Posted by ed_uk2010 on January 17, 2014, at 15:02:51
In reply to Re: FDA Limit Amount Tylenol In Both Pain + OTC Produc, posted by jono_in_adelaide on January 16, 2014, at 21:54:46
>Perhaps thats because strong narcotic painkillers here usualy dont contain acetaminophen/paracetamol, so there isnt any reason for people to excede the recomended dose?
Yes, exactly. In the treatment of severe chronic pain, acetaminophen/paracetamol and opioids should be given as separate tablets. Paracetamol should be Rxed at 650mg or 1000mg up to four times a day (or 500mg four times a day in very elderly pts with low body weight) + an opioid at an appropriately titrated dose. Combo tabs can lead to paracetamol overdose if pts take more than the recommended dose in order to achieve an adequate opioid dose.
Opioids often require a great deal of dosage adjustment to control chronic pain adequately, there is no standard dosage whatsoever. Paracetamol does not require much adjustment at all: 650mg or 1000mg four times a day is suitable for most pts. The use of combo tablets should therefore be restricted to pts whose para and opioid doses can be safely achieved by using them. Pt education is also important to avoid accidental use of other paracetamol-containing products (flu remedies etc) at the same time.
poster:ed_uk2010
thread:1058622
URL: http://www.dr-bob.org/babble/20140104/msgs/1058800.html