Doctor reveals the common medication he 'hates'... and warns it could cause organ failure
Dr Ethan Melillo, a pharmacist from Rhode Island, says one of the medications he 'hates' is Tylenol PM, one of America's top-selling nighttime painkillers that grosses nearly $1billion a year.
But Dr Melillo warns the 17 cent pills designed to provide relief from headaches and minor aches and pains is 'misused' by many patients.
He cautioned that if it is used on a regular basis, it can cause liver damage as it contains acetaminophen.
Meanwhile, diphenhydramine, which induces sleepiness, can cause memory loss.
When acetaminophen is broken down in the liver, a small amount of a toxic byproduct called NAPQI is produced.
Normally, the body's natural antioxidant - glutathione - neutralizes NAPQI. However, when high doses of acetaminophen are taken, or if glutathione levels are low from factors like alcohol use or malnutrition, the liver's capacity to process and eliminate NAPQI becomes overwhelmed.
When NAPQI is not properly detoxified, it can accumulate in the liver and bind to essential cellular proteins, leading to cell injury and potentially liver failure.
Dr Melillo says the risk of liver damage increases significantly when the dose of acetaminophen exceeds 4,000mg daily in adults. This equates to more than eight Tylenol PM pills.
He highlights that acetaminophen is an ingredient in many medicines, not just Tylenol PM, so he recommends checking to see which products contain it and the quantities.
He doesn't recommend against acetaminophen completely but says it should be used sparingly and not habitually.
He says the prevalence of it is one of the reasons why there is so much liver damage in the US.
Liver disease in some form affects one in three Americans, adding up to 100million.
In January 2011, the FDA asked manufacturers of combination drugs containing acetaminophen to limit acetaminophen doses to no more than 325 mg in each tablet or capsule.
This is because there's no data showing that taking more than 325 mg per dosage unit provides additional benefit while outweighing the increased risk of liver injury.
Despite the recommendations, each Tylenol PM tablet contains 500 mg of acetaminophen to relieve pain and 25 mg diphenhydramine to help you go to sleep.
Previous research also found that acetaminophen could alter the perception of risk by making certain activities seem less dangerous.
Participants in the study ingested two acetaminophen tablets (1,000 mg) of the drug or a placebo and were asked to rate certain activities based on risk.
Those under the influence of the of the drug rated activities like bungee jumping, skydiving or starting a new career in your mid-30s as less risky than those who took the placebo.
The 2020 study, conducted by The Ohio State University, built on previous work that determined acetaminophen impacts the user's psychosis, as it was found to reduce positive and negative emotions, such as hurt feelings, concern of other's suffering and even their own joy.
Dr Melillo also dislikes Tylenol PM for its other main ingredient, diphenhydramine.
This is an antihistamine, which means it blocks histamine, a chemical in the body that promotes wakefulness, leading to drowsiness and helping with sleep.
Dr Melillo says that most people will be more familiar with the medication by its brand name, Benadryl.
Explaining why he isn't a fan of diphenhydramine, he said it could 'possibly cause memory loss.'
Diphenhydramine is an anticholinergic medication, meaning it blocks the neurotransmitter acetylcholine, which is essential for memory and cognitive function.
By blocking its action, diphenhydramine can impair these functions, leading to memory loss.
One study found that taking an anticholinergic for the equivalent of three years or more on a daily basis was associated with a 54 percent higher dementia risk than taking the same dose for three months or less.
The other side effects of diphenhydramine, Dr Melillo says, include dry mouth and urinary retention (an inability to empty the bladder).
He says for older patients, these symptoms can prove particularly troublesome as they could trigger other age-related health conditions.
If people need help sleeping, the pharmacist advises talking to a doctor about prescription medications that are available instead of turning to Tylenol PM or Benadryl, which they could become dependent upon.
