Acetaminophen -- widely known by the brand name Tylenol -- is a subject of FDA scrutiny today as regulators explore the risk of liver failure associated with taking too much of the drug.
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"Acetaminophen kills more people annually in the United States than all other prescription drugs combined," Lee said. "That it is [available] over-the-counter, sold in quantities up to 1,000 tablets, and has been advertised for years as being remarkably safe never made sense.
However, some pain management doctors voiced their confusion over the seemingly contradictory recommendations.
"I think that combo products are generally a bad idea -- that is, the idea of giving two or more drugs in fixed ratios," said Dr. Elliot Krane, director of the Pain Management Service at Stanford University's Lucile Packard Children's Hospital.
But he said that he remains baffled as to why the panel would not recommend eliminating acetaminophen from over-the-counter (OTC) combo products as well.
"I'm puzzled by the 'no' vote here, if 10 percent of [overdoses] come from these products," Krane said. "That's a substantial fraction. Why would they not extend the same safety measure to OTC products?"
Other pain physicians noted similar confusion.
"The inconsistency is that they don't address the over the counter combination products -- the 'all-in-one' combinations of cough, 'congestion' and 'fever' products that have acetaminophen, and only reveal the amount of acetaminophen in really small print on the back," said Dr. Timothy Collins of the Pain and Palliative Care Clinic at Duke University Medical Center. "These products are the ones that have given me concern with my own patients, because many patients are not aware that their 'cold, cough and fever' product has acetaminophen in it, and take it along with their pain medications."
Meanwhile, family practitioners and rheumatologists -- those who regularly prescribe acetaminophen-containing medicines to their patients -- expressed some concerns over the recommendation that would eliminate medicines like Vicodin and Percocet.
"I do not think eliminating combination products is necessary and that the vote to do so goes too far," noted Dr. Randy Wexler, assistant professor of clinical family medicine at the Ohio State University Medical Center. "Combination products, especially in caring for patients with chronic pain, are important."
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