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You may know it as acetaminophen, paracetamol, APAP, or ... Tylenol. Today an FDA advisory panel recommended banning prescription drugs that contain acetaminophen, such as vicodin and percocet. The panel of experts also voted to give acetaminophen a black box warning, and reduce the maximum dosage of over-the-counter formulations. Acetaminophen is a popular painkiller by itself and, in combination with opiates, is the most commonly prescribed medication in the US.

Acetaminophen has known for over a hundred years, though its use in the US began in 1955. The brand has survived scares and maintained its popularity for decades, thanks to some innovative marketing (last link is a pdf) and effective analgesia in many clinical settings.

Acetaminophen is generally better tolerated than ibuprofen and other painkillers, but it's not without adverse effects -- acetaminophen is now the leading cause of liver failure in the US. The FDA panel hopes these measures will reduce overdoses leading to fulminant liver failure, but similar restrictions in the UK have had mixed results.

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[Image: Testosterone-Proprianate with a Russian label.]
Not long ago I asked somebody I know with deep knowledge of athletes, athletic training, and performance enhancing drugs to talk to me about what I suspected was a "dark net" of self-monitoring and self-experimentation. Athletes track their performance in many ways. They measure speed, strength, weight, recovery time, and dozens of other variables. Those who are using performance enhancing drugs must also have well developed monitoring routines. What can we learn from them?

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