Q:I have a friend who is a retired nurse. She takes Tylenol when she goes out in case she gets a headache. I only take one if I have a headache and it doesn’t go away within an hour or so.
I have told her that too much Tylenol can be bad for you, but she sees no harm in her behaviour. Can you help to convince her? I will show her your reply.
A:One of the risks of being a nurse or doctor is easy access to medications. Pills such as Tylenol are often prescribed as needed so no records are kept of the amounts in stock bottles.
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Taking any type of medication just in case is sometimes an early sign of addiction, because the pill acts as a type of security blanket in the same way as alcoholics have a drink to prepare themselves for an unpleasant task. With this pattern of behaviour, I wonder what else your friend is taking.
Non-prescription painkillers such as Advil (Ibuprofen), Tylenol, (Acetominophen ) or even Aspirin (ASA) are not without risks, even in normal dosages. Tylenol is one of the most frequently taken drugs in North America.
Sometimes it is found combined with other medications. If you have even two or three drinks a day, Tylenol can be dangerous to your liver. Signs that it is affecting your liver are nausea, vomiting, abdominal pain and lack of appetite. The sufferer may take more Tylenol to cure these problems, resulting in a more dangerous situation.
If this happens, there is a specific antidote that can be administered by the doctor called NAC (N-acetylcysteine) that can help protect the liver. Complete liver failure is a potentially fatal condition.
Acetominophen can also affect the kidneys if taken on a regular basis. Studies have shown that there is a marked increase in cases of hypertension (high blood pressure) in women taking this painkiller at doses of 500 milligrams or more on a daily basis.
Kidneys help control blood pressure. NSAIDS such as Advil can also have a damaging affect on the kidneys over the long term.
Many people with chronic pain, such as arthritis sufferers, need some type of pain killing medication on a regular basis, but it would be safer for them to take the pills only three times a week at most to give their livers and kidneys a break.
Check with your doctor before doing this. It is a difficult problem, because choices are limited. It is mainly a question of balancing the risks with the benefits of pain control.
Your friend may wish to see a neurologist to find out the reason for her chronic headaches. It could be migraine or sinusitis or another type of headache for which there are alternative solutions.
Clare Rowson is a retired medical doctor in Belleville, Ont. Contact: health@producer.com.
