Caffeine and acetaminophen don’t mix well

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Sep 27 2007

Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal.

The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

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Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

http://www.acs.org/

Posted in: Drug Trial News

Tags: Acetaminophen, Alcohol, Anti-Epileptic Drug, Arthritis, Bacteria, Caffeine, Coffee, Drugs, E. coli, Enzyme, Laboratory, Liver, Metabolite, Migraine, OCT, Painkiller, Research, Toxicology, Toxin

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Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

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• Mixing large doses of both acetaminophen painkiller and caffeine may increase risk of liver damage

FOR IMMEDIATE RELEASE | September 26, 2007

WASHINGTON, Sept. 26 2007 — Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.

Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.

While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.

Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.

In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.

“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol. ”

Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.

Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.

Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.

The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.

— Mark T. Sampson

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The most scandalous cases when firms recalled their products

• Stories

In the pursuit of revenue, corporations lose millions of dollars, and customers lose their lives.

April 23, 20202

Just this year, the US Consumer Product Safety Commission asked customers to stop buying Panasonic laptops because their batteries caught fire; IKEA lamps, because their metal frames shock people; lights for bicycles that ignited while under the driver’s seat . ..

Companies often try to protect their customers. But not always.

Tylenol 1982

In the summer of 1982, there were seven cases of poisoning in Chicago with Tylenol, then the most popular pain reliever in the United States at the time. The first victim was a 12-year-old girl. After drinking the pill, she dropped dead after a few seconds. It turned out that the tablet contained 65 mg of cyanide (lethal dose – 5 mg!). Similar incidents occurred over the next two days in different parts of the city.

As you might guess, panic seized the city: people threw away their supplies of Tylenol, and sales in stores fell to zero. The management of Johnson & Johnson took unprecedented measures: they recalled the entire drug from pharmacies and stores, and this, so you understand, is about $ 100 million. As it turned out, the manufacturers were not to blame for anything: an anonymous poisoner was operating in Chicago, who poured poison into medicine packages, and then returned them to store shelves.

Johnson & Johnson developed a new way of packaging Tylenol: now under the cap of the vial, the neck was hermetically sealed with foil. Today it is the standard for pharmaceuticals. Tylenol has managed to regain its place in the drug market.

Firestone and Ford Explorer tires, 2000

In 2000, a scandal erupted in the United States when it became public knowledge that Ford Explorer SUVs rolled over on the roads much more often than other cars. In this case, we are talking only about cars equipped with original Firestone tires. The situation was aggravated by the fact that, as it turned out, both companies – Ford and Firestone – were aware of what was happening since 1996 years old, but made every effort not to correct technical errors, but to hush up the matter.

The number of victims in the USA alone exceeded one thousand people. When the secret became clear, every more or less self-respecting newspaper in the United States hastened to write a devastating, revealing article, their total number exceeded 5 thousand. Ford’s sales decreased by 80%, the company lost about $3 billion. Firestone has withdrawn about 3 million tires from sale.

Both companies, instead of paying compensation to the victims and their families, hastened to blame each other and got bogged down in lawsuits and litigations, some of which have not been completed to this day.

Chinese milk formulas and milk, 2008

In June 2008, a “melamine scandal” broke out in the world: a high content of melamine was found in the dairy products of a number of Chinese manufacturers – a substance that is essentially non-toxic (at least not more than than table salt), but at ultra-high concentration leading to kidney stones. It is commonly used in mineral fertilizers and plastics. Manufacturers added it so that when measured, the protein level in milk seemed higher (the milk itself was diluted with water). Two companies — Mengniu Dairy Group and Yili Industrial Group — added melamine to their milk (regular and powdered), infant formula, chocolate bars, instant coffee and cookies. Among other things, milk was supplied to schools and kindergartens. By the time the decision was made to recall the products, six children had died.

