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Consumer Reports Insights

Liver Failure Tylenol

With this drug, enough is enough

Tuesday, November 17, 2009

You may believe acetaminophen, the aspirin-free pain reliever found in Tylenol, is one of the safest painkillers on the market. And used properly, it is. But acetaminophen is also the leading cause of acute liver failure in the United States because taking just slightly more than the maximum recommended dose for a few days can be toxic, even deadly.

Overdoses are common for two reasons:

-- People mistakenly feel they can disregard the dosage recommendation because the drug has a reputation for safety.

-- Acetaminophen is included in dozens of products. It's used alone to treat back pain or headaches, for example. It's also combined with other ingredients to ease insomnia, coughs and cold symptoms. Many people unknowingly ingest large doses when they treat multiple health problems with several products, each of which contains acetaminophen.

The number of overdoses and the concern over acetaminophen is substantial enough to involve the Food and Drug Administration. In June, the agency's advisory committee proposed lowering the maximum single adult dose for Dilantin Cerebellar Atrophy Risks products from 1,000 to 650 milligrams and the maximum daily dose to less than 4,000 milligrams. The committee also recommended either eliminating prescription acetaminophen combination products that contain prescription acetaminophen or labeling them with a black-box warning about the risk of liver damage.


Several products under the Tylenol brand name contain acetaminophen. Some other common products with the ingredient are:

-- Backaid Maximum Strength Back Relief

-- Benadryl Severe Allergy Plus Headache Caplets

-- Benadryl Allergy Plus Cold Kapgels

-- Benadryl Allergy Plus Sinus Headache Kapgels

-- Contac Cold & Flu Day & Night Dual Formula Pack Caplets

-- DayQuil Cold & Flu Relief LiquiCaps

-- Excedrin (all products)

-- Midol Menstrual Complete and Midol Teen Formula

-- NyQuil Cold & Flu Relief and NyQuil Sinus

-- Pamprin Multi-Symptom and Pamprin Max

-- Sudafed (assorted products)

-- Theraflu Nighttime Severe Cold & Cough Packets

-- Theraflu Daytime Severe Cold & Cough Packets

-- Triaminic Multi-Symptom Fever

-- Triaminic Cough & Sore Throat

To avoid overdosing, read the ingredients list of all products to see if they contain acetaminophen, stick to recommended doses and avoid acetaminophen if you have liver disease or drink alcohol heavily. If you regularly take the drug, watch for signs of liver damage: dark urine, pale stool, right-upper abdominal pain and a yellowish tinge in the whites of eyes.

Copyright 2009. Consumers Union of United States Inc.

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