Acetaminophen toxicity with concomitant use of carbamazepine.
Acetaminophen is a widely used analgesic that can cause acute liver failure when consumed above a maximum daily dose. Certain patients may be at increased risk of hepatocellular damage even at conventional therapeutic doses. We report a case of a 34-year-old man on carbamazepine for complex partial seizures who developed acute liver and renal failure on less than 2.5 grams a day of acetaminophen. This raises caution that patients on carbamazepine should avoid chronic use of acetaminophen, and if required use at lower doses with vigilant monitoring for signs of liver damage.
Jickling
Glen
G
University of Alberta Hospital, Alberta, Canada.
Heino
Angela
A
Ahmed
S Nizam
SN
D000082:Acetaminophen / Q000008:administration & dosage / Q000633:toxicity*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000633:toxicity*; D000927:Anticonvulsants / Q000008:administration & dosage / Q000633:toxicity*; D001416:Back Pain / Q000188:drug therapy*; D002220:Carbamazepine / Q000008:administration & dosage / Q000633:toxicity*; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology*; D002998:Clonazepam / Q000008:administration & dosage / Q000633:toxicity; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D017029:Epilepsy, Complex Partial / Q000188:drug therapy*; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008721:Methocarbamol / Q000008:administration & dosage / Q000633:toxicity*; D009125:Muscle Relaxants, Central / Q000008:administration & dosage / Q000633:toxicity*; D009395:Nephritis, Interstitial / Q000139:chemically induced / Q000175:diagnosis; D009460:Neurologic Examination / Q000187:drug effects
D018712:Analgesics, Non-Narcotic; D000927:Anticonvulsants; D009125:Muscle Relaxants, Central; D008721:Methocarbamol; D002220:Carbamazepine; D000082:Acetaminophen; D002998:Clonazepam