Painkillers linked to liver failure

Concern over paracetamol use has re-emerged after it was discovered the widely-used painkiller has become the main cause of liver failure in the US.

A research team discovered the number of liver failure cases linked to paracetamol in the US has almost doubled, rising from 28 per cent in 1998 to 51 per cent in 2003.

They found that as few as 20 pills a day could cause liver failure.

The researchers, who were part of the US Acute Liver Failure Study Group, studied data on 662 patients treated for acute liver failure between 1998 and 2003.

Among the 275 painkiller-related cases, around 48 per cent were unintentional, while 44 per cent were attempted suicide – the rest were unknown. Around 27 per cent of cases resulted in death.

Those who had overdosed unintentionally had mostly been taking several different paracetamol-containing products.

Experts in the UK have said restrictions placed on the sale of paracetamol in 1998 has helped cut the number of liver failure cases.

Pharmacies in Britain are not allowed to sell more than 32 paracetamol tablets per person under the sales regulations, which also required manufacturers to cut the size of packs. Some retailers have cut the size of packs from 24 to 14.

After the legislation was introduced, a British Medical Journal (BMJ) report revealed the measures had helped cut suicide rates. They found 25 per cent fewer people took aspirin and paracetomol overdoses in the three years after 1998.

Lead author of the study, Dr Anne M Larson, said the US may have to also think about changing the painkiller’s pack size: “Efforts to limit over-the-counter packaging size and to restrict the prescription of narcotic-acetaminophen combinations (or to separate the narcotic from the acetaminophen) may be necessary to reduce the incidence of this increasingly recognized but preventable cause of acute liver failure in the United States.”

The study appeared in the journal Hepatology this month.

© Adfero Ltd