Hepatotoxicity | Tylenol Liver Failure

Tylenol and acetaminophen toxicity accounts for 42% of the acute liver failure cases involving drug-related hepatotoxicity. This is an astonishing number when you consider that Tylenol is one of the most highly recommended over-the-counter medications available.

Acetaminophen is considered an analgesic and antipyretic, because it is used to relieve pain related to muscle aches, backaches, toothaches, headaches, sore throats, cold symptoms, reactions to immunizations and reducing fever. With a large range of symptoms that Tylenol is used to treat, it is found in a variety of non-prescription and prescription medications, multiplying the possibility of overdose and hepatotoxicity. Children are extremely susceptible to the possibility of drug-induced hepatotoxicity due to acetaminophen.

Hepatotoxicity Due to Tylenol

Hepatotoxicity is an injury or damage to the liver, usually by an agent, chemical, or drug. The symptoms of liver toxicity vary. Depending upon the level of severity, one can expect a mild rise in liver enzymes to acute liver failure. Signs of hepatotoxicity due to an individual taking above the recommended dosage of Tylenol may include:

• Loss of appetite
• Nausea with or without vomiting
• Lethargy
• Sweating
• Flu-like symptoms
• Abdominal pain
• Uncommon bruising or bleeding
• Yellowing of the eyes or skin

Immediate physician care is needed if hepatotoxicity is suspected. Unintentional acetaminophen overdose leading to acute liver failure was estimated at 48% of all cases and 44% were intentional.

Acute Liver Failure

Acute liver failure is a general term used to describe both fulminant hepatic failure, or FHF, and subfulminant hepatic failure, also known as late-onset hepatic failure. The subdivisions are based on the duration of time before the onset of hepatic encephalopathy. This is a condition of worsening brain function as the liver becomes compromised and unable to clear the blood of toxins. In fulminant hepatic failure, encephalopathy occurs within 8 weeks of a previously uncompromised liver, and in subfulminant hepatic failure the individual has had liver disease for at least 26 weeks before the condition develops.

FHF is associated with drug-related hepatotoxicity due to acetaminophen overdose. The outcome for an individual who develops FHF as a result of acetaminophen poisoning is varied with age, complications and level of encephalopathy being a major determining factor. Young children and adults over the age of 40 are more susceptible to FHF as compared to others. Those individuals who progress into renal failure or develop cerebral edema, infection or respiratory distress also have a poor prognosis when compared to uncomplicated cases. With advances in medical care and techniques, survival rates have been estimated at 60%.