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FDA Warns About Vicodin and Percocet

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FDA advisers vote to take Vicodin, Percocet off market

(CNN) -- A government advisory panel voted Tuesday to recommend eliminating prescription drugs that combine acetaminophen with narcotics -- such as Vicodin and Percocet -- because of their risk for overdose and for severe liver injury.

The panel, assembled by the Food and Drug Administration, voted 20 to 17 to advise the FDA to remove such prescription combination drugs from the market.

The group recommended that the FDA "send a clear message that there's a high likelihood of overdose from prescription narcotics and acetaminophen products," Dr. Sandra L. Kweder of the FDA's Office of New Drugs said at a news conference after Tuesday's meeting.

The panel was meeting for the second day to vote on recommendations to reduce the risk of serious liver injury associated with acetaminophen, which is found not only in prescription drugs, but also in over-the-counter medications such as Tylenol and NyQuil.

It also advised the FDA to lower the maximum daily dose of acetaminophen in over-the-counter and prescription medications, and to address the formulations and dosing recommendations for children.

Kweder said the FDA is already "well on the road" to addressing the pediatric concerns.

The FDA is not required to follow the recommendations of its advisory committees, although the agency typically does.

If the agency does not choose to eliminate prescription combination drugs, the panel said the FDA should lower the amount of acetaminophen in the drugs and also take some action to ensure that subscribers and patients are aware of potential liver damage posed by taking these products, Kweder said.

In another vote, the panel had voted to advise the FDA to put a boxed warning on the prescription combination drugs.

Although acetaminophen is one of the most commonly used drugs in the United States for treating pain and fever, overdoses of acetaminophen have been linked to 56,000 emergency room visits, 26,000 hospitalizations and 458 deaths during the 1990s, according to the FDA, citing one study.

The agency cited another study, a 2007 Centers for Disease Control and Prevention population-based report, that estimated acetaminophen was the likely cause of most of the estimated 1,600 acute liver failures each year.

The advisory panel could have voted to recommend pulling over-the-counter drugs that use acetaminophen in combination with other ingredients -- such as NyQuil, Pamprin and Allerest -- but it chose not to.

Some panelists cited data that suggests that combination over-the-counter drugs account for less than 10 percent of acetaminophen overdoses.

Kweder said families should carefully read medicine labels to know what is in the medicine and how much should be taken.

Abbott Laboratories, which makes the brand-name Vicodin, which has also been available as a generic since the mid-1980s, said in a statement that "today's discussion is an important continuation of the dialog around balancing patient safety with the need for treatment options for patients in pain."

It said, "Pain affects 75 million Americans, more than diabetes, cancer and heart disease combined" and added that it would follow the FDA's final determination.

Endo Pharmaceuticals, which makes the brand-name Percocet, did not immediately return a phone call seeking comment. Percocet is also available as a generic.
 
Sorry this disappeared for a few mins, sis. I was trying to copy it into a similar thread in the Information Centre FDA to Curtail Pain Meds but it went all kapewy! Think I may be too tired from my travels to be attempting stuff like that just now!
 
Is this all they really have to do....I could think of many other things right off the top of my head....ecomomy stinks and their voting on this. just my opinion....
 
This was also covered in some detail in this morning's Washington Post. Which has raised a number of questions for me. Recently, I have had a little problem with my right hip, due, I think, to my work schedule and the fact that I took about 1 week off from my PT and workout sessions. Everything kinda tightened back up resulting in some pain and gait issues. So I am back on some pain meds, mostly non-prescription. My personal favorite is 2 tylonel and 1 ibuprofin, but I vary it depending on how I'm feeling. For now, I'm sticking with it as I'm still only 3 months out and I think that these pain meds are for people like us who have had major surgery. But I did play lots of basketball over the years and took a lot of ibuprofin, so I read the article with great interest.
 
Okay, I see that some people don't follow directions on labels or doctors advice. Now we will all be penalized because of ignorance. How hard can it be to take 2 tablets and let it be.

Is this an offshoot of the Michael Jackson overdose??? Just thinking maybe they don't have enough to do like you say Kim.

Also Jo, why do the studies date back to the 90's? This is 2009 incase they didn't notice.

I remember the first time I went in Walmart to buy some cough and cold products for my children and I had to show my drivers license and sign a paper stating I wouldn't use it to make some illegal drug. I usually bought 3 bottles. 1 for my home and 1 for each of the grandchildren to take home. But no, I could only buy 2 within a 30 day period or they would come knocking at my door to see if I had a laboratory brewing some meth.

Some of us are responsible, read the labels and use as directed. Too bad our society takes a good thing and uses it for bad so we all suffer! :hissy:
 
I agree my 70 yr old mom called last night in a panic because she takes 2 tylenol pm at night to sleep. Now she is so scared something is wrong with her liver. And at 70 she said what can I take at night. She called this morning saying she didnt sleep because she was afraid to take it...Because thats all shes be hearing..:(
 
"Truth" in advertising???? That's so sad, Kim! Tell Mom to take her meds.....on a FULL stomach!!!
 
