Tylenol: Fabulous Product, but the Wrong Dose Can Kill You!
Written: Jul 26 '00 (Updated Jul 26 '00)
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Product Rating:
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Pros: No risk of Reyes Syndrome, virtually no side effects, works effectively on minor pain and fever
Cons: Dangerous if overdosed or for those with compromised livers
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| WorkingMomof2's Full Review: Infants' Tylenol Concentrated Drops |
It’s easy enough to realize that there are two different doses of Tylenol. Clearly, you wouldn’t give your infant the same tablets that you take yourself for a headache! But did you know that there are actually three different children’s formulas? Sure enough, there is Tylenol Junior (for children from 6-12, in both tablet and capsule form). Then there is Children’s Tylenol (for ages 2-11) in both liquid and tablet form, and Infant’s Tylenol (for up to 35 lbs.) in liquid form only. Easy enough, you think, how could this be dangerous?
The danger I want to warn you about lies not in the product itself – although there are some inherent risks there also, if you have liver disease or drink regularly. But did you know that there have been hundreds of deaths and serious liver injuries directly attributed to the primary ingredient in Tylenol (acetaminophen)? The first of these, the death of five year old Lacy Keele who received double the normal dose of Tylenol for a flu and died within a week, brought nation-wide visibility to the dangers of overdosing of Tylenol. And I’m not talking about purposeful double dosing, either. I’m talking about the tragic overdosing from mixing up formulations.
Let me quote from Forbes.com, to give you one specific example of how this happens.
“Sophie Regosin-Hodges was 14 months old when an overdose of Tylenol almost killed her. Sophie's mother gave her Tylenol infant drops-but, acting under instructions from a pediatrician, used the dosage for a different product, Tylenol children's suspension liquid. You'd never know it from looking at the packages … but the infant drops are three times as potent as the children's formula.
Sophie is 4 years old now. She survives by dint of a transplant of liver tissue from her father. She will be on immunosuppressant drugs all her life. “
The main problem (for children, at least) lies in the formulations. Realizing that infants have much more trouble swallowing, and it’s hard to get a huge teaspoonful of medication down a newborn’s throat, the Infant formula is far more concentrated than the children’s formula. Specifically, the “Infant Tylenol has 80 mg in 0.8 ml, while the Children's Liquid Tylenol has 80 mg in 2.5 ml (three times the volume of the infant dose).” (from Helen’s Health Corner, see below).
So you can see that if you gave your child a teaspoon of the infant formula, thinking it was the children’s formula, you could be giving them three times as much of the active medicine as you intended. Conversely, if you gave your infant the Infant formula, but followed the dosing instructions on the Children’s box (as happened with poor Sophie’s mother, above) you could be delivering a lethal dose to your baby!
To clarify, and show you how easy it is to buy or give the wrong formula:
• Infant Tylenol (Drops): Each .8ml dropperful contains 80mg acetaminophen
• Children’s Tylenol (Drops): 160 mg Acetaminophen per teaspoon (5ml)
• Children’s Tylenol (Tablets): Each tablet contains 80mg Acetaminophen
• Tylenol Jr.: Each tablet contains 160-mg acetaminophen
• (Adult) Tylenol: Each Tablet contains 325 mg Acetaminophen
• Extra Strength Tylenol: Each Tablet contains 500 mg Acetaminophen
• Extra Strength Tylenol (Liquid): 500 mg Acetaminophen per Tablespoon
A little on the product itself: Tylenol is a Johnson and Johnson product that has done a lot for children. It contains Acetaminophen, so it eliminates the miniscule risk of Reyes Syndrome that exists from giving your child aspirin. It works to reduce pain and fever, and in my personal experience, is extremely effective. As you can see above, it's available in liquid or tablet, many different formulations, and several different flavors. I have not seen any significant difference in how my kids react to the flavors; however, I tend to avoid the grape because it is harder to wash up if spilled or vomited up on my white carpet. And yes, I had to learn that the hard way with my eldest, aka "the barfer".
