Old drug, new warnings: Acetaminophen (paracetamol, Tylenol)

Acetaminophen is the leading cause of acute liver failure in the United States. Nearly half of acetaminophen-associated cases are due to unintentional overdose.

Especially vulnerable patients are:

- taking enzyme-inducing drugs
- chronic users of alcohol
- malnourished

Although no consensus has been reached on what is a safe dose in patients with liver disease, 4 g/day is too much: a total daily dose of no more than 2 g is recommended to decrease the risk of toxicity in these patients.

The US Food and Drug Administration (FDA) is considering banning acetaminophen-narcotic combination products.

References:
Acetaminophen: Old drug, new warnings. Cleveland Clinic Journal of Medicine January 2010 vol. 77 1 19-27.
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