He adds: 'If you're someone who takes this on a blue moon, then that's fine, it's not a big deal.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Telegraph
30 minutes ago
- Telegraph
Milei took a chainsaw to Argentina's health system. Now it's ‘bleeding to death'
'You pay, you contribute, and then they make you feel like a beggar,' said Claudia Pilla, a 56-year-old teacher from Buenos Aires with breast cancer. This has become the grim reality of Argentina's cancer patients since right-wing President Javier Milei yanked the plug on free healthcare after taking the helm in December 2023, chanting his mantra 'There is no money'. Once a proud Peronist pillar in the nation's constitution, hospitals are crumbling after Mr Milei waved his subsidy-slashing chainsaw. The libertarian government has sliced the health budget by half in real terms, halted free cancer drugs and fired 2,000 health ministry employees – a quarter of its workforce. HIV-positive patients are left waiting months for antivirals after Milei axed HIV, TB and STI funding by 76 per cent, and once they arrive they are often expired. This has coincided with new HIV infections climbing for the first time in over a decade with a 25 per cent spike and syphilis cases hitting a three-decade high. Now the public health system is 'bleeding to death in silence', said Argentina's Federation of Health Professionals' (FESPROSA) President María Fernanda Boriotti. Formally employed Argentines are eligible for social security, funded by payroll contributions, which in theory provides some medical coverage and subsidies. But less than half of the employed population hold registered salaried jobs, leaving the rest to the mercy of public hospitals. Even for those who supposedly have medical coverage, the bureaucratic nightmare often means they end up paying catastrophic sums out of pocket anyway – after a long wait in the queue. Ms Pilla was turned away from the oncology hospital after waiting two months for an appointment. 'I was number 312 that day at the hospital, and there were just as many people waiting behind me. 'When they finally saw me, the doctor didn't even want to check me. I had a five centimetre lump in my breast. 'My insurance says it covers medicines, but the pharmacy tells me it doesn't. So I end up buying everything as if I had no insurance at all.' Facebook groups have sprouted up where desperate cancer patients like Mrs Pilla and their families plea for donations from those with spare medication. To bypass Facebook rules against advertising prescription drugs, the words are embedded with emojis. 'Even if you have social security, you are forced to keep calling, emailing and fighting to get them to recognise what you are owed.' Director of the public oncology clinic Hospital María Curie, Dr Gustavo Jankilevich, explained: 'We are in a moment of transition, moving from one healthcare system to another.' 'Depending on where a person lives, the healthcare experience can be very different. In some public hospitals, patients can receive treatment for free, while in other regions, this is not the case,' he explained. 'There's a significant issue with very high-cost medications.' Argentina's reforms echo the USA, as Milei becomes the pet project of Trump and Elon Musk. During US Health Secretary RFK Jr's trip to Buenos Aires in May, Argentina confirmed it was following in Trump's footsteps in quitting the WHO. A joint statement revealed a shared commitment to Make America Healthy Again's values. After his election victory in 2023, Milei swooped in to remove price caps in an attempt to deregulate a plethora of industries, promote a market-driven economy and propel the privatisation of state-owned companies. 'Everything that can be in the hands of the private sector will be in the hands of the private sector,' Mr Milei vowed on the radio. However, medicines and prepaid health premiums prices skyrocketed even quicker than inflation – to such an extent that in an uncharacteristic move, Milei intervened months later to roll back the surges, castigating healthcare providers for 'abusing prices' and turning into 'cartels'. But it was too late for patients already priced out of private hospitals, leading to clinics like Hospital María Curie being flooded with patients. Previously, Argentina provided free care to everyone, residents and foreigners alike. This month, a decree came into effect demanding travellers show proof of travel insurance upon entering the country. Unlike Britain's centrally managed NHS, Argentina has long had medical disparities between the formally and informally employed, and the system was gradually being decentralised. But Mr Milei has accelerated the fragmentation by slashing federal funding and leaving each district to manage its own health department, with a vision of a smaller, more efficient state. However, the effect has been a postcode lottery, forcing patients to travel across the country to hospitals with more resources. By law, free HIV tests and medication have been universally available as a basic right since the 1990s – but it rings hollow when shortages and austerity measures have left patients scrambling for tests, antiretrovirals and even condoms. Claudio Mariani, 59, is a prominent HIV activist who has been living with the virus for over 30 years. He recently received four boxes of expired medication, and he isn't alone. 