title: A perspective on the epidemiology of acetaminophen exposure and toxicity in the United States.
abstract: Acetaminophen is a commonly-used analgesic in the US and, at doses of more than 4 g/day, can lead to serious hepatotoxicity. Recent FDA and CMS decisions serve to limit and monitor exposure to high-dose acetaminophen. This literature review aims to describe the exposure to and consequences of high-dose acetaminophen among chronic pain patients in the US. Each year in the US, approximately 6% of adults are prescribed acetaminophen doses of more than 4 g/day and 30,000 patients are hospitalized for acetaminophen toxicity. Up to half of acetaminophen overdoses are unintentional, largely related to opioid-acetaminophen combinations and attempts to achieve better symptom relief. Liver injury occurs in 17% of adults with unintentional acetaminophen overdose.
authors.affiliation: Evidera, 430 Bedford St, Suite 300, Lexington, MA 02420, USA.
authors.forename: Marissa
authors.initials: M
authors.lastname: Blieden
authors.forename: L Clark
authors.initials: LC
authors.lastname: Paramore
authors.forename: Dhvani
authors.initials: D
authors.lastname: Shah
authors.forename: Rami
authors.initials: R
authors.lastname: Ben-Joseph
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000633:toxicity*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use / Q000633:toxicity; D056486:Chemical and Drug Induced Liver Injury / Q000453:epidemiology* / Q000209:etiology; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen