PARACETAMOL (acetaminophen) is an effective painkiller but a risky one, making it the leading cause of acute liver damage in the US. Now there are two ways it could get a whole lot safer. A US Food and Drug Administration panel wants to slash the recommended dosage. And a safer alternative can be made cheaply for the first time.
When used as directed paracetamol is safe, but it doesn鈥檛 take much more than the recommended dose to cause permanent, possibly fatal, liver damage. Among over-the-counter drugs, 鈥渋t probably has the smallest difference between how much it takes to be effective and how much it takes to cause damage鈥�, says Sidney Wolfe of the watchdog group in Washington DC. Because paracetamol is an ingredient of numerous preparations, from cold medicines to prescription narcotics such as Vicodin, it鈥檚 easy to double-dose by mistake.
Last month the FDA鈥檚 advisory panel recommended specifying smaller doses of paracetamol and clearer labelling of medications that contain it. More controversially, the panel recommended removing it entirely from prescription narcotics. The FDA usually follows its panel鈥檚 recommendations.
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A more comprehensive solution may be on the horizon, in the form of drugs such as SCP-1, which is made up of a molecule of paracetamol joined to a saccharin molecule. In early tests in people SCP-1 does not seem to produce the same toxic by-products as paracetamol. Now and colleagues at the University of New Orleans, Louisiana, together with the New Orleans company , which ran the tests, have reported a way to synthesise SCP-1 cheaply and in large quantities (Organic Process Research and Development, ).
鈥淭he molecule does not seem to produce the same toxic by-products as paracetamol鈥�
鈥淎t this point, we鈥檙e pretty much ready to go,鈥� says Trudell.