'During the country's economic collapse in 2001, I left for Europe because Argentina had no medication. Now people are receiving their medication one or two months late.' He is part of a collective that documented 103 cases of patients deprived of their daily antiretroviral pills for weeks at a time last year. 'Once we see that someone is missing something, we set up alerts, tour pharmacies and speak with infectious disease specialists across the country.' With modern medicine, people living with HIV can now achieve a near-normal life expectancy and an undetectable viral load, which means that there is not enough of the virus in body fluids to pass it on during sex. However, the national shortage of certain antivirals has left 48,000 people at risk of becoming transmissible, according to a new report by the GEP Foundation. The Huésped Foundation is a major STI and TB charity in Argentina filling in the gaps with tests and education campaigns that the government is failing to provide, amid rising cases. Tuberculosis cases have increased by 38 per cent in comparison with the last five years. The Huésped director, Leandro Cahn, said: 'For at least 10 years, the number of new HIV diagnoses was around 5,000 a year. But the latest figures jumped to 6,500. Given that the proportion of late diagnoses has climbed too, we think that it isn't an outlier.' Last year, the government provided 25 million free condoms to the public. This year, it has provided only 3 million condoms for a country with a population of 45 million. In Argentina there are more than 140,000 people living with HIV, of which 93 per cent know they are infected – compared to the UK's 107,000. The vast majority (98 per cent) of infections are due to unprotected sex, making condoms a key strategy to curbing the spread. But safe sex is now a luxury. At pharmacies, a box of 12 condoms typically costs 12,500 pesos (£7.60), which is almost an entire day's pay on the daily minimum wage (£8.80). 'The federal government didn't buy a single condom, and gave no explanation,' said Cahn. 'None of the decisions made by this government have helped in creating a more integrated system.' Patients with disabilities that have high care costs are fighting to keep their disability allowances. Victoria Rojo, a 23-year-old woman from a town near Córdoba in central Argentina, has Hanhart syndrome, which means she was born with three limbs missing. 'I took the insurance company to court because they said my prosthetic limbs were too expensive,' she said. Ms Rojo uses Instagram, on which she has 190,000 followers, to increase visibility for people with disabilities. 'I went through the whole process to get disability benefits, but when Milei came to power he scrapped my progress and I had to start again. I waited over a year, and even that was lucky – it would've been longer if a politician hadn't helped me out.' She receives just £165 per month, which is less than the region's average rental price. Parkinson's medication is supposedly still free, but as the wife of one 65-year-old patient, Nélida García*, from a suburb of Buenos Aires said, 'all the other costs will bankrupt you'. Parkinson's disease is a disorder of the nervous system that primarily affects movement. Mrs García had to send their daughter to the UK to earn enough money to cover her husband's medical expenses. 'We spend over $2,000 USD per month on caregivers alone. My children cover 80 per cent of that. Add consultations, supplies, food and transport and it becomes impossible.' 'Caregivers used to be free. Now the public system pays outsourced companies so little that no one takes the jobs. Patients are left without care. If you have no family, you're simply abandoned. 'If you own a car, you lose access to many other free medications. The system punishes people for simply having a vehicle.' Argentina is also seeing a wave of medical professionals leaving public hospitals for the private sector and abroad. FESPROSA President María Fernanda Boriotti said: 'I don't recall in my 30-plus years in public health seeing such a marked migration of professionals from various disciplines who are leaving public health in this manner. 'We are gradually dismantling the public health system, closing doors, losing professionals, and losing medications. Bit by bit, we are losing everything.'
