The state of California is studying the possibility of declaring one of the most widely used drugs worldwide to relieve pain and fever as a carcinogen, a measure that has caused controversy between scientists and regulatory authorities.
This medicine, paracetamol , also known as acetaminophen, is used in more than 600 medicines, some controlled and others over the counter, and is found in recognized brands such as Tylenol, Excedrin, Sudafed, Robitussin and Theraflu , The news agency reported. Associated Press
Paracetamol has been sold without the need to present a prescription in the United States since 1955. The reason for studying its possible link to cancer comes from its relationship with the drug phenacetin, which was banned by the Food and Drug Administration in 1983 because it caused cancer.
State regulators have evaluated 133 studies on paracetamol, all published in arbitrated scientific journals. Some of these reported an increase in the risk of certain types of cancer, but others did not find this relationship. But they warned that, in general, it is difficult to determine the relationship between cancer and paracetamol , because it is difficult to isolate the effect of other variables, such as smoking.
A state law known as Proposition 65 states that California must warn people about any chemical known to cause cancer or reproductive toxicity.
Now that list includes more than 900 chemicals, including toxic pesticides and inflammatory retardants, and is more extensive than any other in the country. Some critics say California regulators have gone too far, and require warning labels for countless confusing products instead of informing consumers, when the risk of cancer is still in dispute.
Proposition 65 supporters say it protects not only Californians, but also consumers across the country by forcing manufacturers to make products safer.
Evidence of the link between paracetamol and cancer has been weak enough for the International Agency for Research on Cancer to decline to mention it as a possible carcinogen after reviews in 1990 and 1999. The Food and Drug Administration warned state officials that Labeling paracetamol as a carcinogen would be " false and misleading" and also illegal, according to federal law.
A panel of scientists appointed by the governor add chemicals to this list. In 2011, the panel voted to make acetaminophen a "high priority" for consideration because it believed there was relevant evidence to consider, according to Sam Delson, spokesman for the Office of Environmental Health Risk Assessment of the California Office .
The review process has been slow, but the panel is scheduled to hold a public hearing on the list this spring, after the close of the public comment period on January 27.
"It is a difficult problem because it is a widely used drug. But that makes no difference. That is not our mandate," said Thomas Mack, chairman of the Carcinogen Identification Committee and professor of preventive medicine at the University of Southern California.
Adding a chemical to the list can have wide repercussions . After the state listed glyphosate, known as the Roundup weed killer, as a carcinogen in 2017, a jury ordered the company that makes Roundup pay more than $ 2 billion to a Californian couple with cancer. A judge then reduced that compensation to 87 million. That is just one of the 13,000 pending pending lawsuits involving the chemist.
That is one reason why the industry is rejecting the possible inclusion of paracetamol in the list. The Consumer Healthcare Products Association , a commercial group that represents over-the-counter medications and dietary supplements, made its own review and found that most studies do not suggest any risk for most forms of cancer, although some studies showed a higher risk of kidney , liver and some forms of blood cancer .
The association urged California regulators to have a "cautious interpretation" of studies showing an increased risk of cancer.
Some medications listed in California require warning labels. But the state has made exceptions. Alcohol has been listed as a carcinogen since 1988. But instead of warning labels, the state orders the alcohol industry to provide posters to California retailers to be placed where alcohol is sold.
Acrylamide, a by-product of roasted coffee beans, has been listed as a carcinogen since 1990. But when a court ruling would have resulted in warning labels for coffee, state regulators intervened and exempted the beverage.
Excedrin temporarily suspends the production of two migraine medications