News from the FDA: Tylenol and Zicam

Friday, October 29, 2010 // Uncategorized

6/30/2009 11:23:33 PM


One of the most common causes of liver failure in the United States is acetominophen, the most common trade name of which is Tylenol.  People often are counselled to take acetominophen to avoid the potential side effects of NSAID’s (non-steroidal anti-inflammatory drugs).  But, Tylenol is potentially toxic to the liver especially when taken with alcohol or in the setting of starvation.  The maximum recommended total daily dose is 4,000 mg per day.   Most of the time, people take 1or2, 325 mg tablets four times a day.   Recent studies show that even lower total daily doses can have an effect on the liver.  For that reason, I have advised patients to take 3,000 mg or less a day.  Today the FDA made it official.  They recommended taking  a maximum of 3,250 mg a day.  This is the equivalent to ten regular strength Tylenol a day for those who are challenged by math.  Many patients don’t know that Acetominophen is present in other OTC medications.  Be sure to read the labels.FDA Tylenol


Zinc lozenges taken early in the course of a cold may shorten the duration of the illness.  Maybe.  The studies are conflicting.  Since there are no other effective treatments for colds, I often will take some Cold Eaze tablets or equivalent when I start to get that irritation in the back of my throat that signals that I’m coming down with something.  We usually try to convince ourselves that this is allergies, even though we know that it is not.  Newer non- sedating antihistamines don’t help.  Older antihistamines may dry the runny nose, but cause sedation as a side effect.  Some people swear by zinc swabs that are put in the nose.  One of the most common brands is Zicam.  There have been isolated reports over the years that this can, rarely, be associated with loss of smell or anosmia.  For that reason, I have discouraged my patients from using them.  Recently, the FDA made it official and  advised against the use of these preparations.

You can use Afrin decongestant nasal spray for a few days, but don’t squirt other things up there.  People with allergies may continue their allergy medications when they get a cold, but there is minimal efficacy for these drugs in the absence of allergies.  FDA Zicam


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