Am I afraid to give my kids Tylenol? Absolutely not. It has worked effectively for them for years, helping with teething pain and minor fevers. What I am extremely careful of, though, is not to double dose, and to make sure that I am absolutely positive which tablets I have in my hand before I give them to my kids. Since I have several different formulations in my house, I have to double check. Do I ever get confused? Sure, one time I stopped in the midst of pulling out tablets to deal with some minor catastrophe (the kids fighting or such). I turned back to realize that the tablets were on the counter, but the packages put away. I had no idea. I’m sure they are labeled clearly, and I could have figured it out, if I’d tried. I didn’t – I threw them in the trash, and got out new ones. It is just not worth the risk, in any way, shape or form.
In case you are treating a flu or cold, be sure to check the medicine's label as well. Many cold medicines contain pain reliever, and it's easy to double dose without knowing it if you're giving your child a cold & cough reliever "for sore throat" (like the Triaminic I use) or any with pain reliever. It's worth a double check on the label, just in case...if it says "pain reliever" or Acetaminophen, don't hit them with Tylenol as well!
As an aside, there have also been many cases of adults going into liver failure or dying from ingestion of Tylenol. Most of these, as far as I know, had to do with adults who had compromised livers (typically from alcohol use). Several publicized cases, though, did not involve what you would necessarily call “alcoholics”, but rather every day folks who had a glass of wine or a beer with dinner. Again from Forbes.com,
“Antonio Benedi, then a 37-year-old aide to George Bush, drank wine with dinner on a Saturday night in 1993 and over the next four days took ten extra strength Tylenol tablets, hospital records show. He went into a coma and was saved only by a liver transplant. He sued and won $8 million from J&J.”
At the least, this is certainly food for thought for all of us who have been known to imbibe now and then. My work with Emergency Room doctors certainly reinforces the frequency of this occurring, and their knowledge of the correlation between alcohol use and Tylenol leading to liver failure. In our house, we reach for the Advil if we’ve been drinking at all. Again, the risk is just not worth it to us.
My goal is not to bash Johnson and Johnson in any way. Tylenol is a fabulous product, and as long as you don’t have any liver problems and are very careful with your dosages, you will probably n ever have any problems with it. I do however want to draw your attention to this issue so that you can be careful when you give your loved ones their medicine. J&J has recently relabeled their packaging to make it easier to identify the differences, and indicated that you should be sure to use the right dropper with the infant formula. Nonetheless, if you have older medication at home, or (like me) discard the packaging as soon as the box is open, you still need to exercise caution. And as always, if you aren't sure what product is right for your child, ask your pediatrician... and read the label very, very carefully.
Remember, the right dose can take their pain away, and make you rest easier. The wrong dose can cause irreparable harm, and possibly be fatal. Measure twice, my friends, and make sure that you pay very careful attention to which dropper, and which formula, you are using… and how often you are giving it. The risk is there, and every parent should be aware of it.
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A Note: I give Tylenol 4 stars for effectiveness, and I would recommend it without fail to new parents I know.... but with the strong advisory warning that I have posted here about dosing. I just wanted to explain my rating!
I'm also posting this under Infant's Tylenol, which is where the most concentrated formula (and highest risk for over-dosing!) is. However, the review of the effectiveness of this product as well as it's inherent risks could apply to the Children's Tylenol or even adult formulas, as well.
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More Resources for you to Research, Should You Wish:
http://www.forbes.com/forbes/98/0112/6101042a.htm
http://www.paccc.com/html/article9803.htm
http://homearts.com/depts/health/b7newsf2.htm
http://www.widesmiles.org/WS-778.html
http://www.hvmedweb.com/mw1/updates/medicinedosescmg.html (A dosing chart)
http://www.market.econ.vanderbilt.edu/ba250/fall98/Tylenol/tylenolproduct.html
http://www.forbes.com/forbes/98/0112/6101042s1.htm
http://www.drpaula.com/topics/otcdosages.html (Dr. Paula's Dosage guide)
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WorkingMomof2
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Member: Amy
Location: Southern California
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Every time I close the door on reality it comes in through the windows.
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