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Safer medicine bottles could prevent acetaminophen poisoning in kids

The FDA calls for life-saving features on bottles of liquid medications

Published: August 19, 2015 05:00 PM

To help reduce the threat of acetaminophen poisoning, the Food and Drug Administration (FDA) recently called on all drug manufacturers to include a simple safety feature in bottles they produce of infant and children's liquid medications that contain acetaminophen, the active ingredient in Tylenol. Acetaminophen poisoning is one of the leading causes of accidental medication overdoses in children.

While acetaminophen is safe in recommended doses, ingesting too much can cause severe liver damage and rarely, even death. For many infants and young children, a syrupy liquid medication that smells and tastes like candy can be all too tempting to grab when a caregiver’s back is turned. So to stop a free-flow of liquid acetaminophen from getting out of a bottle, drug manufacturers may use a small device known as a "flow restrictor." It fits into the neck of the bottle to make it harder for kids to drink or suck out the liquid contents.

We tested the various flow restrictors of more than 30 infant and children’s liquid acetaminophen bottles in late 2013, and found two basic types. Each type added an extra layer of protection against acetaminophen poisoning in children, but one design used in PediaCare products, and a store brand, DG Health, found at Dollar General Stores worked, much better than the other.

McNeil, maker of market-leading Tylenol products, was not one of the manufacturers using the flow restrictor we found most effective in our testing. The company also recently confirmed that they are still using the same flow restrictor.

Unfortunately, the recent FDA recommendations stopped short of suggesting manufacturers use the more effective design.

Read more about how flow restrictors work and see results from our tests of more than 30 bottles of liquid infant acetaminophen in our December 2013 report.

"We’d like to see all manufacturers using the more effective valve," says Doris Peter, Ph.D., director of Consumer Reports’ Health Ratings Center, adding that acetaminophen is not the only medication that poses an overdose danger to kids. "Well-designed flow restrictors should be used on all liquid medications for adults and children."

The FDA’s new voluntary guidelines also call for manufacturers to include a well-labeled tool for giving medications such as an oral dosing cup or syringe. That’s a good idea says the Centers for Disease Control and Prevention (CDC), because a spoon or different dosing tool might hold the wrong amount of medication. In addition, the CDC advises the following steps to protect your kids from acetaminophen poisoning as well as accidental overdose from any medication:

  • Store  all medicines out of the reach of children.
  • Don’t leave medicines lying around. Put them back after each use.
  • Always relock the safety cap every time you open it.
  • Teach your children about medicine safety.
  • Program the Poison Help number into your phone: 1-800-222-1222.
– Teresa Carr
Editor's Note:

This article is made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin (gabapentin).

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