Can paracetamol cause severe side effects effects, liver disease and even organ failure? There have been some reports in the media recently regarding the dangers of acidosis. What we need to know.
The possibility that paracetamol can cause metabolic acidosis, although in very rare cases, has long been described in the product information. But in the future, all manufacturers of medicines containing paracetamol will have to explicitly indicate this risk in the instructions accompanying the medicine. They will have to write that the frequency of this side effect is “unknown”.
What is metabolic acidosis?
Metabolic acidosis with an increased anion gap (HAGMA) is a rare but potentially dangerous increased acidity of the body. In essence, this is a violation of the alkaline-acidic balance.
It is important for the body that the blood has a stable pH between 7.36 and 7.44. This pH value is the measure of acidity of any solution, in the case of blood. If the metabolism and the balance between bases and acids in the body are disturbed, the blood can increase its acidity. Then it comes to the so-called anion gap – with it, the pH of the blood falls below 7.35.
With acidosis, breathing becomes difficult, the affected begin to hyperventilate – that is, to breathe too rapidly and deeply. Other typical symptoms are disorientation, weakness and loss of consciousness.
What does paracetamol have to do with acidosis?
In people with impaired metabolism, an overdose of paracetamol can lead to increased acidity of the blood. But this happens extremely rarely. The risk is increased only in people with severe kidney function disorders and sepsis (blood poisoning).
If acidosis is diagnosed, paracetamol should be stopped immediately. And in more severe cases of acidosis, the pH values of the blood are usually normalized with the help of special “buffer“ substances.
Does paracetamol have other side effects?
If taken responsibly, paracetamol is an effective and safe medication to reduce pain and reduce fever.
Although paracetamol puts less strain on the gastrointestinal tract than ibuprofen or acetylsalicylic acid, it can in some rare cases cause abdominal pain, dizziness or vomiting.
Another known but also rare side effect of paracetamol is allergic reactions such as itching, rash or swelling.
Can paracetamol cause serious illnesses?
Patients often underestimate the risks of over-the-counter medications. But just because in some countries paracetamol and other painkillers are sold alongside chewing gum in supermarkets, they should not be used uncontrollably.
In case of overdose, especially in combination with alcohol consumption or with existing liver diseases, this organ can be seriously damaged.
The liver breaks down paracetamol into its component parts, which are then absorbed by the body. If there is an overdose or the medication is taken for too long, the liver is overloaded. Then it is no longer able to break down the toxic intermediate N-Acetyl-p-Benzoquinonimine, which can damage liver cells and in the most severe cases lead to liver failure.