That's awful! How do you reassure people when they hear such garbage! And the stupidest part of all is that a pharmaceutical company actually came up with the idea of adding the antidote (yes, there is one!) into the mix so everyone who takes it gets it as well. Now why doesn't anyone ever hear about that?
 
I know but at 70 and she has some peoblems. Trying to covince her now will be nearly immpossible, but I will continue...Thanks...
 
Jo! We are such a litigious society ......people are just AFRAID of repercussions!
 
Anybody forget how slow the FDA moves? :sct: Even it they do this, the doctors will just give you something else.

Just means there will be a rush to buy all the meds up by folks.

I don't mean to take this light, but you have to remember the FDA moves very very slow. I say this and it will probably be implemented tomorrow.:evil:

I don't take tynol as it has never helped me, but for those folks that do, for your sake, I hope the FDA moves at its
usual snail pace.

As I stated in another post, if people would just read directions and do as directed we would not have this problem. However, no matter how they try they can not
force a person to follow directions.:hissy:
 
Went to our family physician with Rick today for him to get a cortizone injection in his right shoulder. I asked him about this subject.

He said "hogwash!" In all of his 23 years of practice + Residency, he has never seen any liver damaged by acetaminophen when used for medicinal purpose, except 2 which were suicide attempts and tooks bottles of it. He said, not only that, neither have any of my partners and there are 5 of them.

He was outraged! Said those who are overdosing aren't reading the directions or don't have a bottle to read!

My thought exactly.
 
I don't think the FDA will ban acetaminophen...I think the drug cartel is far too influential. I can see them making the dosages smaller...like one pill has 400 milligrams instead of 500mg.

Believe it or not there are people who actually overdose f acetaminophen .. I undersand that it is a terribly painful. I believe that the problems the FDA feels needs to be fixed is....a child has a fever, mom gives tylenol to child for fever, cough syrup that has acetaminophen in it, decongestant with acetaminophen and then Childrens' Nyquil. WAY TOO much for a little or big body for all that is worth.

:pzld:Perhaps better labeling...in BIG print..this medication contains acetaminophen. Why don't the drug companies voluntarily make better labeling. :pzld::pzld::pzld::pzld::pzld:

Bar

Barb
 
The problem is not so much with plain acetaminophen products like Tylenol but the fact that so many products that you buy for other reasons than pain/inflammation contain acetaminophen and if you don't know that you can end up with an overdose. The problem is the fact the product also contains acetaminophen is not clear on the label (like on the front of the package) so people don't know to count that amount in with their daily dose. I am wondering how many of you that have been prescribed Vicodin or percocet where told it contains acetaminophen and not to take Tylenol or aspirin.


I don't think the FDA wants to get rid of acetaminophen, they just want to eliminate it from other products like cough syrup etc so that people don't get an overdose by mistake.

Simon
 
Quite so, Simon. But then, how often does that actually happen? Cough mixtures and such are, by definition, short term use products. An occasional consumption of a few mgs over the daily total is not going to cause liver damage as the 'maximum' is usually set with quite a wide error margin. It has to be either a deliberate act or a long term abuse to cause any real damage.
 
I agree, Jo. And by law in the US, a pharmacist MUST provide literature with all prescriptions that detail how to take it and any dangers like this. 'Course....most people probably don't read the literature that comes with their prescription.

I suppose one could make a case for all the over-the-counter things that are sold containing acetaminophen. But I would be surprised if the statistics support some of the controls being proposed. I don't believe in punishing the vast majority of people who use these drugs properly just because some are too lazy to read about them. In my opinion, the FDA should do a better job of educating people to read labels and instructions if this is really a problem for some people and leave the rest of us alone. Uh-oh....I sneaked back up on my soap box, didn't I.....sorry!
 
I think the problem lies in people taking a pain reliever like Darvocet, for example, and when it is not enough they through in some extra Tylenol. Since Darocet includes Tylenol, this can lead to an overdose. In America, most of the prescription painkillers that end in "cet" include acetaminophen, but other, like Vicodin, give one no clues.
 
Interesting thought Linda.

I'm not sure how all pharmacies label their medications, since we have used CVS for the last 20 years. However, they not only give you the product sheet, but list the narcotic and acetominophen on the label of the bottle. There is no question what you are taking if you read it. Also, you have to sign a sheet indicating you don't want to talk to the pharmacist. They always ask if we have taken this medicine before and review it with me if we haven't.

Even when I pick up my pet medication at Kerr Drug (only ones who carry it in stock), they review it with me. They chuckle when I tell them it's for my cat, and yes, we know all about it. I am fairly sure this is how other pharmacies work.

I firmly believe the real problem is as Jamie and Jo say...intentional abuse and ignorance because they are too lazy to read the labels. Some people just take whatever to get relief without thinking about the consequences. Others just don't care! Their level or resistance to the pain med is built up because of this therefore they take more. I have heard of people depleting their entire script in less than a week. These are the ones who are getting their meds on the street or are addicted and need rehabilitation.

Ultimately it is up to us to make wise choices in pain relief. Not sure how the FDA can police this problem since it's the people who aren't listening or reading the labels. The pharmacies seem to be doing their job already.

Okay, Jamie...guess I need to step down as well off that soap box. Sorry for the tangent...ignorance and indifference makes me angry! :hissy:
 
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