Painkiller liver failure/permanent kidney damage/cancer warning

[Guest guest]

Painkiller liver failure warning

 

Scientists are warning about the risks posed by paracetamol after it emerged

the painkiller had become the leading cause of liver failure in the US.

 

The annual proportion of cases caused by paracetamol - known in the US as

acetaminophen - had risen from 28% in 1998 to 51% in 2003, researchers said.

The US team found just 20 pills a day - the recommended maximum is eight - was

enough to kill, New Scientist reported. Experts said restrictions on sales

had helped cut the number of UK cases. Since 1998 in the UK, pharmacies have

been advised not to sell more than one pack of 32 paracetamol tablets to any

individual.

 

Efforts to limit over-the-counter packaging size and to restrict

prescription... may be necessary

Dr Anne Larson, report co-author

 

 

Other retailers are limited to 16, down from 24. The US Acute Liver

Failure Study Group, involving researchers from a host of US universities,

analysed data on 662 patients treated for acute liver failure between 1998 and

2003. Among the 275 painkiller-related cases, 48% were unintentional, 44%

were attempted suicide, with the rest being unknown. Over a quarter of the cases

resulted in death. Those who had not meant to overdose tended to be taking

several products containing the drug. The investigators found as little as

10g - the equivalent of 20 pills - could cause liver failure. Education

Dr Anne Larson, co-author of the report, which first appeared in the Hepatology

journal, said there needed to be more education for patients, doctors and

pharmacies about the risk the painkiller posed. And she also called for

tighter restrictions in the US. " Efforts to limit over-the-counter

packaging size and to restrict prescription of

acetaminophen may be necessary to reduce the incidence of this increasingly

recognised but preventable cause of liver failure. " John O'Grady, of the

Institute of Liver Studies, at London's King's College Hospital, said since the

restrictions had been in place in the UK, there had been a 30% reduction in

hospital admissions for liver failure related to the drug. He added the

warnings should be considered in the context of the number of people using the

painkiller - over 500m tablets are sold each year in the UK. He said:

" Educational initiatives to highlight the range of preparations containing

paracetamol, together with advice on maximum daily dosing, have potential

benefits, especially with respect to unintentional overdosing. "

 

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/4507562.stm

 

Published: 2005/12/08 00:22:43 GMT

 

© BBC MMVI

 

Painkillers 'cause kidney damage'

 

Taking too many painkillers can damage some people's kidneys permanently,

scientists claim.

 

Overuse was defined as taking two doses of full strength aspirin or extra

strong paracetamol every day. The risk only affects people who are

susceptible - most people, including cardiovascular patients taking small doses

of aspirin - are not at risk. But doctors told the American Society of

Nephrology they had no way of spotting the few who are at risk.

There is some anxiety that if large doses can cause disease in

many subjects, lower doses may cause it in a few subjects

National Kidney Research Fund spokeswoman

 

 

The researchers found that heavy use of aspirin or paracetamol - defined as

300 grams a year - was linked to a condition known as small, indented and

calcified kidneys (SICK).

 

The condition was detected in patients with irreversible kidney failure by

carrying out computed tomography (CT) scans. Changes in the kidneys

Over 200 patients treated for kidney failure across the US were scanned for SICK

and asked about their use of painkillers. Seven per cent were found to have

SICK, and a third of those patients had overused analgesics. Scientists from

the National Analgesic Nephropathy Study said: " We conclude that heavy use of

analgesics at least nine years prior to the development of irreversible kidney

failure is associated with the anatomic changes of small, indented and calcified

kidneys. " Dr Vardaman Buckalew, a kidney specialist at Wake Forest

University Baptist Medical Center in North Carolina said: " If a patient does

have SICK, there is an increased likelihood of analgesic abuse. " He added:

" We think just some individuals are susceptible, But there is no way yet to

figure out which individuals are susceptible and

which aren't. " A spokeswoman for the National Kidney Research Fund told

BBC News Online: " Large doses of some analgesics, including aspirin and

paracetamol, may depress kidney function in patients who already have kidney

disease. She added: " Extremely large doses of aspirin and paracetamol can

cause acute renal failure, usually when taken as a suicide attempt. " And

there is some anxiety that if large doses can cause disease in many subjects,

lower doses may cause it in a few subjects. " The advice is don't take

analgesics unless you really need them, take single drugs such as aspirin and

paracetamol, carefully study the instructions - and if you have any kidney

disease, seek medical advice before taking analgesics. "

Story from BBC NEWS:

http://news.bbc.co.uk/go/pr/fr/-/1/hi/health/3271191.stm

 

Published: 2003/11/23 00:50:25 GMT

 

© BBC MMVI

 

 

Friday, 10 September, 1999, 14:11 GMT 15:11 UK Regular painkiller use linked

to cancer

 

People who regularly take higher doses of painkillers like aspirin, paracetamol

and ibuprofen are raising their risk of kidney cancer, according to research.

 

But scientists say that no-risk low doses of aspirin and other drugs are

enough to protect against heart attacks, colorectal cancer, and Alzheimer's

disease. The study, published in the British Journal of Cancer, found that

regular use of all the major types of over-the-counter painkillers could raise

the chance of developing renal cell carcinoma, which accounts for the vast

majority of kidney cancer cases. Researchers quizzed more than 1,000 renal

cell carcinoma sufferers on their painkiller usage before they were diagnosed.

On average, those taking more than 20g of painkillers a week were found to more

than double the risk. Even those taking only two pills a day showed a marked

increase.

 

When broken down into drug types, phenacetin and acetaminophen (Paracetamol)

provided the highest risks, followed by aspirin and non-steroidal

anti-inflammatories (NSAIDs) such as ibrubrofen.

 

NSAIDs are also taken by sufferers of bowel conditions such as Crohn's

Disease, and as a preventive measure against Alzheimer's Disease. Low doses

did not raise risk However, those who were taking 325mg - one regular

strength pill - of aspirin a day exclusively to protect their hearts showed no

signs of increased risk regardless of how long they had been taking the drug.

The report said: " Given that there is no evidence that ingestion of a regular

strength aspirin a day even for as long as 10 years leads to any increased risk

of renal cell carcinoma, we would recommend that dosage or less for preventive

health purposes. " The overall risk of renal cell cancer remains small in

comparison to that of other major diseases. Professor Peter Selby, director

of clinical studies at the Imperial Cancer Research Fund, said that the research

added to the debate on cancer and analgesics - but did not represent the last

word. He said: " The messages overall are

still mixed, although this does add weight to the theory that there is a small

risk connected with taking a lot of analgesics over a long period. " He

reassured those taking lower doses of aspirin and NSAIDs to prevent heart

disease and colorectal cancer that there was no evidence of potential harm, and

urged them to continue. Only six per 100,000 people are expected to develop

the condition compared to 204, 44, and 95 per 100,000 for fatal heart disease,

colorectal cancer and Alzheimer's respectively. Renal cell carcinoma

accounts for approximately 2% of all cancers diagnosed in the UK, although it is

difficult to treat, with a cure rate of about a third. New evidence

released this week showed that daily aspirin can reduce the risk of stroke in

women - although high doses were found to actually increase the risk. Taking

more than 15 aspirins a week raised the chance of haemmorhagic stroke, caused by

a burst blood vessel in the brain, although lower

doses reduced the risk of ischaemic stroke, caused when a blood clot blocks a

major vessel.

http://news.bbc.co.uk/1/hi/health/443250.stm

 

 

 

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