Marianne Martinez
Paracetamol, the active ingredient in Panadol, is the most common medicine taken in an overdose. While it is a safe and effective painkiller when used as directed, exceeding the recommended dose can lead to paracetamol poisoning, causing liver damage and even death. Accidental overdoses are common, especially among young people, but intentional overdoses with suicidal intent are also frequent. Recognising the signs and symptoms of paracetamol overdose is crucial to seeking timely medical attention and reducing the risk of severe health consequences.
| Characteristics | Values |
|---|---|
| Common names | Paracetamol, Acetaminophen, Panadol |
| Overdose symptoms | Tiredness, abdominal pain, nausea, yellowish skin, blood clotting problems, confusion, kidney failure, pancreatitis, low blood sugar, lactic acidosis |
| Treatment | Medicine called acetylcysteine, intravenous NAC infusion |
| Overdose causes | Accidental, suicidal intent, spur-of-the-moment, pre-planned |
| Overdose risk factors | Alcoholism, malnutrition, taking certain hepatotoxic medications |
| Overdose effects | Liver failure, death |
| Overdose prevention | Limited quantity sold at once, sold in blister packs, awareness of recommended dosage |
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What You'll Learn
Paracetamol poisoning symptoms
Paracetamol poisoning, also known as acetaminophen poisoning, is caused by the excessive use of the medication paracetamol. It is the most common medicine taken as an overdose and can lead to liver failure and death within just a few days.
In the first 24 hours following an overdose, symptoms are typically mild or non-existent. These may include tiredness, abdominal pain, and nausea. After this initial period, there may be an absence of symptoms for a couple of days, providing false reassurance. However, this is followed by more severe symptoms, including yellowish skin, blood clotting problems, and confusion, which are indicative of liver failure.
Additional complications of paracetamol poisoning may include kidney failure, reduced urine output, pancreatitis, low blood sugar, and lactic acidosis. These symptoms can be life-threatening and require immediate medical attention.
The risk of paracetamol toxicity is increased by certain factors, such as chronic excessive alcohol consumption, malnutrition, and the use of certain other hepatotoxic medications. It is important to seek medical attention immediately if an overdose is suspected, as early treatment improves the chances of recovery.
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Risk factors for toxicity
Paracetamol poisoning, also known as acetaminophen poisoning, is caused by the excessive use of the medication. It is the most common medicine taken as an overdose and can lead to liver failure in just a few days. In rare cases, paracetamol toxicity can result from normal use due to individual differences in the expression and activity of certain enzymes in one of the metabolic pathways that handle paracetamol.
There are several risk factors for toxicity:
- Alcoholism: Chronic excessive alcohol consumption can induce CYP2E1, increasing the potential toxicity of paracetamol.
- Malnutrition: Those who are malnourished may be at increased risk of experiencing toxicity at therapeutic doses.
- Other medications: The risk of toxicity is increased by the taking of certain other hepatotoxic medications.
- Liver disease: Underlying liver disease increases the risk of paracetamol-related liver damage.
- Weight: Individuals with a body weight under 50 kg may be at increased risk of toxicity at therapeutic doses.
- Genetics: Genetic factors can enhance acetaminophen's ability to damage the liver.
- Age: Age can also play a role in increasing the risk of toxicity.
- Herbal supplements: The use of herbal supplements can increase the risk of toxicity.
- Nutritional status: Poor nutritional status can increase the risk of metabolic acidosis and toxicity.
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Treatment for overdose
Paracetamol overdose can lead to liver failure in just a few days, and even result in death. If you suspect that you or someone else has overdosed on Panados, call emergency services immediately. While waiting for emergency services to arrive, lie the person on their side, loosen any tight clothing, and open a window or take them outside for air. If the person is unresponsive and not breathing, be prepared to administer CPR.
Upon arrival, the medical team will assess the patient and decide on the best course of treatment to reduce the chance of liver damage. Treatment for paracetamol overdose typically involves the administration of acetylcysteine, an antidote that works to reduce paracetamol toxicity by replenishing the body's stores of the antioxidant glutathione. This medication is usually given as two infusions over a period of about 12 hours through an intravenous (IV) drip.
Activated charcoal may also be administered if the patient seeks medical help soon after the overdose. However, inducing vomiting is not recommended as it can delay the effective administration of activated charcoal and acetylcysteine. In severe cases of liver damage, a liver transplant may be necessary.
Following treatment, most patients tend to recover fully within a couple of weeks. Psychiatric care may be required as part of the recovery process.
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Accidental overdose
Paracetamol, the active drug ingredient in Panadol, is the most common medicine taken in an overdose. It is easily accessible and available over the counter without a prescription. This makes accidental overdose a common occurrence, especially in young people aged 18 to 25, who may take more than the recommended dosage of eight tablets per day to relieve pain or reduce fever. Accidental overdose can also occur when someone takes multiple combination products containing paracetamol to treat cold and flu symptoms.
The symptoms of a paracetamol overdose can vary. For the first 24 hours, there may be few or no symptoms at all. Some people may experience nausea, vomiting, abdominal pain, or tiredness. After a couple of days, symptoms such as yellowish skin, blood clotting problems, and confusion may occur as a result of liver failure. Other complications can include kidney failure, pancreatitis, low blood sugar, and lactic acidosis.
If you suspect an accidental overdose, it is important to seek medical attention immediately. The medical team will assess the situation and may perform blood tests to determine the risk of liver damage. Treatment may include a medicine called acetylcysteine, which is given through intravenous infusion to reduce the risk of liver damage. It is important to provide accurate information about the tablets taken to ensure proper assessment and treatment.
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Intentional overdose
Paracetamol, the active drug ingredient in Panadol, is the most common medicine taken in an overdose. In 2021, there were 227 deaths recorded in England and Wales due to paracetamol overdose, with a further 261 deaths in 2022. Paracetamol is widely available over the counter and is present in most homes, making it an easily accessible drug for intentional overdose.
Intentional overdosing, often with suicidal intent, is frequently implicated in paracetamol toxicity. Paracetamol poisoning can lead to liver failure and even death within a few days, even if medication is given to protect the liver. Liver failure can cause yellowish skin, blood clotting problems, and confusion. Additional complications may include kidney failure, pancreatitis, low blood sugar, and lactic acidosis.
Those who take an intentional overdose may experience more symptoms, such as nausea and vomiting, or they may regret their actions and seek medical attention earlier. It is important to bring any empty packets or suicide notes to the hospital, as this information can help medical professionals assess the situation and provide the best treatment.
To prevent an accidental overdose of paracetamol, it is important to be aware of the recommended dosage, which is no more than 4g or eight tablets per day. Paracetamol is sometimes included in multiple combination products for the treatment of coughs and colds, so it is important to read the drug ingredients listed on the medication packaging and be mindful of how much paracetamol is being consumed from various sources.
While death from paracetamol overdose is rare when N-acetylcysteine (NAC) is administered within 8 hours of ingestion, it is still possible to die from paracetamol poisoning even with early and appropriate treatment. Therefore, seeking immediate medical attention is crucial in the event of an intentional overdose.
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Frequently asked questions
Panadol is a brand name for paracetamol, a common painkiller that is normally safe.
Yes, you can overdose on Panadol. Paracetamol is the most common medicine taken in an overdose.
Symptoms of a Panadol overdose include tiredness, abdominal pain, nausea, yellowish skin, blood clotting problems, and confusion.
If you overdose on Panadol, seek medical attention immediately. Be prepared to provide information on the number of tablets taken, the time of overdose, and any other substances consumed.
