Excess paracetamol kills the liver

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Extract from the article: Paracetamol is an over-the-counter painkiller in most countries. Again called acetaminophen, it is used to lower fever. It is marketed alone or in combination with other active ingredients (such as an anti-allergic in flu medicines). Although it has

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Paracetamol is an over-the-counter painkiller in most countries. Again called acetaminophen, it is used to lower fever. It is marketed alone or in combination with other active ingredients (such as an anti-allergic in flu medicines). Although it has always been considered a safe drug and a good option over ibuprofen, or diclofenac, it is not without risks. Excessive intake of paracetamol can damage the liver.

Paracetamol painkillers are inexpensive and available without a prescription, but should be taken with great moderation. It can lead to liver damage, sometimes fatal.

Paracetamol poisoning or adverse reaction?

It is necessary to differentiate between two situations: poisoning oneself with paracetamol, acutely, taking a large amount of paracetamol in a short time or accumulating a dose gradually toxic for weeks.  

Every year, there are approximately 30,000 hospital admissions for liver damage caused by drug overdose. The Spanish Paediatric Association reports that 20% of drug poisoning in children under 5 years of age in this country is due to acetaminophen. But most of them are involuntary and are part of domestic accidents.

Acute paracetamol poisoning, which can damage the liver, occurs when more than 150 milligrams (mg) per kilogram (kg) of weight is consumed in a single day. This equates to an average of 8 grams (g) of medication for an average adult. The adverse effect on the liver, which occurs over several days, is continuous poisoning. It is then estimated that an adult should consume the toxic dose for at least 4 days. However, symptoms may be felt before.

Symptoms of Paracetamol Poisoning

Acetaminophen can cause liver damage with 4 grams per day. Pay attention to the marked dosage on the medication box. If the dosage form is 1 gram, take no more than 1 tablet every 6 hours. It will be double if the dosage is 500 mg.

The symptoms of intoxication are not specific. In general, the person goes through 4 phases: First phase: nausea, vomiting and general discomfort. Second phase: liver damage usually begins 24 hours after reaching the toxic dose. There are almost no symptoms and those that were present in the first phase disappear. However, if a laboratory study is performed, blood alterations referring to the liver may be observed. Third phase: nausea, vomiting, jaundice (yellowing of the skin and mucous membranes), liver failure with clotting disorders and brain disorders and kidney failure. Fourth phase: entry into coma, with risk of death.

Precautions to take

In short, the main way to avoid liver damage is not to exceed 4 grams per day. It is important to read the labels to know the active ingredients.  The easiest thing to do is always seek advice from a healthcare professional.

There are certain conditions and characteristics that make a person more susceptible to paracetamol poisoning: alcohol consumption: according to scientific data, people who drink alcohol chronically and continuously have a higher risk of liver damage when taking paracetamol. There is also advanced age: polymedication increases with age. Older people taking chronic pain medications are at increased risk of paracetamol overdose. Also, people with malnutrition or eating disorders activate compensation mechanisms in their liver. This organ is then more easily exposed to damage caused by drugs, as scientific studies report.
Avoid self-medication: Consult a doctor to take the appropriate dose to avoid intoxication.

William O.

Article validated by Dr Jean-Claude Bakpatina, General Practitioner (Lomé-Togo)