Excessive Use Of Paracetamol Can Cause Kidney Damage – Expert Warns

Olumide Akintayo, a fellow and ex-president, Pharmaceutical Society of Nigeria, has warned the public about the dangers of paracetamol abuse, including kidney damage and infertility. In a chat with Punch, he said:

“…Paracetamol is classified pharmacologically as an analgesic. An analgesic is a pain-relieving medication or pain killer, and it comes in various dosage forms; liquid dosage forms for paediatrics, tablets or capsules for geriatric patients, and in more recent times, we have had the etheral form, that is, injection form, especially in situations where one does not want to use what we conventionally call non-steroidal anti-inflammatory agents.

…Most medications are routinely misused and abused in our country. One of the reasons for this is that, generally speaking, people have unrestricted access to medications…from stark illiterates who know nothing about medicine to the stakeholder in care provisioning, everybody dabbles into this, which is most unfortunate.

…paracetamol tablets come in 500mg. The ideal dose is 1g as needed. So, one gramme would be two tablets. The most common prescription is two tablets in the morning, afternoon and night, which makes up six tablets. But under normal circumstances, one is not supposed to exceed eight tablets in a 24-hour period.

…In conventional health practice, one can actually combine analgesic and drugs like ibuprofen. So, one could find some formulation like chlofenac-paracetamol tablet combinations. It is allowed. But usually, these are not medicines, people should buy without expert advice. It should be taken based on the prescription and advice of a pharmacist. Also, there are specific pieces of information that must be conveyed by the pharmacist when one needs to buy such combination.

…I give you a classical example of a drug interaction profile, which is very common in our environment. If one takes paracetamol tablets with chloramphenicol for instance, which a lot of people use in the management of typhoid fever, what one sees is that the paracetamol reduces the half-life of the chloramphenicol by a factor of about two. Prescribers sometimes make that mistake. That means the person taking it would be vulnerable to chloramphenicol-induced toxicity, and that would usually manifest as excessive destruction of the white blood cells in the body. The white blood cells are like soldiers of the body because they protect the body against normal infection. So, if a drug destroys these white blood cells, the body becomes very vulnerable to infection.

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…if an individual indulges in the excessive use of paracetamol, that person is likely to develop kidney damage. Excessive overdose is if one takes more than eight paracetamol tablets in a day, or takes the tablets against the prescription, like taking more than the prescribed two tablets thrice during an eight-hourly interval for 24 hours. Sometimes, it is a little more dangerous to indulge in the excessive use of paracetamol than aspirin because of the factor I highlighted. If the kidneys, which are vital organs of the body, are destroyed, it would cause more problems, such as renal failure and renal diseases. Some recent studies have also linked infertility to the use of paracetamol. It is not good to indulge in excessive use of paracetamol or any other medicine, because these medicines could in turn become poisonous to the body.

The body weight would indicate (appropriate dosage). For instance, children between the ages of eight to 11 years need a half dosage of what an adult is supposed to take, that indicates one tablet daily, which is about 200mg. Age five and below is lower. That is why the prescription of a pharmacist is important to determine an appropriate dose based on the weight of the child through appraisal, even if there is no weighing scale.

One of the major things I have observed in my practice is that people think paracetamol is a routine drug. Often times, people take paracetamol for anything whether they have pains, headache or not. They just wake up in the morning and take paracetamol. They relegate it to the level of a multivitamin. They just feel they must take paracetamol. There are a few other drugs that can fit into this category. In essence, I am saying that except it is proven that one has a headache or pain, one does not need to indulge in the use of paracetamol…”