Thursday, July 2, 2009

Mixing Drugs

I've got a bit of a personal interest in the FDA's move to ban Percocet and Vicodin because of the liver toxicity problems associated with Acetaminophen.

ADELPHI, Md. — A federal advisory panel voted narrowly on Tuesday to recommend a ban on Percocet and Vicodin, two of the most popular prescription painkillers in the world, because of their effects on the liver.

The two drugs combine a narcotic with acetaminophen, the ingredient found in popular over-the-counter products like Tylenol and Excedrin. High doses of acetaminophen are a leading cause of liver damage, and the panel noted that patients who take Percocet and Vicodin for long periods often need higher and higher doses to achieve the same effect.

Acetaminophen is combined with different narcotics in at least seven other prescription drugs, and all of these combination pills will be banned if the Food and Drug Administration heeds the advice of its experts. Vicodin and its generic equivalents alone are prescribed more than 100 million times a year in the United States.

http://www.nytimes.com/2009/07/01/health/01fda.html?_r=1&ref=health


During my recovery from my broken humerus, I went through some serious pain that is treated with Hydrocodone (Vicodin). The main problem for me was the limit I could safely take (I have a tolerance level for opiates that rivals that of an elephant) because of the Acetaminophen content, and it's potential for liver damage. In the hospital, they could give me morphine, which is much safer, but once out of the hospital, that wasn't an option. (aside: Oxycodone (Percocet) does almost nothing for me when it comes to pain. All it does is make my brain as mushy as Lush Rimbaugh's. Stupid and still in pain is not a desirable situation.) I repeatedly wished that I could get Hydrocodone (which I needed) without Acetaminophen (which I didn't need), but thanks to the pharmaceutical lobby that wasn't an available opton.
I'm way better now, and rarely need to take a pain pill. But for millions of people with chronic pain, this could be really major. Getting rid of the Acetaminophen is a good idea, but Hydrocodone and Oxycodone need to still be available for those who need them. That's an issue that is still unresolved, what alternatives will be offered.
How typical of health care in America. The pharmaceutical companies can push Acetaminophen (which can kill you) into a wide variety of medications. But most of us can't get Medical Marijuana, which is safe AND effective.

3 comments:

Mike Goldman said...

They deliberately put the acetominophen in in order to make the opiate medications more toxic, so they will be less likely to be abused.

pygalgia said...

H in NV, your case is exactly why we need to change health care. My complaint was that the pharmaceutical lobby has pushed the combination medication into being the standard treatment, rather than having the best for the individual patient. But each different patient has different needs. In my case, I'm a former heroin addict, so while I needed a very high dose in the short term, I don't need pain meds in the long term. The problem was that I couldn't take enough hydrocodone to effectively relieve the pain without nearing a toxic dose of acetaminephon. And alcohol (as much as I love beer) really isn't a very good pain med.
It's somewhat funny that the opiates, even with their problems, are actually safer than the drug you can buy OTC.

pygalgia said...

Added: The Oxycodone vs. Hydrocodone issue seems to be very individual in effecacy. The two chemicals are almost identical, but individual responses aren't. I have a friend who would be demographically and physically almost identical to me, but he reacts badly to hydrocodone, and finds oxycodone to be quite effective.