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True, taking large doses of Paracetamol with carbonated drinks could damage your liver

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Claim:  An online news medium on Instagram claimed taking large doses of paracetamol in a carbonated drink is damaging to the liver

Taking large doses of paracetamol with a carbonated drink is indeed damaging to the liver.

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On July 1, 2021, an online news medium on Instagram  instablog9ja posted some pictures of a post by a Twitter user, Sub-pharmacist( @Tobenna__)  on the supposed danger faced by three friends who overdosed on paracetamol.

 Screenshot of the first Instagram post

According to the post, taking large doses of paracetamol in a day is already dangerous and putting it in a carbonated drink even makes it more damaging.

Screenshot of the second Instagram post

The post added that paracetamol is broken down in a toxic metabolite which is still cleared by the liver and taking high doses of paracetamol results in accumulation of this toxic metabolite to a level the liver can handle. And this leads to the damage of liver cells and this damage becomes extensive and results in liver failure.

The post as of July 3 had garnered 19,880 likes and 1,725 comments.

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What is Paracetamol?

In a published article, a  general surgeon, Dr Binita Priyambada says paracetamol is a generic name and is used as an ingredient in a certain group of medicines intended to work as a painkiller, anti-inflammatory drugs.

Also, the drug carries antipyretic properties and hence prescribed or combined in the medicine which is used to reduce fever.

Meanwhile, information on a certified Paracetamol patient information leaflet shows that the drug is used to treat pain (including headache, toothache, back and period pain) and cold or flu symptoms. 

The active substance is paracetamol and other ingredients are, maize starch, potassium sorbate, purified talc, stearic acid, povidone, and soluble starch.

Paracetamol is also available as tablets or caplets, capsules, liquid-usually for children, soluble tablets (tablets that dissolve in water to make a drink), suppositories and an injection into the vein-normally only used in hospitals.

Users were asked to take special check with doctors before taking paracetamol if:

1.       They have severe Kidney or Liver problems.

2.       They have a liver problem caused by alcohol.

Users were also advised against drinking alcohol whilst taking the drug, as taking alcohol with paracetamol can increase one’s chance of getting side effects.

 What is a Carbonated drink?

The medical dictionary defines carbonated drink as a fluid infused with carbon dioxide and consumed for hydration or refreshment, such as Coca-Cola or other soft drink. According to a publication by  Harvard University’s School of Health carbonated drinks which are also categorized as sugar-sweetened beverages or ‘soft’ drinks refer to any beverage with added sugar or other sweeteners (high fructose corn syrup, sucrose, fruit juice concentrates, and more). 

This includes soda, pop, cola, tonic, fruit punch, lemonade, sweetened powdered drinks as well as sports and energy drinks. As a category, these beverages are the single largest source of calories and added sugar in the world’s diet.

So, is taking large doses of paracetamol with carbonated drinks really dangerous to the liver?

Spokesperson for the Association of Community Pharmacists of Nigeria (ACPN), Adebola Lawal, said taking large doses of paracetamol with carbonated drinks is indeed damaging to the liver adding that drugs are meant to be taken with water.

He said carbonated drink is almost a drug itself and when taken together with paracetamol, the liver is made to work more in eradicating what it terms as waste thereby causing a severe problem to it.

“Drugs are meant to be taken with water and not with any form of drinks, because the drink(either alcoholic or carbonated) is also a drug on its own. So, the liver has to go through a process called Metabolism to process it before it gets to the site of action. Therefore, it is absolutely true that when drugs are taken with carbonated drinks, one is bound to exert the liver,” he said.

Another pharmacist and a member of the Pharmaceutical Society of Nigeria (PSN), Abiodun Ayeku, said paracetamol when taken in large doses has an effect on the liver  whether taken with any drink or not.

“As a matter of fact, paracetamol when taken in large dose alone has an effect on the liver, a situation referred to as Hepatotoxicity, and whether taken with any drink or not, if one is taking paracetamol beyond the prescribed dose, it definitely has an effect on the liver.

“This is because paracetamol is metabolic and is broken down in the liver. Basically, regardless of taking the drug with carbonated drinks, taking it in a large dose in the first place is harmful to the liver,’ he stated.

He added that the liver has to work extra hard to break down the carbonated drink and as such it is better that people avoid things that make the liver work more than its capacity.

Conclusion

Taking large doses of paracetamol has a damaging effect on the liver in the first instance and when combined with carbonated drinks, the liver has to exert itself to break down its content and this has a damaging effect on it.

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