PUBLISHED: 5:48 PM on Wednesday, April 26, 2006
One pain pill too many
Most overdoses from overuse of pain relievers are accidental

  Courtesy photo
Got a headache? Pop a couple Tylenol. Or, if you are like a lot of people, ignore the recommended dosage and take three caplets.

Allergies acting up? Pull out the Benedryl Severe Allergy or maybe some Sudafed.

Cramps? Try Midol.

If you take all those medicines on the same day, you might want to call 911.

Between 40 percent and 50 percent of all acute liver failure cases are caused by acetaminophen overdose, and nearly half of those overdoses are accidental, said researchers at the University of Michigan Health Center.

The condition, also known as fulminant hepatic failure, is a medical emergency with a high mortality rate, said Brent Roeder, a gastroenterologist.

Roeder said acetaminophen-caused acute liver failure isn't common, but it happens often enough that probably every doctor in Topeka would quickly recognize the condition.

Initial symptoms, which can include varying degrees of confusion, as well as lethargy and yellowing skin, can occur within hours of an overdose, Roeder said.

Left untreated, acute liver failure can cause systemic reactions. Roeder said a person's kidneys may shut down, and their heart and lungs can begin to fail.

An antidote for acetaminophen overdose is available, but it should be taken quickly. Roeder said people should see a doctor within 24 hours of an overdose.

"Usually, there is no residual effect, if you recover," he said, emphasizing the word "if."

On a positive note, Roeder said people don't need to panic and clear their medicine cabinets of acetaminophen-based products. They just need to be aware of how much they are taking.

"It is a very good and very safe medicine when taken properly," Roeder said.

For the average adult, that means no more than 4 grams per day. Given the number of prescription and over-the-counter drugs containing acetaminophen, those 4 grams can quickly be reached -- and exceeded -- if a person isn't paying close attention to labels.

"Just because a medicine is over-the-counter, that doesn't mean you can take as much as you want," Roeder said.

A list of more than 120 OTC medicines with acetaminophen can be found at

Acetaminophen also is found in several prescription medications, including Lorcet Plus, Darvocet and Vicodin.