Acetaminophen Toxicity
Drug Testing Advisory Board (DTAB) recommended limiting the amount of paracetamol in prescription combination
products to not more than 325mg per tablet or capsule . It gave warning of potential severe liver injury and
allergic reaction (eg. swelling of face, mouth and throat, difficulty in breathing, itching, rash).
Paracetamol (PCM) is widely available and has been under clinical use since the 1950s. It is a safe drug and also
widely prescribed. Being a common OTC drug, it is often taken in excess. The maximum tolerable dose PCM is
approximately 4 gm/day.
Paracetamol overdose can be:
- Planned overdose- sometimes people take too much PCM on purpose to harm
- Unplanned overdose (accidental) - taking too much or for too many days in a row; taking more than one
concomitant medicine at a time(all of which may contain PCM); taking extended release forms PCM toxicity can be
asymptomatic at first. However, as it progress, the following clinical
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)
picture is seen:
Damage to liver (hepatotoxicity), results from PCM and its metabolites, N-acetyl-p-benzoquinone imine (NAPQI). NAPQI
depletes the liver’s natural antioxidant glutathione and directly damages liver cells, leading to liver
failure.
Treatment is aimed at removing the PCM from the body and replacing glutathione. Other methods include:
- Gastric
- Use of activated charcoal to adsorb acetaminophen within one hour of its
- Antidote acetylcysteine acts as a precursor for glutathione and also supplies thiols that function as
antioxidants, helping the body regenerate enough to prevent damage to the
Patient counselling and role of Pharmacist:
- Educate the patient about the maximum permitted dose per 24 hours (i.e. 8 tablets of 500mg each with spacing of
3 hours) and associated liver toxicity with long terms use of
- Check all prescriptions for multiple products containing
- Do not take PCM for more than 10 days to treat pain or for more than 3 days to treat a fever, unless prescribed
by
- Inform patients to read label carefully and identify the active ingredients, so that they can keep a check
whenever they are using more than one OTC products
Dinesh M Choudhary
(T Y B Pharm)
Tags: MET Institute of Pharmacy