Rainbow at shoreline

The Massachusetts ME/CFS & FM Association, a 501(c)3 founded in 1985, exists to meet the needs of patients with ME (Myalgic Encephalomyelitis), CFS (Chronic Fatigue Syndrome) or FM (Fibromyalgia), their families and loved ones. The Massachusetts ME/CFS & FM Association works to educate health-care providers and the general public regarding these severely-disabling physical illnesses. We also support patients and their families and advocate for more effective treatment and research.

Increasing number of fatal acute liver failure cases linked to the popular painkiller acetaminophen (Tylenol)

Details
Last Updated: 20 November 2015 20 November 2015

Article Index

Page 1 of 4

Research published in the December 2005 issue of the medical journal Hepatology found that the annual percentage of potentially fatal acute liver failure (ALF) cases caused by acetaminophen (TYLENOL) rose from 28 percent in 1998 to 51 percent in 2003. The research was conducted by the Division of Gastroenterology at the University of Washington Medical Center, Seattle WA. The facility is part of the U.S. Acute Liver Failure Study Group (ALFSG), a consortium of 22 academic medical centers that monitor cases of liver toxicity around the country.

The ALFSG collected information on all cases of acute liver failure that occurred between Jan. 1, 1998 and Dec. 31, 2003, including outcome information. A careful history of each patient's acetaminophen use, including the total dose, the type of product used, and the duration of use, was obtained where possible.

The researchers identified a total of 662 patients during the six year study period who met the criteria for acute liver failure. Of these 662 patients, in 275 (42%) cases, liver failure was found to have resulted from acetaminophen-induced liver toxicity. The fraction rose from 28% in 1998 to 51% in 2003, almost doubling in five years. The median total dose of acetaminophen taken by these patients was 24 grams, the equivalent of 48 extra-strength acetaminophen tablets.

Unintentional overdoses were responsible for 131 (48%) of the acute liver failure cases. Intentional overdoses, or suicide attempts, accounted for 122 (44%) episodes. In 22 (8%) of the cases, the intent was unknown. Of the 131 patients who overdosed unintentionally, 38% took two or more acetaminophen containing products simultaneously, and 63% used narcotic combination painkillers that contained acetaminophen.

Overall, 178 (65%) of 275 patients identified as having acetaminophen-induced liver toxicity survived. Seventy-four (27%) died without a liver transplantation, and 23 (8%) patients underwent a liver transplantation operation.

The authors of the study concluded:

"...acetaminophen hepatotoxicity far exceeds other causes of acute liver failure in the United States."

Notice about names

The Massachusetts ME/CFS & FM Association would like to clarify the use of the various acronyms for Chronic Fatigue Syndrome (CFS), Chronic Fatigue & Immune Dysfunction Syndrome (CFIDS) and  Myalgic Encephalomyelitis (ME) on this site. When we generate our own articles on the illness, we will refer to it as ME/CFS, the term now generally used in the United States. When we are reporting on someone else’s report, we will use the term they use. The National Institutes of Health (NIH) and other federal agencies, including the CDC, are currently using ME/CFS. 

Massachusetts ME/CFS & FM Association changed its name in July, 2018, to reflect this consensus.