The Sun
an hour ago
- The Sun
Woman died after ‘rampant STI' invaded her body and attacked her vital organs – 4 signs you must know
A WOMAN died after an untreated STI invaded her body and attacked her vital organs. The unnamed woman from Alaska, who was in her 50s, passed away from disseminated gonococcal infection (DGI). 1 This is a rare but serious complication of the sexually transmitted infection gonorrhoea. It occurs when Neisseria gonorrhoeae bacteria spreads from the initial site of infection, seeping into the bloodstream and vital organs. DGI is thought to occur in just 0.5 percent of all gonorrhoea cases. The woman arrived at her local emergency department in Anchorage, Alaska, in spring this year, already in a critical condition. She was in respiratory distress - when the lungs aren't working properly due to serious illness - and was diagnosed with septic shock and heart failure, caused by endocarditis, a potentially fatal infection of the heart's inner lining. Further testing revealed her body had been invaded by gonorrhoea bacteria. But the patient wasn't diagnosed with DGI until after she'd passed away. There were no records of her being tested for gonorrhoea prior to her presenting at the emergency department. She'd been treated twice in the prior six months for opioid abuse, according to the Alaska Department of Health. Eight cases of DGI were reported in Alaska between January and May 2025, report authors added. How to put a condom on - NHS The cases were spotted after patients were evaluated in emergency departments in Anchorage. Epidemiologic investigations didn't establish connections between any of the DGI cases. While gonorrhoea can be got rid of with antibiotics, some infected people may not get tested or treated as they don't have symptoms of the STI, according to Dr Liz Ohlsen, a staff physician with the Alaska Department of Health who wrote the report. As a result, they run the risk of developing dangerous DGI, she told the Alaska Beacon. Health officials fear that a strain less likely to cause symptoms is circulating in Alaska, Dr Ohlsen went on. 'We think the most likely explanation for the rise in DGI cases is that more people with gonorrhoea are not getting tested and treated in a timely manner," she said. "Asymptomatic infections are thought to pose a greater risk of persistent untreated infection because people are less likely to have sought care." The Alaska Department of Health bulletin warned that people in Anchorage with a new sexual partner, more than one sexual partner, or a partner with multiple partners might be at risk of acquiring a strain of N. gonorrhoeae that's thought to carry a higher risk of causing DGI. Symptoms of gonorrhoea Typical symptoms of gonorrhoea include: A thick green or yellow discharge from the vagina or penis Pain when urinating Pain and discomfort in the rectum Lower abdominal pain and bleeding between periods in women and other people with a uterus or ovaries Gonorrhoea can affect other parts of your body that come into contact with semen or vaginal fluid. This can cause: Pain, itching and discharge from your bottom A sore throat Eye redness, pain and discharge However, many people infected with gonorrhoea will have no symptoms, especially for infections in the throat, vagina or rectum. This lack of symptoms makes it important to test regularly when having sex with new or casual partners. If you do get symptoms, they usually start around two weeks after infection, although they sometimes do not appear until many months later. Untreated gonorrhoea can lead to serious health complications including: Infertility and pelvic inflammatory disease (PID) An infection of the female reproductive system, which includes the womb, fallopian tubes and ovaries An infection in the testicles or prostate In rare cases, gonorrhoea bacteria can cause a disseminated gonococcal infection (DGI). It can cause frequently results in purple or pus-filled spots on the skin, joint pain, inflamed tendons or septic joint infections. Rarely, DGI can lead to inflammation of the liver, endocarditis - an infection of the inner heart lining - and meningitis. Having gonorrhoea during pregnancy can increase your risk of premature birth and your baby having a low birth weight. There's also a risk the infection could spread to your baby's eyes during birth, which is called gonococcal conjunctivitis. This can cause blindness if it's not treated with antibiotics. "While no specific sexual network has been identified, this strain may be circulating more broadly among persons with gonorrhea infection in Southcentral Alaska," report authors said. "The absence of documented gonorrhoea risk factors in most DGI cases suggests patients may not be asked about or disclosing key sexual history. "Few had symptoms before presenting with DGI, consistent with its progression from untreated mucosal infections. "Asymptomatic or mildly symptomatic patients with GC are less likely to seek health care and may be at a higher risk of persistent untreated infection leading to disseminated infection." In the UK, health officials issued warnings earlier this year over cases of "extensively drug resistant" gonorrhoea that aren't responding to antibiotic treatment. While most gonorrhoea infections can be treated effectively, certain resistant strains "present significant treatment challenges", the UK Health Security Agency (UKHSA) said. It warned that increased resistance could one day make the STI 'untreatable'. Meanwhile, the NHS announced it would begin vaccinating people against gonorrhoea come August, after cases of the STI hit a record 85,000 in 2023. Local sexual health clinics will offer the jab to gay and bisexual men, who are most at risk. Patients will receive the 4CMenB vaccine for meningitis B, which has been found to nearly halve the chances of catching gonorrhoea in adults. Health chiefs reckon they can prevent around 10,000 cases per year.
