What are the health risks of taking 6-10 panadols a day?

Question

I usually take about 6-10 panadols a day.
i dont take only 2 at a time anymore, i usually take 3-4 at a time
i get chronic headaches alot


what are the health risks?

Answer 1

Paracetamol has a narrow therapeutic index – the therapeutic dose is close to the toxic dose. Additionally, paracetamol is contained in many preparations (both over-the-counter and prescription only medications). This means that, despite being one of the safest analgesics available at recommended doses, there is a large potential for overdose and toxicity.[6] Without timely treatment, paracetamol overdose can lead to liver failure and death within days. Because of the wide over-the-counter availability of the drug, it is sometimes used in suicide attempts by those unaware of the prolonged timecourse and high morbidity associated with paracetamol-induced toxicity.

In the UK, sales of over-the-counter Paracetamol in pharmacies are restricted to packs of 32 tablets per customer per occasion (only 16 tablets in non-pharmacy stores). In Ireland, the limits are 24 and 12 tablets respectively.


Mechanism of toxicity
As discussed above in the section regarding metabolism, paracetamol is mostly converted to inactive compounds via Phase II metabolism by conjugation with sulfate and glucuronide, with a small portion being oxidized via the cytochrome P450 enzyme system. Cytochrome P450 2E1 (CYP2E1) converts paracetamol to a highly reactive intermediary metabolite, N-acetyl-p-benzo-quinone imine (NAPQI).

Under normal conditions, NAPQI is detoxified by conjugation with glutathione. In cases of paracetamol toxicity, the sulfate and glucuronide pathways become saturated, and more paracetamol is shunted to the cytochrome P450 system to produce NAPQI. As a result, hepatocellular supplies of glutathione become exhausted and NAPQI is free to react with cellular membrane molecules, resulting in widespread hepatocyte damage and death, clinically leading to acute hepatic necrosis. In animal studies, 70% of hepatic glutathione must be depleted before hepatotoxicity occurs.


Toxic dose
The toxic dose of paracetamol is highly variable. In adults, single doses above 10 grams or 150 mg/kg have a reasonable likelihood of causing toxicity.Toxicity can also occur when multiple smaller doses within 24 hours exceeds these levels, or even with chronic ingestion of doses as low as 4 g/day, and death with as little as 6 g/day.

In children acute doses above 200 mg/kg could potentially cause toxicity. This higher threshold is largely due to children having relatively larger kidneys and livers than adults and hence being more tolerant of paracetamol overdose than adults. Acute paracetamol overdose in children rarely causes illness or death with chronic supratherapeutic doses being the major cause of toxicity in children.

Since paracetamol is often included in combination with other drugs, it is important to include all sources of paracetamol when checking a person's dose for toxicity. In addition to being sold by itself, paracetamol may be included in the formulations of various analgesics and cold/flu remedies as a way to increase the pain-relieving properties of the medication. To prevent overdoses, one should read medication labels carefully for the presence of paracetamol and check with a pharmacist before using over-the-counter medications.


Risk factors for toxicity
Chronic excessive ethanol (alcohol) consumption can induce CYP2E1, thus increasing the potential toxicity of paracetamol. For this reason, other analgesics such as aspirin or ibuprofen are sometimes recommended for hangovers.

Fasting is a risk factor, possibly because of depletion of hepatic glutathione reserves.

It is well documented that concomitant use of the CYP2E1 inducer isoniazid increases the risk of hepatotoxicity, though whether CYP2E1 induction is related to the hepatotoxicity in this case is unclear. Concomitant use of other drugs which induce CYP enzymes such as antiepileptics (including carbamazepine, phenytoin, barbituates, etc) have also been reported as risk factors

Answer 2

1st: you probably have headaches caused by the medication.
2nd your liver won't last very many years.
You would need a workup and detoxification -no point of having headaches because of medication -not originally probably, but now.
Find a Neurologist specialising in headaches and do somthing about this. Your body can't take that for long. There are all kinds of methods to get you off chronic medication, so be of good cheer -but act, things won't change if you don't do something about it.
Wishing you a painless spring!

marya

Answer 3

Liver damage.