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nostrademonstoday at 6:03 PM2 repliesview on HN

The article kinda glossed over it, but one fact under-appreciated by the general public is just how dangerous acetaminophen overdoses can be.

Scientists often talk about the "therapeutic index" or "safety ratio" of a drug. It's the LD50 (dose at which 50% of recipients die) divided by the effective dose. Common hard drugs like heroin or methamphetamine have a safety ratio of about 6-10 [1]. "Soft" drugs like marijuana or LSD often have safety ratios of about 1000.

The safety ratio of acetaminophen is under 4. A typical dosing schedule for an adult is 4-6 500mg tablets within a 24 hour period [2], for a total of no more than 3g. 7g of acetaminophen can kill you, and 12g is likely to [3]. Acetaminophen is the leading cause of liver failure in the U.S, causing 50% of cases and 20% of transplants.

When they tell you "don't exceed 6 doses daily", they really mean it, and it's across all acetaminophen-containing products. The margin for error is narrower than heroin.

[1] http://politicsofsin.50megs.com/risk/Toxicity.Comparison_Add...

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC3585765/

[3] https://www.ncbi.nlm.nih.gov/books/NBK441917/


Replies

m_a_gtoday at 6:28 PM

In most countries 4g is the upper limit and it is considered perfectly safe within that limit. So 8 500mg pills in 24 hours.

show 1 reply
rsynctoday at 6:13 PM

Thank you - this is correct and cannot be repeated enough, especially in the context of infant and child doses.