Reviewed by Varnada Karriem-Norwood on December 03, 2011
Ira Katz, pharmacist, Owner, Little Five Points Pharmacy, Atlanta. Nicole Metzger, PharmD, clinical assistant professor, Mercer University College of Pharmacy and Health Sciences. WebMD Feature: “Living With Pain: 9 Pain Pill Mistakes.” FDA: “A Guide to Safe Use of Pain Medicine.” Mayo Clinic: “Medication errors: Cut your risk with these tips.” Mayo Clinic: “Acetaminophen and children: Why dosage matters.” The American College of Gastroenterology: “The Dangers of Aspirin & NSAIDS.” Food and Drug Administration: “Acetaminophen and Liver Injury: Q & A for Consumers.”
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Narrator: Carolyn McGlaughlin is very familiar with a certain aisle of her local pharmacy, looking yet again for a cough and cold remedy for members of her family.
Carolyn McGlaughlin : And so we should probably get this one. Okay.
Narrator: Many people also pick up some acetaminophen or ibuprofen for fever.
Ira Katz, Pharmacist: What people don't realize, it says multi-symptom cold medication. It's very important that you read the label. OKay, this particular cough and cold medicine does have acetaminophen in it.
Narrator: And that's how a person could accidentally take too much pain medication
Ira Katz, Pharmacist: I catch this all the time.
Narrator : Dosing mistakes can happen with chronic pain as well, if you assume more is better.
Ira Katz, Pharmacist: We always think one's good, 2 is better and if 2 is good, 3 might be better or 4 might be better. Patients don't read the labels. We try to encourage the patients to read the label because it will say maximum daily dose is.
Narrator : Ensuring that you don't go over the maximum dose for a 24-hour period can get trickier when you combine over-the-counter and prescription pain relievers. Rheba smith suffers from pain due to a previous surgery.
Ira Katz, Pharmacist: This information about the medication, see it's oxycodone with APAP
Narrator : Did you know that APAP is the abbreviation of the chemical name for acetaminophen?
Ira Katz, Pharmacist: Please don't take any over the counter acetaminophen while you're taking this, okay
Nicole Metzger, PharmD: Unfortunately a lot of people don't realize that opioid pain medication such as hydrocodone or oxycodone are commonly mixed with acetaminophen and less commonly mixed with ibuprofen and they may be taking other combination over-the-counter products for pain or for cough and cold and then they may unknowingly overdose.
Narrator : Check the label for the recommended daily limit before you use acetaminophen. Why is this important? Too much acetaminophen can lead to liver damage.
Nicole Metzger, PharmD: The scary thing about it may be that they don't know they're doing damage until it's too late.
Narrator : The recommended daily dose for an nsaid such as ibuprofen, naproxen or aspirin varies. Here again, too much can be harmful.
Nicole Metzger, PharmD: For NSAIDS, the major toxicities are related to the GI tract, specifically to GI bleeding which can be very serious.
Narrator : To avoid pain medication mistakes, be sure to read your prescription drug inserts and the drug facts label on over-the-counter remedies. And know your active ingredients.
Ira Katz, Pharmacist: If you need to, you can take over the counter acetaminophen, over the counter ibuprofen if you need to.
Narrator : If you're ever in doubt about how much is too much, just ask your doctor or pharmacist. For WebMD, I'm Rhonda Rowland.