By: Laurie Edwards for Medtech1Whether it’s for a shoulder pain, headache, backache or fever, millions of people turn to Tylenol and similar pain relievers containing acetaminophen every day for safe, effective relief. But it’s surprisingly easy to take too much medication unintentionally, and doing so can cause serious liver damage. In fact, according to the March issue of the Harvard Woman’s Health Watch, each year more than 56,000 trips to the emergency room and 458 deaths from liver failure are attributed to excessive acetaminophen use.
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Tips to Avoid Liver Damage:
Discuss past liver disease and chronic alcohol use with your physician before you start taking acetaminophen.
Carefully read the labels on your medications to make sure you’re not getting acetaminophen from several different sources.
Do not take an entire day’s worth of the drug in one sitting – spreading it out over the course of the day helps your body metabolize it better.
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While it is important to increase awareness of this growing trend, it’s just as critical for patients to realize that there many things they can do to take advantage the pain-relieving aspects of acetaminophen without exposing themselves to these serious risks. A recent study out of the University of Michigan found that a whopping 40 to 50 percent of all acute liver failure in the United States is caused by acetaminophen overdoses, and nearly half of those cases involved unintentional misuse.
“My overall recommendation for people using Tylenol is that it is a safe drug. However, like most other things in life, too much of a good thing can be bad for you,” said Dr. Robert J. Fontana, an associate professor of internal medicine at the University of Michigan Medical School as well as a member of the Gastroenterology Division and medical director of liver transplantation.
Experts say an adult shouldn’t consume more than eight extra strength Tylenol pills – each of which contain 500 milligrams – in a 24-hour cycle. Or, in other words, patients shouldn’t exceed 4,0000 milligrams of the drug in one day to avoid potential liver damage.
It’s the acute daily dose of acetaminophen that can cause so many problems rather than extended use of the drug over time. Researchers at the University of Washington Medical Center, found that the percentage of acute liver failure nearly doubled between 1998 and 2003, rising from 28 percent to 51 percent.
So how does acetaminophen cause liver problems? It’s a question of metabolism. Whenever we take a medication, it is the liver’s job to metabolize the drug and then eliminate it from our systems. When we ingest too much acetaminophen, it overwhelms our system and we aren’t able to metabolize it the way we need to. When it builds up in our livers, it can damage the cells and lead to potentially serious liver damage.
The reason mistaken overdoses are so common is because of what University of Michigan researchers call “therapeutic misadventures.”
“What I mean by that is that individuals were taking acetaminophen for some type of medical condition – such as headache, back pain or the flu – inadvertently took too much and subsequently developed liver failure,” said Dr. Fontana.
Another problem is that people taking prescription painkillers like Vicodin or Darvocet who also take Tylenol don’t always realize that their prescription drugs contain acetaminophen. Checking the labels of both prescription and non-prescription drugs is essential in terms of avoiding accidental overdoses.
Patients who drink alcohol on a regular basis should also be aware of the risks since drinking can result in nutritional deficiencies or a reduction in the level of detoxifying enzymes in the blood; this can affect the body’s ability to metabolize the drug.
While more research is ongoing in terms of exploring possible genetic predisposition to acute liver failure, experts are sending out the message that taking pain relievers is a safe option for people but for your liver’s sake make sure you know just how much acetaminophen you’re taking each day.