The Guardian
an hour ago
- The Guardian
Landmark US study reveals sewage sludge and wastewater plants tied to Pfas pollution
Sewage sludge and wastewater treatment plants are major sources of Pfas water pollution, new research finds, raising questions about whether the US is safely managing its waste. A first-of-its-kind study tested rivers bordering 32 sewage sludge sites, including wastewater treatment plants and fields where the substance is spread as fertilizer – it found concerning levels of Pfas around all but one. The study is the first to sample water up- and downstream from sites, and to test around the country. It found the levels downstream were higher for at least one Pfas compound 95% of the time, suggesting that the sludge sites are behind the increased pollution levels. 'We have an indication of very widespread problems and significant exposures that people are going to be facing,' said Kelly Hunter Foster, an environmental attorney with the Waterkeeper Alliance, which conducted the study. Pfas are a class of about 15,000 compounds that are dubbed 'forever chemicals' because they do not naturally break down, and accumulate in the human body and environment. The chemicals are linked to a range of serious health problems like cancer, liver disease, kidney issues, high cholesterol, birth defects and decreased immunity. Sludge is a mix of human and industrial waste that is a byproduct of the wastewater treatment process. Its disposal is expensive, and the Environmental Protection Agency (EPA) allows it to be spread on cropland as 'biosolid' fertilizer because it is also rich in plant nutrients. But public health advocates have blasted the practice because the nation spends billions of dollars annually treating water only to take the toxic byproduct, insert it into the food supply and re-pollute water. Wastewater treatment plants' effluent, or allegedly clean water that they spit back into water systems, often contain high levels of Pfas. Most of the levels far exceeded the EPA's draft guidance for Pfas in surface waters, which is as low as 0.0009 parts per trillion for PFOA, one of the most common and dangerous types of compounds. The authors looked at water in 19 states, and found the highest levels in Detroit's Rouge River, which showed 44ppt of PFOA; North Carolina's Haw River; South Carolina's Pocotaligo River and Maryland's Potomac River. The largest increase around a wastewater plant was found in the Rouge River, where Detroit's mammoth facility spits Pfas-tainted effluent. The chemicals' levels jumped by 146% to about 80ppt for all Pfas. The Pocotaligo, Haw, and Santa Ana River in southern California saw similar spikes. The largest increase around a field on which sewage sludge was spread was found in the Dragoon Creek near Spokane, Washington, where total Pfas levels jumped from about 0.63 ppt to about 33ppt, an increase of over 5,100%. The EPA has long resisted calls to ban the spreading of sewage sludge on agricultural fields, though a 2024 lawsuit that alleges Clean Water Act violations could force some regulatory action. The Trump administration has scrapped the rulemaking process for industrial discharges of Pfas that Joe Biden's EPA began. That would have forced treatment plants to rein in their pollution.
