Must-read: combination acetaminophen-opioid formulations should be abandoned

4 out of 5 stars The prescription paradox of acetaminophen safety. Dart RC, Green JL. Pharmacoepidemiol Drug Saf 2015 Dec 29 [Epub ahead of print] Reference Last week, we pointed out that the American College of Medical Toxicology (ACMT) had issued a position statement on prescribing opioids that had missed a good opportunity to call for abandoning use of pharmaceutical products that combined strong opioids such as hydrocodone with acetaminophen. I just discovered that a recent editorial by Richard Dart and Jody Green from the Rocky Mountain Poison and Drug Center agree with my take on this matter. They point out that a review by Major et al determined that the rate of adverse events associated with acetaminophen — including fatalities and hepatotoxocity — increased from 2009 to 2012 as a proportion of drug sales. A large percentage of these adverse events are associated with exposure to combination products: Overall, 42% of patients admitted for acetaminophen-induced ALF [acute liver failure] will identify an opioid-acetaminophen combination drug as the source of exposure. The authors further note that there is scant evidence (translation: no real evidence that adding acetaminophen to opioids such as hydrocodone or oxycodone increases effectiveness. Since there is clear evidence that these products increase risk of hepatotoxicity, there is absolutely no rational for using them. The authors conclude: The components of pioid-acetaminpohen combination drugs are readily avai...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical acetaminophen adverse effects hepatotoxicity opioid Source Type: news