More Tylenol Overdoses, Liver Failure
Researchers Find Rise in Liver Failures Due to Too Much Tylenol
The patients who unintentionally took too much Tylenol had some things in
More than a third (38%) simultaneously took at least two products containing
acetaminophen. An example might be a combination medication such as Sudafed
Severe Cold or Tylenol Cold & Flu.
Tylenol's web site tells patients taking more than one over-the-counter
medication to check the products' active ingredients.
"Do not take two medicines with the same active ingredient at the same
time unless instructed to do so by your doctor, pharmacist, or other healthcare
professional," states Tylenol's web site.
In addition, nearly two-thirds of the patients who unintentionally overdosed
were also taking drugs containing narcotics, the study shows. Some commonly
prescribed narcotic medications containing acetaminophen include Percocet,
Vicodin, and Lortab.
Most patients (79%) said they were taking the medication(s) for pain
The FDA predicts 458 deaths per year in the U.S. from acetaminophen-related
acute liver failure, note Larsen and colleagues.
They suggest more education for doctors, pharmacists, and consumers about
avoiding acetaminophen overdoses.
An editorial in the journal notes that the study broadly defined
acetaminophen-related acute liver failure.
"The adoption of these broader criteria almost certainly resulted in the
inclusion of some cases that were not truly related to acetaminophen,"
writes editorialist John O'Grady, MD, FRCPI.
O'Grady didn't work on Larsen's study. He's a hepatologist (liver
specialist) with the Institute of Liver Studies at King's College Hospital in
O'Grady adds that the patients' liver tissue wasn't examined. Still, he
states that the study "establishes the need for greater circumspection with
regard to the possible role of acetaminophen in the causation of liver
O'Grady predicts "potential benefits" from educational initiatives
about safe use of acetaminophen.
He also notes that "huge numbers of patients [take] acetaminophen with
good effects and in the absence of any adverse event."