Experts have issued a warning that taking more than the recommended dosage of paracetamol, specifically exceeding four doses instead of the prescribed two, elevates the risk of suffering severe consequences such as acute liver failure, harm to organs, and even death.

They cautioned that although paracetamol may seem uncomplicated, inexpensive, and easily accessible, abusing or overdosing on it can prove fatal.

Experts specializing in liver and digestive system disorders stressed the importance of strictly adhering to the doctor’s instructions when taking paracetamol.

University Hospitals Sussex NHS Foundation Trust disclosed that paracetamol is a common pain reliever found in various cold and flu medications, often combined with other painkillers.

The trust cautioned that taking amounts exceeding the recommended daily dosage of paracetamol can have detrimental effects, as it overwhelms the body’s defense against a breakdown product of paracetamol, resulting in damage to the liver and kidneys.

The damage can be severe enough to need a liver transplantation and if you are unable to get a transplant in time you could die of liver disease. Liver disease can lead to bruising easily, bleeding, and swelling of your tummy,” it restated.

The University of Ilorin Teaching Hospital’s Professor of Public Health, Tanimola Akande, highlighted that drug overdose is a hazardous health issue. He emphasized that the correct dosage of medication depends on factors such as the patient’s weight and the severity of their condition, which are determined by medical professionals.

He statedd, “Overdosing on paracetamol also known as acetaminophen can be extremely dangerous and may lead to severe health complications, including liver damage and failure.

“The acetaminophen, depending on dosage and duration of use, can harm the liver, which is the organ that metabolises the drug. The liver primarily metabolises paracetamol. So, when there is an overdose, the capacity of the liver to process it is overwhelmed.

“This leads to the accumulation of toxic by-products that can damage liver cells. The kidney can also be damaged with an overdose of Paracetamol, though not as common as damage to the liver.

“However, the extent to which paracetamol can cause organ damage and death is dependent on the level of overdose and the condition of the patient, particularly if the liver is already compromised.”

Cautioning against self-medication, Akande urged the masses to desist from any form of paracetamol overdose.

“Self-medication is dangerous and should be avoided. Patients should endeavour to see their doctors for treatment and use drugs as prescribed,” he advised.

Supporting this perspective, Dr. Adefunke Babatola, a Consultant Gastroenterologist and Pediatrician at the Ekiti State University Teaching Hospital in Ado-Ekiti, Ekiti State, emphasized that while the range of paracetamol dosage is broad, prolonged usage exceeding the recommended dose can result in liver damage. He cautioned that an excessive amount of paracetamol can lead to acute liver failure, and consistent use of paracetamol in children may trigger hepatic failure.

Dr. Babatola disclosed that she had managed three instances of paracetamol overdose, all culminating in fatalities, and cautioned mothers against administering excessive paracetamol to their children.

She stated, “Paracetamol overdose is a serious condition that has always ended in fatality, especially if such a case is presented after 15 minutes of injection of the paracetamol. This drug shouldn’t be taken against a doctor’s prescription.”

Speaking on the treatment, Babatola mentioned, “The treatment of paracetamol overdose is often cost-intensive and requires machines like dialysis and chemoperfusion, but the prognosis is often bad because the ultimate treatment most times is a liver transplant.

“But if the poisoning is known on time and the individual is brought to the hospital on time within 10 and 15 minutes of paracetamol injection, we can do a gastric lavage procedure to take some of the tablets away from the stomach.

“We pass a feeding tube into the patient’s system, using normal saline to take away the paracetamol that has not been absorbed in the stomach. This procedure will reduce the amount of paracetamol that will get into systemic circulation, which would cause liver failure.

“But once it is established, the prognosis is often very poor, particularly in a developing country like Nigeria, where there is no provision for liver transplantation. There are only a few centres that do liver transplantation in the country.”

Speaking on the survival rate, Babatola emphay, “If the individual is brought in within 10 minutes of overdose and there has not been a liver failure, the prognosis is good but once we start seeing signs of liver failure, such as prolonged bleeding, the prognosis is not good at all.

“I have had a cause to manage three cases and they all resulted in mortality. They died of chronic use of paracetamol. Also, there was a baby that was prevented within four months of life and the baby died of liver failure too.”

Delving deeper into this subject, a research paper authored by Dina Abushanab and colleagues, and published in the National Library of Medicine under the title ‘Patterns and outcomes of paracetamol poisoning management in Hamad Medical Corporation, Qatar: A retrospective cohort study,’ confirms that an overdose of paracetamol can result in liver damage, acute liver failure, and potentially fatal outcomes.

As outlined in the research, instances of paracetamol overdose contribute significantly to emergency hospital admissions and inquiries to poison centers in the United States, leading to heightened direct expenses and imposing a strain on healthcare budgets.

The study highlighted that paracetamol toxicity remains a prevalent issue globally, with approximately 17% of poisoning cases in Qatar being attributed to this cause.

“Moreover, compared with other poisoning cases, paracetamol toxicity is the leading cause of mortality. It is widely used as a counter painkiller in Qatar,” the study mentioned.

It pinpointed that Intravenous N-acetylcysteine is the mainstay treatment for paracetamol overdose, mentioning that the standard local administration of NAC in adults is the 3-bags (21 hours) protocol.

“Based on clinical investigations, NAC should be discontinued once patients recover from toxicity. To date, only a limited number of studies have evaluated paracetamol overdose or toxicity, and most have been conducted in Western countries,” the study emphasized.