Liver Fast Facts: Acetaminophen Use and Liver Injury
An estimated 500 deaths per year are attributed to suicidal or unintentional overdoses of acetaminophen as well as more than 50,000 emergency room visits. This is the most common form of acute liver failure observed in the United States today. While some are intentional at least 50% of these are unintentional, that is, the patient is consuming more than one preparation of acetaminophen or simply using doses more than suggested by the package insert.
How does acetaminophen affect the liver?
Acetaminophen is generally considered safe and effective, but it exhibits a dose-related toxicity, and toxic levels may be reached by any person who takes more than a certain amount. Accidental hepatotoxicity, with liver failure and death, may occur in moderate to heavy alcohol users or simply in those who take too much not realizing the potential for harm. Some are taking two or more acetaminophen-containing products simultaneously. Acetaminophen produces toxic byproducts that the liver usually detoxifies by coupling them with other compounds and flushing them out through the bile. Alcohol intake causes the body to overproduce an enzyme that boosts these byproducts further, while compromising the detoxification.
Acetaminophen produces toxic byproducts that the liver usually detoxifies by coupling them with other compounds and flushing them out through the bile. Alcohol intake causes the body to overproduce an enzyme that boosts these byproducts further, while compromising the detoxification
Is there an antidote for overdose?
There is an antidote for acetaminophen overdose, but it must be administered within a certain period from ingestion, ideally within 10-16 hours. Unfortunately, the symptoms associated with an overdose are very few. There may be nausea and vomiting but it tends to vanish quickly, leaving the patient feeling better for 48 hours, which is when life-threatening liver damage then occurs.
What is the recommended safe dosage?
The manufacturer has set a maximum dose of 4 grams of acetaminophen (the equivalent of eight extra-strength tablets or capsules, 500 mg each) per day, but a number of authors recommend a maximum of 2-3 grams per 24 hours for those who regularly consume three or more alcoholic beverages daily. Newly-released tablets of 750 mg each and the appearance of mint-flavored acetaminophen are also of concern. Particular caution is need in dosing infants with acetaminophen to ensure that the correct dose is given.