RENO, NV - Joe Nannini is the father of two sons; when they get sick, he says he and his wife share the duties taking care of them.
He gets their medication from a locked closet in the hallway.
Here there can be prescription or over-the-counter medications.
Also in the box, measuring devices that make sure his kids are getting the exact dosage specified by the package directions.
“It's read the instructions every single time know matter what. If you are giving something that is going to be given a couple of times a day, I'll usually write it down, and put it with the medicine just in case I give the first dose and my wife gives the second dose,” Nannini.
If his sons have a temperature or are in pain, his choice for an OTC treatment is medication that contains Acetaminophen.
He's not alone.
The drug overtook Aspirin sales in the late 70s when Aspirin was connected with a sometimes fatal disease in children called Reye's Syndrome.
“It was marketed as a very safe drug; didn't cause the GI upset that aspirin was causing and number 2 it wasn't associated or isn't associated with this Reye's Syndrome. Sold at 7-11 so people don't respect them. You don't need to a prescription to get these medications,” says Dr. Brooks Rohlene, and anesthesiology researcher.
More than 30 years later, Acetaminophen is now in many many over-the-counter products, from pain relievers, to cold and flu medicine, children and infant pain medication, and even menstrual pain relief for women.
The drug is clearly marked on the box, but you can get into trouble with something called stacking or double dipping.
"Here's non-aspirin headache remedy; we buy some of that and take some of that; that is Acetaminophen. Ok, you have cold symptoms, some sort of a product that is cold and flu and that has Acetaminophen in it. Night time, you can't sleep; you are coughing. Nyquil, that has Acetaminophen in it. You can see where it could stack up and you could get into a problem real quickly," says Dr. Larry Pinson, Executive Director of Nevada's Board of Pharmacy
Pinson says in his pharmacist days, none of his customers asked about Acetaminophen and dosing.
Overdosing, though, means severe liver damage.
The FDA recommends adult patients take no more than 4000-milligrams a day of Acetaminophen.
“When you are in pain, just had surgery, just had a big ski accident, just had some sort of problem, to ask you to start doing all this math isn't fair,” says Dr. Rohlen.
Dr. Rohlen says the best advice is to monitor your or your child's daily Acetaminophen intake by writing it down and putting in a prominent place.
He says daily intake means from midnight to midnight. Include the milligrams not only for pain tablets, but cold and flu relief, your nighttime cold medicine.
And if you are on a prescription like hydrocodone---otherwise known as Vicodin---look for Acetaminophen in that as well.
Because it's prescribed--check with your doctor or pharmacist if it can be taken with other Acetaminophen products.
“A little too much of Acetaminophen in anybody; healthy or not, can do a lot of damage,” says Dr. Rohlen.
Health experts say if you take Acetaminophen for a chronic problem like a sprained ankle or hurt back, take a different course of pain medication like Ibuprofin, Aspirin, or Naproxin in the following days and rotate the medication.