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> Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid. Yes, but: > Responsible for 56,000 emerge

> Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid. Yes, but: > Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States. Notably, around 50% of these poisonings are unintentional, often resulting from patients misinterpreting dosing instructions or unknowingly consuming multiple acetaminophen-containing products. Source: https://www.ncbi.nlm.nih.gov/books/NBK441917/#:~:text=Acetaminophen%20toxicity%20is%20the%20second,annually%20in%20the%20United%20States. https://www.ncbi.nlm.nih.gov/books/NBK441917/#:~:text=Acetam...

drewg123 1y ago
I was under the impression that a lot of overdoses of acetaminophen are due to it being included in many different multiple-medicine cold/flu remidies, like cough syrup, NyQuil, decongestants, etc. So people end up exceeding the max dose accidentally when they take acetaminophen along with some of those other things. Does the UK have rules that prevent mixing acetaminophen with other drugs? Its getting so its sometimes hard to find over the counter cold/flu medicines without acetaminophen
- tim333 1y ago
  I think it's less mixed in with other products than in the US (?)
  - zdragnar 1y ago
    My wife has negative reactions to it, which is extremely rare at normal doses (to the point many doctors don't believe her). Trying to find medicine for her when she's sick is surprisingly time consuming as it is in so many things even vaguely related to treating cold / cough / flu symptoms.
- roryirvine 1y ago
  The UK rules apply to all medicines containing paracetamol. Non-pharmacy retailers are only allowed to sell in packs of 16, and they'll usually only allow two packs of any paracetamol-containing medication to be sold at a time (eg. one cold/flu and one cough remedy). If the name of the product doesn't already contain the word "paracetamol", then all of the packaging must prominently display "contains paracetamol" - so even small retailers that don't have computerised checkouts are expected to follow the same rules. Deaths from paracetamol overdose fell by 43% (with a similar decrease in the rate of accidental poisonings) in the first 11 years after these changes were implemented: https://www.bmj.com/content/346/bmj.f403 https://www.bmj.com/content/346/bmj.f403
tecleandor 1y ago
There's an interesting thing too about metamizol. It's very popular here in Spain for some types of pain (for example, teeth related stuff or post-surgery) and it's used widely without much problem. In fact, it was the most sold medication in Spain in 2023 (sold under the Nolotil brand) [0]. But it's forbidden in places like the UK. Thing is, as we are a popular destination with British tourists or even pensioners that live in the Mediterranean, we've found in the last years that British population is genetically more likely to have a very dangerous side effect, agranulocytosis, that could result in death. Can't find the exact source (I'm on my phone), but seems like at least half of the metamizol related agranulocytosis cases in Spain have been of British origin, and several deaths have been reported. There's a ongoing legal process where at least 40 deaths are being investigated [1] and doctor have stopped providing metamizol to persons of British origin, and do it carefully for other persons. So what was perfectly safe around here, was found quite dangerous for certain subset of the British population (no jokes about balconies, please). Edit for some sources: From 1998 to 2003, out of the 13 agranulocytosis cases from a hospital in Marbella, 8 were foreigner, and of those 5 were from the UK [2]. According to the ADAF association, out of the 45 deaths attributed to metamizol in Spain since 1996, only 8 of them were Spanish (they don't tell their sources in that article) [3] -- 0: https://fefe.com/wp-content/uploads/2023/05/Obs.-marzo23ok.pdf 1: https://guardian.pressreader.com/article/281857238286709 2: https://www.sciencedirect.com/science/article/abs/pii/S0014256509713104 3: https://www.elespanol.com/ciencia/salud/20231128/denuncian-sanidad-muerte-decenas-britanicos-espana-tomaron-nolotil/812919101_0.html
lupusreal 1y ago
Yes, but: 350 million people in this country.

drewg123 1y ago

I was under the impression that a lot of overdoses of acetaminophen are due to it being included in many different multiple-medicine cold/flu remidies, like cough syrup, NyQuil, decongestants, etc. So people end up exceeding the max dose accidentally when they take acetaminophen along with some of those other things. Does the UK have rules that prevent mixing acetaminophen with other drugs? Its getting so its sometimes hard to find over the counter cold/flu medicines without acetaminophen

tim333 1y ago
I think it's less mixed in with other products than in the US (?)
- zdragnar 1y ago
  My wife has negative reactions to it, which is extremely rare at normal doses (to the point many doctors don't believe her). Trying to find medicine for her when she's sick is surprisingly time consuming as it is in so many things even vaguely related to treating cold / cough / flu symptoms.
roryirvine 1y ago
The UK rules apply to all medicines containing paracetamol. Non-pharmacy retailers are only allowed to sell in packs of 16, and they'll usually only allow two packs of any paracetamol-containing medication to be sold at a time (eg. one cold/flu and one cough remedy). If the name of the product doesn't already contain the word "paracetamol", then all of the packaging must prominently display "contains paracetamol" - so even small retailers that don't have computerised checkouts are expected to follow the same rules. Deaths from paracetamol overdose fell by 43% (with a similar decrease in the rate of accidental poisonings) in the first 11 years after these changes were implemented: https://www.bmj.com/content/346/bmj.f403 https://www.bmj.com/content/346/bmj.f403

tecleandor 1y ago

There's an interesting thing too about metamizol. It's very popular here in Spain for some types of pain (for example, teeth related stuff or post-surgery) and it's used widely without much problem. In fact, it was the most sold medication in Spain in 2023 (sold under the Nolotil brand) [0]. But it's forbidden in places like the UK. Thing is, as we are a popular destination with British tourists or even pensioners that live in the Mediterranean, we've found in the last years that British population is genetically more likely to have a very dangerous side effect, agranulocytosis, that could result in death. Can't find the exact source (I'm on my phone), but seems like at least half of the metamizol related agranulocytosis cases in Spain have been of British origin, and several deaths have been reported. There's a ongoing legal process where at least 40 deaths are being investigated [1] and doctor have stopped providing metamizol to persons of British origin, and do it carefully for other persons. So what was perfectly safe around here, was found quite dangerous for certain subset of the British population (no jokes about balconies, please). Edit for some sources: From 1998 to 2003, out of the 13 agranulocytosis cases from a hospital in Marbella, 8 were foreigner, and of those 5 were from the UK [2]. According to the ADAF association, out of the 45 deaths attributed to metamizol in Spain since 1996, only 8 of them were Spanish (they don't tell their sources in that article) [3] -- 0: https://fefe.com/wp-content/uploads/2023/05/Obs.-marzo23ok.pdf 1: https://guardian.pressreader.com/article/281857238286709 2: https://www.sciencedirect.com/science/article/abs/pii/S0014256509713104 3: https://www.elespanol.com/ciencia/salud/20231128/denuncian-sanidad-muerte-decenas-britanicos-espana-tomaron-nolotil/812919101_0.html

lupusreal 1y ago

Yes, but: 350 million people in this country.