title: Acute liver failure in two patients with regular alcohol consumption ingesting paracetamol at therapeutic dosage.
abstract: BACKGROUND
  The possible role of alcohol in the development of hepatotoxicity associated with therapeutic doses of paracetamol (acetaminophen) is currently debated.
  
  
  METHODS
  We describe 2 patients who were regular consumers of alcohol and who developed liver failure within 3-5 days after hospitalization and stopping alcohol consumption while being treated with 4 g paracetamol/day. A paracetamol serum level obtained in one of these patients was not in the toxic range. Possible risk factors for the development of hepatotoxicity in patients treated with therapeutic doses of paracetamol are discussed.
  
  
  CONCLUSIONS
  In patients with risk factors, e.g. regular consumption of alcohol, liver failure is possible when therapeutic doses are ingested. We propose that the paracetamol dose should not exceed 2 g/day in such patients and that their liver function should be monitored closely while being treated with paracetamol.
authors.affiliation: Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland. kraehenbuehl@uhbs.ch
authors.forename: Stephan
authors.initials: S
authors.lastname: Krähenbuhl
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Brauchli
authors.forename: Oliver
authors.initials: O
authors.lastname: Kummer
authors.forename: Michael
authors.initials: M
authors.lastname: Bodmer
authors.forename: Marten
authors.initials: M
authors.lastname: Trendelenburg
authors.forename: Jurgen
authors.initials: J
authors.lastname: Drewe
authors.forename: Manuel
authors.initials: M
authors.lastname: Haschke
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced*; D008297:Male
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen