The percentage of cases of acute liver failure caused by an overdose of acetaminophen increased considerably from 1998 to 2003, with unintentional overdose accounting for at least half of these cases, a new US study shows.
Acetaminophen, known in some countries as paracetamol, is the active ingredient in painkillers like Tylenol. Too much can cause serious liver damage.
People with chronic pain, depression, and those who abuse substances, including alcohol, may be particularly at risk for unintentional acetaminophen overdose, Dr. Anne M. Larson of the University of Washington in Seattle and colleagues report in the medical journal Hepatology.
“Efforts to limit over-the-counter packaging size and to restrict the prescriptionof narcotic-acetaminophen combinations (or to separate the narcotic from the acetaminophen) may be necessary to reduce the incidence of this increasingly recognized but preventable cause of acute liver failure in the United States,” Larson and her team write. Patients who unintentionally overdosed were older.
“Overall, 178 subjects (65 percent) survived, 74 (27 percent) died without transplantation, and 23 subjects (8 percent) underwent liver transplantation,” Larso’s group found.
The investigators say there is a relatively narrow range between an effective dose of acetaminophen and a dangerous dose. They say that “consistent use of as little as 7.5 grams per day may be hazardous.” One extra-strength Tylenol tablet contains half a gram of acetaminophen.
In an editorial accompanying the study, Dr. John G. O’Grady of King’s College Hospital in London points out that a 1998 rule in the UK restricting over-the-counter sales of acetaminophen to 16 grams led to a 30 percent reduction in hospital admissions for acute liver failure related to the drug, and France’s rule limiting sales to 8 grams has also been effective. SOURCE: Hepatology, December 2005.
Looking for other viable active options to control painful conditions seems to be the best choice; however, it is not the easiest choice. Most people think that OTC (over-the-counter) medications are safe no matter what, but that is simply not true. That is why most bottles list how many to take per day and how long you can keep taking it without a Doctor’s evaluation or stopping for a while. Our seminar series will also cover other options to help headaches and other painful conditions so you can be in control.
God Bless,
Dr. Benzinger
