title: Hepatotoxicity of paracetamol and related fatalities.
abstract: Paracetamol, also known as acetaminophen, is the most commonly used antipyretic and pain reliever and since 1955 it is available over-the-counter as a single formulation or in combination with other substances and, as indicated by the World Health Organization, it can be used in all the three steps of pain intensity. Paracetamol toxicity is one of the most common causes of poisoning worldwide. While paracetamol is described as relatively nontoxic when administered in therapeutic doses, it is known to cause toxicity when taken in a single or repeated high dose, or after chronic ingestion. Repeated supratherapeutic misuse, non-intentional misuse, and intentional ingestion may all result in hepatic toxicity, the main cause of acute liver failure (ALF) in the United States and Europe. Since paracetamol is responsible for nearly half of the cases in the US of acute liver failure and remains the leading cause of liver transplantation, continued awareness promotion, education and research should be constantly undertaken. We herein review the literature on paracetamol toxicity with particular attention to aspects of liver damage and related fatalities.
authors.affiliation: Unit of Forensic Toxicology (UoFT), Department of Anatomical, Histological, Forensic and Orthopedic Sciences, Sapienza University of Rome, Rome, Italy. fra.busardo@libero.it.
authors.forename: R
authors.initials: R
authors.lastname: Tittarelli
authors.forename: M
authors.initials: M
authors.lastname: Pellegrini
authors.forename: M G
authors.initials: MG
authors.lastname: Scarpellini
authors.forename: E
authors.initials: E
authors.lastname: Marinelli
authors.forename: V
authors.initials: V
authors.lastname: Bruti
authors.forename: N M
authors.initials: NM
authors.lastname: di Luca
authors.forename: F P
authors.initials: FP
authors.lastname: Busardò
authors.forename: S
authors.initials: S
authors.lastname: Zaami
mesh_terms: D000082:Acetaminophen / Q000009:adverse effects*; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury; D006801:Humans; D017114:Liver Failure, Acute / Q000139:chemically induced* / Q000401:mortality; D016031:Liver Transplantation
chemical_list: D018712:Analgesics, Non-Narcotic; D000082:Acetaminophen