Acetaminophen (APAP) hepatotoxicity—Isn't it time for APAP to go away?

Research output: Contribution to journalReview articlepeer-review

266 Scopus citations

Abstract

Acetaminophen (APAP) is the most commonly used drug for the treatment of pain and fever around the world. At the same time, APAP can cause dose-related hepatocellular necrosis, responsible for nearly 500 deaths annually in the United States (US) alone, as well as 100,000 calls to US Poison Control Centers, 50,000 emergency room visits and 10,000 hospitalisations per year. As an over-the-counter and prescription product (with opioids), APAP toxicity dwarfs all other prescription drugs as a cause of acute liver failure in the US and Europe, but it is not regulated in any significant way. In this review the ongoing controversy surrounding the proper role for this ubiquitous pain reliever: its history, pathogenesis, clinical challenges in recognition and management, and current regulatory status are highlighted. A new solution to a 50-year-old problem is proposed.

Original languageEnglish (US)
Pages (from-to)1324-1331
Number of pages8
JournalJournal of Hepatology
Volume67
Issue number6
DOIs
StatePublished - Dec 2017

Keywords

  • APAP
  • Acetaminophen
  • Hepatotoxicity

ASJC Scopus subject areas

  • Hepatology

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