SEATTLE, Nov. 30 - Liver toxicity from acetaminophen poisoning is by far the most common cause of acute liver failure in the United States, researchers reported.
Users of the popular painkiller who are most at risk include those with depression, chronic pain, alcohol/narcotic use, and those who take several acetaminophen-containing products at the same time, they added.
"Education of patients, physicians, and pharmacists to limit high-risk [acetaminophen] use settings is recommended," wrote Anne M. Larson, M.D., of the University of Washington, and colleagues at 21 other U.S. centers, in the December issue of Hepatology.
Acetaminophen (Tylenol and generics) is widely available in over-the-counter preparations for headaches, colds, allergies, osteoarthritis, and other conditions.
The data suggest that consistent use of as little as 7.5 g/day of acetaminophen could lead to severe hepatic injury, Dr. Larson and colleagues wrote.
As some of us have seen, innocuous Tylenol can be a real nasty medication in larger quanities. Some suggestions to avoid a problem for our patients are:
*Inform patients that acetaminophen dosing greater than 7.5 g/day could be hazardous. Reassure them, however, that acetaminophen-related liver toxicity is an uncommon occurrence, and that the drug itself is not toxic.
*Instruct patients who use over-the-counter medications to read labels carefully and look for the ingredient acetaminophen in analgesics, cold and allergy medications, sleep aids, and other products.
*Inform patients who have alcoholic liver disease that smaller amounts of acetaminophen (4-5 g/day) have been reported to cause acute liver failure.
From Med Page Today.
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