like all drugs of this class, its main mechanism of action is the inhibition of cyclooxygenase (COX), an enzyme responsible for the production of prostaglandins, which are important mediators of inflammation, pain and fever. Therefore, all NSAIDs are said to possess anti-inflammatory, analgesic (anti-pain), and antipyretic (anti-fever) properties.

The reason why drugs like Vicodin use it is because it allows for a reduced amount of hydrocodone to be used, thus reducing the negative side effects while maintaining the positive results.
 
Acectominophen (paracetamol) most certainly serves as a pain reliever.



The reason why drugs like Vicodin use it is because it allows for a reduced amount of hydrocodone to be used, thus reducing the negative side effects while maintaining the positive results.

Please show me where I said it had no analgesic qualities.

And your reason for why it's used so often in opiate pain killers does not satisfy me. More people are killed and suffer serious internal injuries as a result of acetaminophen enough in my opinion to warrant taking it out of the drug than leaving it in to save on the cost of producing opiate painkillers. The negative side effects of using acetaminophen are severe and numerous, the benefits of keeping in the medication are really quite minimal by comparison.

And for people taking opiate pain killers that were marred by combining it with acetaminophen, there are ways to remove the acetaminophen very easily and simply using nothing but water.
 
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Acetaminophen is something you'd want for a fever not for pain. Take some tylenol the next time you break a bone and see how well it works.
Acetaminophen and its precursor phenacetin have been used as analgesics since the 1800s. It is an older analgesic than even aspirin.

[ame=http://en.wikipedia.org/wiki/Paracetamol]Paracetamol - Wikipedia, the free encyclopedia[/ame]
 
Acetaminophen and its precursor phenacetin have been used as analgesics since the 1800s. It is an older analgesic than even aspirin.

Paracetamol - Wikipedia, the free encyclopedia

Please show me where I said acetaminophen is some ground breaking new drug.

Oh wait a minute, you can't because I never said that. And the fact that it's been using _only since_ the 1800s really doesn't say anything about it's safety.

Have any of you guys studied pharmacology?
 
Acetaminophen is classified as an analgesic and antipyretic. It boosts the efficacy of certain opioid analgesics. You should always pay very close attention to the ingredients in any medication you take, whether OTC or prescribed by a physician. It's called taking responsibility for your own health. You can always call and talk to a pharmacist if you have questions. In fact, I always go to them before I go to any doctor if I have a question about a medication.

I think the government is making a big mistake. How ever did any of us manage to survive this long without the government to step in and decide what's safe for everyone? :roll:
 
Right here:

It's more effective at reducing fevers than it is for pain. Next time you suffer a serious injury take some tylenol and let me know how much better you feel and how completely manageable the pain is. It's really meant for minor pain, opiates are not meant for minor pain, so I'm not really seeing why you guys seem to think it's so necessary. You know opiates are addictive too, if a person can get a good source for it and dont know how to remove the acetaminophen then they can really do some serious damage to their liver over time.
 
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Acetaminophen is classified as an analgesic and antipyretic. It boosts the efficacy of certain opioid analgesics. You should always pay very close attention to the ingredients in any medication you take, whether OTC or prescribed by a physician. It's called taking responsibility for your own health. You can always call and talk to a pharmacist if you have questions. In fact, I always go to them before I go to any doctor if I have a question about a medication.

I think the government is making a big mistake. How ever did any of us manage to survive this long without the government to step in and decide what's safe for everyone? :roll:

Or just extract the acetaminophen out of it.
 
It's more effective at reducing fevers than it is for pain. Next time you suffer a serious injury take some tylenol and let me know how much better you feel and how completely manageable the pain is.

Acetaminophen alone isn't marketed for the treatment of severe pain.
 
Please show me where I said it had no analgesic qualities.

See celticlord v. you, supra.

And your reason for why it's used so often in opiate pain killers does not satisfy me. More people are killed and suffer serious internal injuries as a result of acetaminophen enough in my opinion to warrant taking it out of the drug than leaving it in to save on the cost of producing opiate painkillers. The negative side effects of using acetaminophen are severe and numerous, the benefits of keeping in the medication are really quite minimal by comparison.

Is that your professional medical opinion?

And for people taking opiate pain killers that were marred by combining it with acetaminophen, there are ways to remove the acetaminophen very easily and simply using nothing but water.

If that's the goal, I know an even easier way - Ask your doctor for hydrocodone or oxy instead of vicodin or percocet.

Have any of you guys studied pharmacology?

Have you?

