Johnson & Johnson’s best-selling over-the-counter pain reliever Tylenol (generic: acetaminophen) has recently been linked to severe liver injuries and other serious side effects. Each year, the acetaminophen contained in Tylenol is associated with over 800 cases of liver failure in the United States alone. Signs and symptoms of Tylenol-induced liver damage may include jaundice, abnormal bleeding episodes, mental disorientation, sleepiness, and coma.
What’s the problem with Tylenol?
Tylenol belongs to a class of drugs known as analgesics (pain relievers) and antipyretics (fever reducers) that work by elevating the user’s pain threshold. In doing so, it requires a greater amount of pain to develop before the person feels it. Tylenol reduces fever through its action on the heat-regulating center of the brain, telling it to lower the body’s temperature when it becomes elevated. Acetaminophen was first approved by the U.S. Food & Drug Administration (FDA) in 1951, and is one of the most commonly-used drugs in the United States.
Unfortunately, even when used as directed, patients taking Tylenol can put themselves at risk of suffering serious liver injuries. A recent study published in the Journal of the American Medical Association (JAMA) found that up to 44% of test subjects who took acetaminophen, either alone or in combination with other medications, exhibited elevated levels of liver enzyme abnormalities.
In January 2011, the FDA announced that pharmaceutical manufacturers would be required to limit the dosage of acetaminophen to 325 milligrams in prescription versions of the drug, and include a ‘‘black box’ warning (the strictest such warning allowed by law) on all prescription medications containing acetaminophen. Over-the-counter versions like Tylenol had previously been required to change the dosage labeling to warn consumers against the risk of liver injury.
Tylenol Liver Failure
Tylenol-induced liver failure occurs when large portions of the liver become irreparably damaged until the organ is no longer able to perform its duties. This is a life-threatening condition that requires immediate medical intervention to treat. The vast majority of liver failure cases occur gradually over many years; however, rare cases of acute liver failure may occur rapidly (in as little as 48 hours), and can be extremely difficult to detect.
Liver Failure Symptoms
The initial signs and symptoms of Tylenol liver failure may be similar to those that can be caused by any number of conditions. Therefore, the disease may go undiagnosed at first. Early symptoms of Tylenol liver failure may include:
- loss of appetite
As the disease progresses, the symptoms become much more serious, requiring emergency medical treatment. These symptoms may include:
- bleeding easily
- swollen abdomen
- mental disorientation or confusion (known as hepatic encephalopathy)
Liver Failure Treatment
If diagnosed in its early stages, liver failure caused by Tylenol can sometimes be treated and its effects reversed. Supportive care can be given at a hospital to treat the symptoms until the patient is in the clear. In many cases, the liver may still have the ability to recover on its own.
For cases of liver failure that are the result of prolonged deterioration, the initial goal of treatment may be to save whatever portion of the liver is still functioning. If this is not possible, a total liver transplant may be required. Fortunately, liver transplant procedures are becoming quite common, and are often successful.
Over the years, there have been dozens of recalls for Tylenol products. Some of the recalls were related to processing and storage problems, while others were due to drug manufacturing issues which led to more of the active ingredients being included in the products than was listed on the labels. Click here for a comprehensive list of Tylenol recalls.
Tylenol & Pregnancy
Tylenol is widely used in all stages of pregnancy, and is commonly considered the drug of choice for expecting mothers who seek relief from mild pain and fevers. However, Tylenol may be excreted into breast milk in small quantities, and may cause harm to a nursing baby. Always consult your physician before taking Tylenol during pregnancy.