DOCTOR'S VIEW ARCHIVE

Tylenol Toxicity

DALLAS-Just because you can buy many medicines without a prescription doesn't mean they're entirely safe. Over-the-counter drugs can kill you.

Consider Tylenol and other medications containing its active ingredient, acetaminophen. Acetaminophen can be highly toxic. At Parkland Memorial Hospital (where President Kennedy died) in Dallas, acetaminophen is for example the #1 cause of acute liver failure.

At Parkland over a 40-month period from 1992 to 1995, 71 patients were treated for acetaminophen overdoses, according to an article published in The New England Journal of Medicine by Drs. Frank V. Schiodt, Fedja A. Rochling, Donna L. Casey, and William M. Lee from the University of Texas Southwestern Medical Center. Five of the 71 patients died while the remaining 66 recovered, after hospital stays ranging up to almost 2 months in length. Fifty of the patients had taken acetaminophen in an attempt to commit suicide while 21 had accidentally poisoned themselves trying to relieve pain such as from headaches. Although those who attempted suicide had taken on the average almost twice as much acetaminophen, only 1 of them died compared to 4 of the persons who accidently took too much acetaminophen. The accidental overdose patients got sicker in other ways, too. They had severe liver damage more often and were more likely to go into hepatic coma than the would-be suicides.

Why should the accidental overdosers fare worse? Well, a much higher proportion of them were heavy drinkers than in the suicidal group (63% versus 25%). And heavy drinking changes the liver's functioning and makes it much more susceptible to suffer the toxicity of acetaminophen.