Over-the-counter acetaminophen products such as Tylenol are commonly used to treat kids, but a new study suggests many parents may give their children too much – posing a risk of life-threatening overdoses.
The study, published in the Canadian Medical Association Journal, urged better labeling and marketing campaigns to warn parents of potential adverse effects, including liver damage.
"Acetaminophen overdose is a major cause of acute liver failure and is the most common identifiable cause of acute liver failure in children," said researcher Dr. Rod Lim, a pediatric health specialist with Children's Hospital of London Health Sciences Center in Ontario. "Repeated supratherapeutic dosing [above the recommended dose], accidental overdose due to error and intentional ingestion can all result in acute liver failure and even death."
The study spotlighted the case of a 22-day-old baby whose parents misunderstood the correct dose of acetaminophen and administered too much for a circumcision. The child was later treated and recovered, but Lim and his colleagues said the case underscores the need to inform parents of the potential dangers.
They noted a recent analysis by U.S. poison control centers and the American Academy of Pediatrics of 238 cases of serious medication errors in children under age 6 found acetaminophen overdose was the most common single agent responsible for a life-threatening event, longer-term illness or death. The study found 11 percent of children who are given pharmaceuticals experience a medication error such as an incorrect medication, incorrect dose or method of administering.
"Although physicians and pharmacists should continue to educate parents and caregivers regarding the medications prescribed, one-to-one communication cannot be the sole approach to reducing errors in medication administration," Lim and his colleagues concluded. "Error reduction on a large scale requires systems-based interventions and prevention."
Among their suggestions: Better labeling and dosing information; improved dosing devices — many parents use spoons, which are not standard sizes and can lead to overdoses — and placing acetaminophen behind a drug store counter to ensure that a pharmacist can counsel parents on correct dosing.