Chronic Excessive Acetaminophen Use and Liver Damage

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Abstract
Severe, often fatal liver damage results from extreme overdosage with acetaminophen. In usual dosage, it is harmless. Cases (3) of toxic hepatitis associated with chronic ingestion of excessive doses are described. Each patient took approximately 5-8 g acetaminophen/day for several wk. Transient elevations of serum hepatocellular enzyme concentrations and histologic evidence of a toxic hepatitis suggest the liver damage was related to use of the drug. Alcohol abuse in 1 patient and negative N2 balance in another may have increased the susceptibility to its toxicity. With its increasing popularity for mild pain relief, hepatotoxicity from acute or chronic ingestion may be more common, especially in those patients with predisposing conditions.