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Pain Management Health Center

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More Tylenol Overdoses, Liver Failure

Researchers Find Rise in Liver Failures Due to Too Much Tylenol
WebMD Health News
Reviewed by Louise Chang, MD

Dec. 1, 2005 -- Taken properly, Tylenol (acetaminophen) is a safe painkiller. But taking too much Tylenol can lead to liver failure.

That overdose risk is well-known and noted on Tylenol's label. Now, a new study shows a rise in cases of acute (sudden) liver failure reportedly linked to Tylenol overdoses.

The researchers included Anne Larson, MD, an assistant professor of medicine at the University of Washington.

Their report, published in Hepatology, states that the maximum recommended daily dose of acetaminophen is 4 grams.

Check the labels of any over-the-counter drugs you're taking to see how much acetaminophen each pill contains and read up on the products' warnings. If you suspect an overdose, get medical help or contact a poison-control center immediately. The sooner treatment can be initiated in an acetaminophen overdose, the better the chances for recovery and survival.

Latest Study

Larsen and colleagues studied six years of data from 22 university medical centers. During that time, 662 patients met the reseachers' criteria for acute liver failure.

The researchers determined that a little less than half of those cases (42%, or 275 people) were linked to acetaminophen overdoses.

Over the years, acetaminophen accounted for increasing percentages of the cases.

"The annual percentage of acetaminophen-related acute liver failure rose during the study from 28% in 1998 to 51% in 2003," write the researchers.

On average, patients had taken 24 grams of acetaminophen. That's six times the maximum daily dose of 4 grams, or the equivalent of 48 extra-strength tablets.

Intentional Overdoses?

Larsen's team tried to determine whether patients overdosed on purpose and what (if any) other drugs they had also taken.

Figuring that out wasn't always easy, given the patients' condition. The researchers concluded that 44% of the patients had deliberately overdosed in suicide attempts and 48% had overdosed unintentionally. Patients' intentions weren't clear in 8% of the cases, the study shows.

Here's how the patients fared:

  • 65% survived (175 people)
  • 27% died without getting a liver transplant (74 people)
  • 8% got liver transplants (23 people)

Many patients (65%) who reported exceeding acetaminophen's daily limit also abused alcohol, which can damage the liver, the researchers note. They add that some patients were also depressed.

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