As a result, the Chinese authorities decided to seize all spoiled products (most of them were exported to the countries of the Pacific region). Even chicken eggs had to be seized, as melamine was added to chicken feed. 19 people – entrepreneurs and civil servants – were punished (up to life imprisonment). Two entrepreneurs, Jang Yuzhong and Geng Jinping, were shot dead in 2009.

Text author:Semyon Shraik

Which medicines do not go well with food?

Even the healthiest food can become poisonous if seasoned with medicines.

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Medications

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Some foods contain very specific substances that some medications can counteract.

Contents of the article

1. Grapefruit and cough medicine

Also combination of medicine with lime and pomelo. These fruits block the production of an enzyme that breaks down statins and other drugs, such as the cough medicine dextromethorphan. As a result, the drug accumulates in the blood, which can lead to unwanted side effects. In the case of a combination of citrus fruits with dextromethorphan, hallucinations and drowsiness may appear, and with statins – serious muscle damage. The effect of these fruits lasts a little more than a day, which means that they and medicines should be taken with an interval of at least 24 hours.

2. Dairy products and antibiotics

Some antibiotics, such as ciprofloxacin, combine in the stomach with calcium, iron and other minerals found in milk. This leads to the fact that the antibiotic is poorly absorbed and, accordingly, the effectiveness of its fight against infections is sharply reduced. When you buy a new medicine for asthma or colds, the first thing to ask is if it belongs to the group of so-called tetracyclines or fluoroquinols. If it does, try to avoid milk, yogurt, and cheese for 2 hours before and after taking your medication. And if you are also taking multivitamin or mineral complexes, then check this period with your pharmacist, as they may have a similar effect.

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3. Smoked meats and antidepressants

Read the label of your pills carefully. If it contains monoamine oxidase inhibitors (MAOIs), then taking them along with foods rich in the amino acid tyramine will lead to a dangerous surge in blood pressure. Unfortunately, the list of foods containing this amino acid is not limited to barbecue and smoked salmon. It also includes red wine, sauerkraut, hot dogs, aged cheeses, and draft or home-brewed beer. However, do not panic ahead of time! Canned or bottled beer probably won’t hurt you, and monoamine oxidase inhibitors are rapidly being replaced by new generation antidepressants that don’t have these side effects.

4. Chocolate and Ritalin

In addition to caffeine, chocolate also contains a stimulant called theobromine. It is because of this substance that chocolate is harmful to dogs – they simply cannot digest it. Both of these stimulants entering your body can lead to unpredictable consequences and cause seizures. Just like the effects of caffeine, the effects of combining chocolate and Ritalin are highly individual. So the best solution is this: if you are nervous, overly irritable and aroused after taking Ritalin and a chocolate bar, then try increasing the time between taking the medicine and chocolate dessert. Or choose milk or white chocolate: the darker the chocolate, the more caffeine and theobromine it contains.

5. Apple juice and allergy medicines

If you are taking hay fever medicine, never take apple, orange or grapefruit juice with it without waiting 4 hours after taking the pills. These juices inhibit the peptide that transports the drug from the intestines to the blood. As a result, the effectiveness of the drug is reduced by 70 percent, which will make it almost pointless to take it, and your runny nose and sneezing will become non-stop. Also avoid these juices when using the antibiotic ciprofloxacin, the synthroid thyroid remedy, or the allergy and asthma remedy singular.

6. Cassia cinnamon and warfarin

People who have been taking the blood-thinning drug warfarin for a long time know that vitamin K is very important when taking it. broccoli or leafy greens. They contain a large amount of vitamin K, which plays a key role in blood clotting, and its decrease will have a bad effect on its density. But here another problem arises. Cassia cinnamon (cheap cinnamon from China, Vietnam, and Indonesia, often sold as “Indonesian cinnamon”) contains coumarin, which, like warfarin, is a blood thinner. Taking both of these substances can cause serious liver damage. If you are taking warfarin but cannot live without a cup of flavored cinnamon coffee, then switch to a high quality Ceylon cinnamon variety.

7. Alcohol and paracetamol

Your body uses the same enzyme to break down alcohol and paracetamol.