Paracetamol, a common but dangerous medicine



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"Paracetamol is the best and the worst of things, it is an innocuous drug, very well tolerated in 99.999% of cases, but becomes an extremely dangerous weapon when used outside of nails" , explains the pharmacologist Francois Chast to AFP

"It's like a kitchen knife: it's an effective and safe tool when you hold it by the handle, but if you're clumsy, you can

Doliprane, Dafalgan, Efferalgan … Many paracetamol-based medicines are sold without a prescription and commonly used for pain and fevers. But at too high doses, this substance can attack the liver.

The death of Naomi Musenga, who died on December 29 at the age of 22, after being taunted on the phone by an operator of the Samu de Strasbourg, is "the consequence of 'a paracetamol intoxication absorbed by self-medication over several days,' said Yolande Renzi, the prosecutor of this city.

"The evolutionary destruction of the cells of his liver brought a failure of all its organs leading quickly upon her death, "according to Ms. Renzi.

Family Disputed Findings:" I do not believe that paracetamol was the cause that precipitated the death of my daughter, "who was" well informed about how to take this medicine, "responded the father of the young woman.

" Information problem "

According to the World Health Organization (WHO)," a single dose of 10 to 15 grams is enough to cause a necrosis Hepatica may be fatal ". This is why paracetamol is often used in suicides.

The maximum dose is 3 grams per 24 hours, spacing the catches.

"When taking 4 grams per day for several days, especially if consumes alcohol at the same time, it is likely to cause drug hepatitis called fulminant, that is to say, radical quickly, "says Professor Chast.

This is an emergency, which requires the administration of a molecule called N-acetylcysteine. For lack of prompt treatment, this liver condition can be fatal.

An overdose of paracetamol first causes "discrete signs of gastrointestinal irritation", according to the WHO.

They "are usually followed by two days later anorexia, nausea, malaise, abdominal pain, then progressive signs of liver failure and, finally, hepatic coma. "

" Each year in France, nearly a hundred transplants hepatic (about 1,200 in total, ed) are related to paracetamol intoxication, "says Professor Chast. "This is a considerable proportion, all this for a misuse of a drug deemed harmless."

And even if one is vigilant, one can sometimes exceed the maximum dose without knowing it.

"There are 200 medicines which contain paracetamol.I have been a specialist in drugs for 50 years and I am unable to quote them all, "says Professor Jean-Paul Giroud.

" If you take two, for example one prescribed by a doctor and the other self-medication, you can find doses of over 4 grams per day, "he continues.

Professor Giroud pleads for better information of the general public on the potential dangers of paracetamol : "There is an information problem for which I have been fighting for 40 years, but it can not be said that the public authorities seize it, it is up to them to insist on it".

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