TY - JOUR
T1 - Acetaminophen (APAP) hepatotoxicity—Isn't it time for APAP to go away?
AU - Lee, William M.
N1 - Funding Information:
Many of the studies referred to in this paper were the cumulative result of the data and bio-sample collection of Acute Liver Failure Study Group registry. The author gratefully acknowledges the contributions and support of the ALFSG investigators, coordinators and the patients and their families who agreed to participate in this important study. The support of the NIDDK administrative and repository staff has been essential to the success of this study. Support has been provided by NIDDK U-01 DK58369 with additional support from the Southwestern Medical Foundation , Dallas TX, USA.
Publisher Copyright:
© 2017 European Association for the Study of the Liver
PY - 2017/12
Y1 - 2017/12
N2 - 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.
AB - 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.
KW - APAP
KW - Acetaminophen
KW - Hepatotoxicity
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U2 - 10.1016/j.jhep.2017.07.005
DO - 10.1016/j.jhep.2017.07.005
M3 - Review article
C2 - 28734939
AN - SCOPUS:85028385356
VL - 67
SP - 1324
EP - 1331
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 6
ER -