Paracetamol overdose is an important cause of liver failure requiring liver transplantation. But the damage is much greater across the Channel.
Headache, fever, aches and pains to reduce these pains, the reflex is often to take a paracetamol tablet. But the best-selling painkiller in the world is far from trivial. Even used in therapeutic doses (4 grams per day), it can lead to liver failure. For the most severe cases, transplantation may be necessary or even essential.
In France, the overdose of paracetamol is even the first reason for liver transplantation. In England, the situation is even more critical, as revealed by a study published this Thursday in the British Journal of Clinical Pharmcology.
This large-scale work is the first to assess and compare the impact of the misuse of paracetamol in Europe. To do this, the researchers used data from 52 transplant centers in 7 different countries (1). Between 2005 and 2007, nearly 9,500 people were waiting for a liver transplant. Among them, 111 patients suffered from hepatic insufficiency linked to an overdose of paracetamol.
500 million boxes in France
“The overdoses of paracetamol can be voluntary as for a suicide attempt (which are the majority, note) or be accidental”, indicates to Why actor Ezgi Gulmez, pharmacologist at the University of Bordeaux and lead author of the study.
These overdoses represent 20% of the causes of liver transplants in the 7 countries studied. In Ireland, poisoning is responsible for one in two liver failure. Next come Great Britain (28%), France (18%), the Netherlands (8%) and Italy (1%).
So how do you explain this heterogeneity across Europe? The authors do not give an explanation but they reveal “that there is no relation between the quantity consumed by a country and its inhabitants and the number of overdoses”. Thus, while France is the largest consumer of paracetamol with 500 million boxes sold in 2013 (report of the National Agency for the Safety of Medicines and Health Products published in June 2014), it is ranked 3th rank.
Reduce the size of boxes
However, the authors suggest a few avenues for preventing these undesirable effects and promoting the proper use of drugs. They suggest, in particular, to act on conditioning. “In France, paracetamol cans are the smallest with a maximum of 8 grams. », Underlines Ezgi Gulmez. Suspending the sale of these drugs in supermarkets, as Sweden has just done, would also allow better control. In France, health professionals had put forward this argument to push back the Minister of the Economy who was considering the release of this drug from pharmacies.
The pharmacologist also recalls certain actions to adopt to prevent drug poisoning. “You have to read the instructions again before taking a drug and with each new intake, do not consume alcohol. Knowing the molecule is also very important because it makes it possible to avoid the simultaneous intake of several drugs containing the same active principle ”, she quotes. The place of the doctor and the pharmacist is also central. “They can tell you if certain drug cocktails are dangerous and what to avoid,” adds the specialist.
(1) France, Great Britain, Ireland, Italy, Greece, Netherlands, Portugal
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