Prescriptions drug products that include a key pain-relieving ingredient - acetaminophen - should be eliminated from the market, a panel of medical experts told the U.S. Food and Drug Administration Tuesday.

The recommendation has the potential to affect a host of currently approved prescription products, including Abbott Laboratories (ABT) Vicodin, Johnson & Johnson's (JNJ) Ultracet and Endo Pharmaceuticals Holdings Inc.'s (ENDP) Percocet. The recommendation could also affect hundreds of pending drug applications.

Twenty panel members voted in favor of eliminating prescription products that contain acetaminophen with other ingredients while 17 voted against. The FDA doesn't have to follow the panel's advice but generally does. The panel made the recommendation because acetaminophen has been linked to liver damage and death.

The recommendation, if implemented, would affect more than 240 pending new drug applications, according to the FDA. Painkillers that combine acetaminophen with hydrocodone, a powerful pain-killing ingredient, are the most commonly prescribed drugs in the U.S., the FDA said. There are currently no hydrocodone products that don't include acetaminophen.

Acetaminophen is an ingredient found in over-the-counter painkillers such as Excedrin and Tylenol and a host of cough medicines like NyQuil and Theraflu. The panel voted against pulling over-the-counter products that combine acetaminophen with other ingredients, citing data showing liver damage is most frequent in prescription products that include acetaminophen.

The panel also voted 21 to 16 to recommend the maximum daily dose of acetaminophen available in over-the-counter drugs be lowered. The panel recommended the maximum daily dose be lowered to 2,600 milligrams from 4,000 milligrams.

The panel also recommended that 500-milligram doses of the drug be available by prescription only.

The panel said it was against limiting the quantity of acetaminophen that can be sold in a package. The drug is available in 1,000 pill bottles in certain discount stores such as Costco Wholesale Corp.'s (COST) stores. Some panel members said they were concerned large bottles encouraged people to take too much of the drug.

"I think we have to send a message that there is a problem with this medication," said panel member Winifred A. Landis, a pharmacist from Indiana. She said the FDA should consider what size packages for Tylenol and other acetaminophen products should be sold in non-pharmacy settings.

About 100 people die annually from accidentally overdosing on acetaminophen. The FDA says the drug is safe if taken at recommended levels. However, the drug's prevalence in a variety of pain relievers, fever reducers and cough medicines means patients don't realize they are taking several drugs that contain the same ingredient, often leading to an overdose of acetaminophen.

The panel will vote on a series of other options that will potentially limit access to products containing acetaminophen. One of the most important questions, expected to be voted on at the end of the meeting, is whether to eliminate medicines that combine acetaminophen with other ingredients.

This could have implications for a host of products, including Johnson & Johnson (JNJ)'s combination painkiller, Ultracet.

-By Jared A. Favole, Dow Jones Newswires; 202-862-9207; jared.favole@dowjones.com