Tylenol May Affect Liver

A recent study, published in JAMA, showed that healthy adults taking the maximum recommended daily dose of acetominophen developed abnormalities in blood tests that traditionally serve as an early indicator of possible liver damage. This raises concerns that even the daily recommended doses of Extra Strength Tylenol may cause liver damage. Acetominophen, the active ingredient in Tylenol, and frequently found in cold remedies, is used on a daily basis by over 100 million Americans. The maximum suggested dose for Extra Strength Tylenol is four grams daily, or two 500- milligram pills every six hours. The clinical study involved 145 healthy adults. Some subjects were assigned to receive 4 grams of acetaminophen daily, with or without opioid, and others to placebo. Results showed that nearly 40 percent of the patients taking the maximum dose of acetaminophen had blood levels greater than three times the normal limit of ALT-an enzyme found in the liver that has the vital function of producing amino acids. High levels of ALT are associated with liver damage. The results have come as a surprise to many given the 20 plus year safety history that the drug has enjoyed and may question the use of ALT as a proxy for liver damage. The study suggests that people should be careful when taking acetaminophen, especially when taking a combination of different medications. Also, those who are at greatest risk are those individuals whose regularly use or exceed the recommended maximum dose for periods longer than three days-such as people with chronic pain or arthritis.