Acetaminophen Overdose: How to avoid acetaminophen-related liver problems

Each year, overdoses of acetaminophen (sold as Tylenol and other brands) account for more than 56,000 emergency room visits and an estimated 458 deaths from acute liver failure, reports the March issue of the Harvard Women’s Health Watch. And according to a new study from the U.S. Acute Liver Failure Study Group, acetaminophen-related liver failure appears to be on the rise.

Researchers at the University of Washington Medical Center in Seattle found that between 1998 and 2003, the percentage of acute liver failure cases attributed to acetaminophen nearly doubled, rising from 28% to 51%. Compared with study subjects who deliberately overdosed, those who did so unintentionally were more likely to have been taking two or more medications containing acetaminophen.

Acetaminophen is safe when taken as directed. Problems occur mainly when people take more than they realize. The Harvard Women’s Health Watch offers the following tips for avoiding trouble:

• Read labels. For adults, the maximum recommended intake is 4,000 milligrams per day (12 regular or 8 extra-strength acetaminophen tablets).
• Use caution with combinations. Acetaminophen is found in many over-the-counter combination medicines and prescription painkillers, so check the labels to make sure you are not exceeding the recommended intake.
• Alternate painkillers. If the recommended doses of acetaminophen don’t control your pain, talk to your clinician about alternating acetaminophen with a nonsteroidal anti-inflammatory drug, such as ibuprofen or aspirin.
• Be careful about alcohol. The labels warn against using acetaminophen if you have three or more alcoholic drinks each day. But not everyone metabolizes alcohol the same way, so it’s safer to avoid alcohol entirely while taking acetaminophen.