Pittsburgh, PA—In a case where the treatment—or, at least, overuse of it—can be worse than the disease, new research finds that acetaminophen overdosing increases significantly during influenza season in the United States.

The report in the British Journal of Clinical Pharmacology suggests that a primary reason for acetaminophen overdose is use of multiple OTC combination medications to treat upper respiratory symptoms.

The study, which was led by researchers from the University of Pittsburgh and Boston University, had participants fill out daily medication diaries for a week. The study used multiple online research panels from 2011 to 2016 to gather information about 14,481 U.S. adults who used acetaminophen in the preceding 30 days.

Results indicate that 6.3% of acetaminophen users exceeded the maximum adult daily dose of 4 g (4,000 mg) on at least 1 day during a week in which they used the painkiller, with the 4-g limit exceeded on an average of 3.7% of the 7 days.

The study also found that the odds of taking more than 4 g of acetaminophen in a day increased 24% in cold/ flu season (CFS), compared with the off-season—6.5% during CFS versus 5.3% during the off-season.

Researchers pointed out, “This was not due to differences in characteristics of individuals using acetaminophen in CFS, but primarily to increased use of over-the-counter (OTC) combination medications designed to treat upper respiratory cold/flu symptoms (33.2% of usage days in CFS vs. 24.8% in off-season; OR=1.6, 1.5-1.7). When such medications were omitted, there was no statistically significant seasonal variation in exceeding 4 grams.”

“This is the first multi-year, year-round study that includes detailed data on how consumers used acetaminophen medications,” noted lead author Saul Shiffman, PhD. “The study findings suggest the importance of educating consumers about acetaminophen and counseling them about appropriate use and safe dosages of these medications.”

“As we are in the midst of a particularly severe cold/flu season, it’s important for consumers to be aware of the limits on acetaminophen use,” Shiffman added.

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