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Comment by pessimizer | Hacker News Reader

What an unnecessary, garbage drug; one that's responsible for half the liver failures in the United States. Maybe a restriction on pregnant women taking it could move it behind the counter, or better, into the dimly-remembered past.

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Given the issues with NSAIDs in general (and even moreso with NSAIDs with particular populations), acetaminophen being available remains important. It definitely has dangers particularly if used improperly (and a much narrower gap between normal and dangerous doses than many other drugs), but its not an unnecessary or garbage drug.

Right - for example pain management in Crohns.

It's definitely necessary for some people. I'm allergic to NSAIDs, though to differing degrees. Really bad hives (to the point of needing epinephrine) from aspirin, less severe reaction to naproxen.

I can tolerate a single pill of ibuprofen, maybe 2 in 24 hours but that's it. I don't take acetaminophen frequently, but it is one of the only things I can tolerate for pain (sinus/tension headaches mostly).

I cannot take NSAIDs so Acetaminophen remains the only non prescription option for the occasions I need it. I still try to avoid it when possible and keep a careful tally of how much I take.

Regarding your comment on liver failure: wouldn't you need to take more than the allowed dose for this to happen?

You do. The interesting thing about paracetamol is that toxicity arises at only about 3 times the maximum daily recommended dose. For a drug which is perceived as so safe it's common for someone to continue downing them when they're in pain and become quite sick. Certainly a problem of education, not the drug itself.

It surprises me people would just 'down' any medication. I've always stuck strictly to the very clear instructions on the box (I believe it's 2 every 4 hours, no more than 8 within 24 hours for paracetomol) and everyone I know does. Reading through this thread though it seems like a lot of people seem to be confident enough to play doctor and decide what they should/shouldn't take and what is good/bad for them. Maybe it's a cultural thing but everyone I know is pretty careful with even 'staple' medications like this or NSAID's.

Behind the counter, yes, but it's too useful to take away entirely and the politics of pain management medication are a mess.

(In the UK, you can buy it OTC but only in regulated small pack sizes, as it used to be the most common drug used in attempted suicide-by-overdose.)

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