It's more effective at reducing fevers than it is for pain. Next time you suffer a serious injury take some tylenol and let me know how much better you feel and how completely manageable the pain is. It's really meant for minor pain, opiates are not meant for minor pain, so I'm not really seeing why you guys seem to think it's so necessary.

You don't seem to understand how it's designed to work in conjunction with the opiates.

You know opiates are addictive too, if a person can get a good source for it and dont know how to remove the acetaminophen then they can really do some serious damage to their liver over time.

Right, as opposed to the opiates themselves, which have absolutely no side effects or risk of damage.
 
Acetaminophen alone isn't marketed for the treatment of severe pain.

Jesus christ, what is it with you people. Where did I say it was marketed for severe pain? You guys seriously know jack **** about pharmacology and it's almost like you want to argue even if you're not really arguing about anything at all.
 
Jesus christ, what is it with you people. Where did I say it was marketed for severe pain? You guys seriously know jack **** about pharmacology and it's almost like you want to argue even if you're not really arguing about anything at all.

Between pharmacology, economics and the constitution, is there anything that you aren't an expert on?
 
Or just extract the acetaminophen out of it.

That is an option. However, as I mentioned, acetaminophen boosts the efficacy of opioid analgesics. If you're taking the opioid analgesic alone and it's not working, what do you think the next step is? People will end up adding OTC meds such as acetaminophen or ibuprofen themselves or they will call their doctor and ask for something stronger. Depending on how the stronger medication is excreted from the body, you may be looking at liver or renal damage. This recommendation isn't going to change that.
 
It's more effective at reducing fevers than it is for pain. Next time you suffer a serious injury take some tylenol and let me know how much better you feel and how completely manageable the pain is. It's really meant for minor pain, opiates are not meant for minor pain, so I'm not really seeing why you guys seem to think it's so necessary. You know opiates are addictive too, if a person can get a good source for it and dont know how to remove the acetaminophen then they can really do some serious damage to their liver over time.
In your enthusiasm for being contentious and argumentative, you are overlooking the synergestic effects observed when opiates such as hydrocodone are mixed with acetaminophen (Vicodin). Taken together they are more effective at lower doses than hydrocodone alone.
 
Is that your professional medical opinion?

Yeah, when I prescribe opiate pain killers I always make it either contains ibuprofen if they need additional short term help for pain management or no other analgesic. Acetaminophen only has a minimal role the treatments that I prescribe.

Have you?

Yes actually, you?

You don't seem to understand how it's designed to work in conjunction with the opiates.

I do understand, I just do not feel the small benefits are necessarily worth the added risk in the event that the medication IS abused.

Right, as opposed to the opiates themselves, which have absolutely no side effects or risk of damage.

They are far safer than acetaminophen.
 
In your enthusiasm for being contentious and argumentative, you are overlooking the synergestic effects observed when opiates such as hydrocodone are mixed with acetaminophen (Vicodin). Taken together they are more effective at lower doses than hydrocodone alone.

Hey guys it's a really dangerous drug that kills thousands every year but lets go ahead and give it praise because it's such an awesome drug for very minor aches and pains.

Between pharmacology, economics and the constitution, is there anything that you aren't an expert on?

No reason to be jealous new york
 
That is an option. However, as I mentioned, acetaminophen boosts the efficacy of opioid analgesics. If you're taking the opioid analgesic alone and it's not working, what do you think the next step is? People will end up adding OTC meds such as acetaminophen or ibuprofen themselves or they will call their doctor and ask for something stronger.

What, are you crazy? You think people would actually mix drugs without their doctor's advice in order to achieve a desired feeling?

Pshhh, everyone knows that nobody would ever dream of mixing vicodin or percocet with other drugs such as alcohol or marijuana in order to feel a particular way. That's just crazy talk. :lol:
 
It would be interesting to see the make up of the whole panel and find out if any have any ties to drug companies that might benefit from such a ban. The negative effects of the over use of are well documented and have been know for a very long time. I'm curious why now and who has to gain that is in a position to effect the outcome,
An out right ban may not come as came out in this story.

FDA Advisers Urge Smaller Doses of Acetaminophen

FDA Advisers Urge Smaller Doses of Acetaminophen - US News and World Report

U.S. health advisers recommended Tuesday to lower the maximum dose of over-the-counter acetaminophen -- the key ingredient in Tylenol, Excedrin and many other pain-killing medications.

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Having been prescribed most if not all of the drugs mentioned I have to say that the most dangerous I have seen is oxycodone I had to stop using it for third degree burns because it made it had to impossible to function and driving was out of the question. I can see how people can get hooked on it.

As for Acetaminophen when used as directed by the label it seems safe enough.
 
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