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Reuters Health Information: Acetaminophen overuse spikes during cold and flu season

Acetaminophen overuse spikes during cold and flu season

Last Updated: 2018-03-29

By Lisa Rapaport

(Reuters Health) - A growing number of people are taking high doses of acetaminophen, and many take so much during cold and flu season that they run the risk of liver and kidney damage, two studies suggest.

Throughout the year, 6.3% of acetaminophen users take more than the maximum recommended daily dose at least one day during weeks when they use the drug, one study of 14,481 U.S. adults found.

During cold and flu season, however, people were 24% more likely to exceed the maximum recommended dose of 4,000 mg at least once a week.

Acetaminophen can ease a fever, but many people may take too much of the painkiller out of a mistaken belief that it will also cure the flu, said Dr. Liffert Vogt, a researcher at the University of Amsterdam Academic Medical Center in the Netherlands who wasn't involved in the study.

In the U.S. study, the proportion of people taking too much acetaminophen wasn't large - 6.5% during cold and flu season compared with 5.3 % at other times of year. But because millions of adults use the drug, the increase during cold and flu season adds up to a large added risk in the general population, the authors note.

"Getting this message out is especially important during cold and flu season, when people may be more likely to treat symptoms with acetaminophen combination products, sometimes without even realizing they contain acetaminophen," lead study author Dr. Saul Shiffman of Pinney Associates and the University of Pittsburg said in a statement.

The problem of acetaminophen overuse isn't limited to the U.S.; a second study examining painkiller use in France from 2006 to 2015 found that country to be the top user of acetaminophen in Europe. France also ranked third for use of mild opioids, researchers found.

During the study period, use of acetaminophen surged 53 percent in France.

Thousand-mg tablets of acetaminophen have been the most commonly used drug among adults there since 2008. While use of these high-dose pills more than doubled during the 10-year study period, use of 500-mg tablets declined by 20%.

Both studies were published in the British Journal of Clinical Pharmacology.

Neither study examined rates of health problems associated with taking too much acetaminophen, nor why usage goes up seasonally or over time. Another limitation of the studies is that researchers couldn't distinguish medically necessary usage from potential substance use problems or accidental overuse.

"This extensive analgesics consumption that we have documented raises the concern of overuse and misuse, as well as addiction to opioids," said the lead author of the French study, Karima Hider-Mlynarz of the French National Agency for Medicines and Health Products Safety in Saint-Denis.

"Even it is prescribed and widespread used, none of the analgesic drugs are harmless and the dose must always be respected," Hider-Mlynarz said by email.


Br J Clin Pharmacol 2018.

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