Panadol (Tylenol) Can be Fatal

Panadol (Tylenol) is readily available as an over the counter medication in most countries and used as a pain reliever and for reducing fevers. Panadol, also known as Paracetamol, Tylenol, Acetaminophen or as it's scientific name - N-acetyl-p-aminophenol. A more extensive list of brand names can be found on Wikipedia.

However readily available, Panadol isn't without its risks. In fact, there have been cases of people who have died taking the drug. To make things more complicated, Panadol is often also found as a combination of other cold and flu or pain medications. If such a cold and flu tablet is taken with Panadol, it's additive effect can lead to poisoning. 

Examples of Panadol containing Medicines

Panadol itself doesn't cause toxicity to the body. However, when it is broken down in the body, it forms N-acetylimidoquinone, which causes liver damage. When taken in small quantities, the liver has an amazing ability to regenerate. However, when taken in large quantities or continuously significant quantities, the rate of destruction can outstrip the regeneration leading to liver failure.

According to the Royal Children's Hospital, Melbourne, patients requiring management are those who have taken:

·       More than 200mg of Panadol for every 1 kg of your lean body weight in one go; or

·       More than 100mg of Panadol for every 1 kg of your lean body weight, each day over a period of a few days

Lean body weight is your body's normal weight if you are overweight. For example, if you are 1.60m and 70kg, your lean body weight would be around 63kg. (BMI < 25). Hence, if you are underweight, you would be able to tolerate less Panadol.

Most Panadol are found in 500mg tablets. Here's a table of conversion of how many 500mg tablets are dangerous for a normal adult. If you are under 50kg, you have a good chance of taking too many, if taken over time.

Lean Body Weight (kg)	No of Tablets if Taken in 1 go	No of Tablets per day over a few days
40	16	8
45	18	9
50	20	10
55	22	11
60	24	12
65	26	13
70	28	14
75	30	15
80	32	16
85	34	17
90	36	18

According to NSW Health, those who are elderly, frail, fasting, dehydration, use excessive alcohol chronically, have liver impairment, the risk of panadol poisoning is increased. Panadol can also interact with other drugs, so check first with your doctor or pharmacist before taking it. Diseases such as eating disorders and HIV also can increase the risk.

There are cases where people try to kill themselves using Panadol. This is not a quick and easy death. Death does not come immediately and patients often suffer for an extended period. If you are thinking of killing yourself, please seek help. Contact details are available below. If you have already taken an excessive amount, please attend your nearest Hospital Emergency Department or call for an Ambulance.

Taking Panadol/ Tylenol is not without risks. Don't take if it you are just using it to sleep. To be safe, always speak to your doctor or pharmacy to make sure how much Panadol you are taking is safe, especially if you unsure.

If your life is in danger call an Ambulance immediately.
Australia: 000
USA/ Canada: 911
Singapore: 995
UK: 999 

If you are needing help with your suicidal or self harm thoughts you can contact:

Lifeline - 13 11 14 (Australia)

Kids Helpline - 1800 55 1800 (Australia) - For those who are 5 - 25 years old

Samaritans of Singapore - 1800 221 4444 (Singapore)

State Mental Health Crisis Numbers:

NSW - 1800 011 511

VIC - 1300 651 251

QLD - 13 432584

TAS - 1800 332 388

SA - 13 14 65

WA - 1800 575 822

NT - 08 8999 4988

ACT - 1800 629 354

References

Royal Children's Hospital

NSW Health - Panadol Use
Patient.co.uk

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