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Use of New Zealand's most widely taken painkiller, paracetamol, is being reviewed because of concerns in the United States about side-effects that include liver damage.

Three advisory committees have advised the US Food and Drug Administration to reduce the single maximum dose of the common painkiller - known in the US as acetaminophen - from 1000mg to 650mg.

They also recommended reducing the maximum daily dose, but did not specify by how much.

The FDA does not have to follow the advice of its panels, though it usually does. The agency has given no indication on when it might act on the recommendations.

New Zealand's drug regulator, Medsafe, said yesterday that it was consulting the FDA to see if any action was needed here.

Health experts the Herald spoke to welcomed the review.

Medsafe group manager Dr Stewart Jessamine said the number of tablets in each packet and the strength of the drug were lower in New Zealand than in the United States.

Local laws required product labels to identify medicines containing paracetamol and warn that other paracetamol medicines should not be taken at the same time.

"Labels also state that these products should be taken for only a few days at a time in adults, except on medical advice."

But Pharmacy Guild chief executive Annabel Young said the use of paracetamol was worrying because so many products contained it.

People often took cold medication containing paracetamol without realising other painkillers they bought from the supermarket also contained it.

"There's always a concern when you take a medicine out of an environment where you're given advice ... and put it in an environment where you're buying it alongside cigarettes and Coca-Cola," Ms Young said.

Overdosing on paracetamol could lead to liver damage or failure and people didn't realise how harmful it could be.

"It is a gruesome way to die."

Ms Young said regulators were taking a "leap of faith" that people would follow over-the-counter drug instructions and the United States developments should be monitored.

"It's definitely something that we need to keep an eye on. Being able to buy it at the supermarket is a concern."

Auckland City Hospital emergency department specialist Dr Lynn Theron said paracetamol overdoses occurred about once a week, but most were deliberate, attempted suicides.

Accidental overdoses occurred about once a year, usually in people predisposed to liver problems, she said.

Australian authorities are also monitoring the United States developments.

Herald

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