The Food & Drug Administration (FDA) has asked manufacturers of prescription combination products to limit the amount of acetaminophen to no more than 325mg per dosing unit. This is in response to the incidence of acetaminophen-related liver failure in the United Sates many of which result in liver transplant or death.
The current maximum recommended daily dose of acetaminophen is 4,000 milligrams. There are a variety of combination products that contain varying amounts of acetaminophen: prescription pain relievers such as Vicodin, over-the-counter preparations like Tylenol PM, and many cough and cold medications. Some prescription medication contains 500mg to 750mg of acetaminophen per tablet or capsule. You can see how it might happen that an individual could get more than 4,000 milligrams per day if not aware of the serious consequences and how much acetaminophen they are getting daily. The FDA is attempting to decrease that likelihood.
The problem with combination products is that you cannot increase the amount of one ingredient without increasing the amount of the other ingredient(s) in a dosing unit. This is where compounding pharmacy can help. Let’s look at the pain controller Vicodin (hydrocodone + acetaminophen) as an example. Some patients require high doses of the narcotic hydrocodone but not necessarily a high dose of acetaminophen. This is sometimes very difficult to manage with the fixed combinations of hydrocodone + acetaminophen currently available. Your compounding pharmacy can prepare a capsule containing the two drugs with just about any amount of each. This allows your physician to customize your pain management to your needs.
Ask your pharmacist if you might be getting too much acetaminophen in the medication your are taking.