…Says it can lead to death
Stories by Ogonnaya Nwogwugwu
The founder and Group Chief Executive Officer (CEO) of Emzor Pharmaceutical Industries Limited, Dr Stella Okoli said that adults should not take more than six tablets of paracetamol (acetaminophen) daily.
She gave the advice at the 30th anniversary of Emzor paracetamol, where a special pack of Emzor paracetamol was unveiled in Lagos recently.
She said most users have ‘staggered’ overdoses after taking paracetamol in other forms, such as caffeine drinks or panadol, thereby failing to realise that the amount they have taken could be fatal in a few days.
Dr Okoli emphasized that 500mg tablets – the equivalent of 4g – should be the maximum dose daily, warning that anyone who exceeds this dose will be endangering his life.
She further said that some people may have complaints, such as vague abdominal pain and nausea. With time, signs of liver injury – low blood sugar, low blood pH, easy bleeding, and hepatic encephalopathy- may develop. Some will be spontaneously resolved, though untreated cases may result in death.
Okoli, who pioneered the production of Emzor paracetamol, explained that a damage to the liver, or hepatotoxicity, results not from paracetamol itself, but from one of its metabolites (the chemical processes that occur in a living organism to maintain life) Nacetylp-benzoquinoneimine (NAPQI).
NAPQI decreases the liver’s antioxidant glutathione and damages cells in the liver, leading to liver failure.
NAPQI, inactivated by glutathione, prevents harm. When glutathione stores are depleted to less than 30 percent, NAPQI reacts with nucleophilic aspects of the cell, leading to necrosis. Necrosis occurs in the liver and in the kidney tubules. Toxicity is increased in patients with induction of the P450 system through drugs such as rifampicin, phenobarbital, phenytoin, carbamazepine and alcohol. This also occurs in patients with low glutathione reserves.
“So, I always tell our people not to take paracetamol with alcohol. This is because risk factors for toxicity include excessive long-term alcohol intake, fasting, lack or loss of appetite for food (anorexia nervosa), and the use of certain drugs, such as a synthetic compound used as a bacteriostatic drug, chiefly to treat tuberculosis (isoniazid). It is important to remember that, when used at therapeutic levels, paracetamol is usually safe and effective,” she said.
She added: “Over the years, Emzor Pharmaceutical has gone the extra mile in ensuring that affordable healthcare is readily available to everyone. This has made the company consistent in delivering time valued quality products and services to the delight of our customers.