What do 681 Drug Tablets and 4,080 Skittles Have in Common?

Ever wonder how many drug tablets you’d need to ingest per day to reach the dose that the European Food Safety Agency considers might cause you genotoxicity? No?

Hmmmmm….

Oh, I bet you want to know how many drug tablets it would take to be equivalent to 4,080 skittles per day for 9 years. Turns out, it’s 681 drug tablets, taken every 6 hours (or 4 times a day) every day for about 8.5 years!

Yep, 681 drug tablets, 4 times a day, every day for 8.5 years — and then you’ll reach the dose that an EFSA committee thinks might cause genotoxicity. I’m pretty sure at that rate you’re going to have much, much bigger problems than genotoxicity.

If you’d like to see the analysis, go here.

Real World Ramifications

So let’s think about this. 681 drug tablets. If we imagined something like acetaminophen in tablet form, that’s going to be 500mg. How much is that in a single dosage? Well, 618 tablets * 500 mg = 340,500mg of acetaminophen. According to the Merck manual death is more likely if someone takes 40 * 325mg tablets = 13,000mg of acetaminophen. Since 340,500mg > 13,000 mg, in my professional opinion as a toxicologist, if you ingested 618 tablets of acetaminophen you’d likely die.

In other words, your risk of death is far greater than your risk of genotoxicity at 618 tablets. In fact, you may not even make it to your next dose of 618 tablets. Thus, your risk of genotoxicity from taking 618 tablets is virtually zero, as you’d unfortunately die.

What about something like fluoxetine (brand name Prozac). Well, if we assume someone is taking 60mg of fluoxetine per day, once per day, then we’d assume they’re taking a 60mg tablet. 618 tablets * 60mg/tablet = 37,080mg. In a 2009 case report a fatal overdose was reported where the patient had 1,400mg/kg fluoxetine in their liver.

We know that 3,300mg of diltiazem (a heart medication) is fatal. So, if someone is taking the 60mg tablet, then that would be 618 tablets * 60mg/tablet = 37,080mg.

So, I guess my point is this — if you were going for genotoxicity, and you ingested 618 tablets of some of the more common drugs on the market, you’re probably going to either die, or have some very serious complications/side-effects. Those are much bigger problems than the genotoxicity that you might one day have if you did this regimen for 4 times a day, every day, for 8.5 years.

The Bottom Line

You’re likely never going to get genotoxicity from the titanium dioxide in a drug tablet. In fact, at 618 tablets, 4 times a day, every day for 8.5 years you’re going to have some very serious problems, all of which aren’t genotoxicity. Just don’t do it.

Lyle Burgoon
Lyle Burgoon
Dr. Lyle D. Burgoon is a toxicologist, biostatistican/data scientist, and risk assessor. He has over 15 years of experience as a government risk assessor, senior science and policy advisor, and as a private consultant. He is currently the President and CEO of Raptor Pharm & Tox, Ltd.

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