Hepatotoxicity Hot Topic

Medications, whether prescription or over-the-counter, are used for just about everything in today’s society. People take medication for minor aches and pains, such as a headache or a stomach ache, and for more traumatic events where a prescription for a higher dose of pain relief is needed. What people often don’t know is that your liver is the organ responsible for processing these drugs. When you take more than the recommended dose, you can severely injure your liver. This is commonly referred to as drug-induced liver injury, or DILI.

Over-the-counter drugs can contain dangerous substances that, when abused, can lead to liver failure and even death. Prescription medications also may contain dangerous substances, and at a much higher dose, which is why a doctor’s order is required when receiving those drugs. If over-the-counter meds can cause this, why are some consumers not aware about the dangers of hepatotoxicity? 

A common pain reliever is acetaminophen, found in many over-the-counter medications as well as in a large handful of doctor-prescribed medications. Acetaminophen, although extremely helpful when used properly, can be toxic, and can even lead to an overdose, causing death. Too much of this drug and the liver can no longer process it, leaving free drugs in your body, which can cause devastating effects. Tylenol, one of the most common and widely used medication, contains acetaminophen.

Doctors often do not have the time to explain the consequences of over doses with Tylenol. Most people do not read labels when buying medications such as Tylenol and have no idea how much of the drug is actually present, which commonly leads to an overdose and acetaminophen toxicity. The Harris Interactive consumer poll from 2002 revealed statistics that prove this point: 

• 44% of consumers take more of a drug than the instructions state
• 63% took the next dose before they should have 
• 69% took a larger dose per day than instructed

These are the kind of decisions that lead to deaths cause by acetaminophen toxicity. Overdosing on acetaminophen, which is only eight tiny pills of extra strength Tylenol, is the leading cause of over-the-counter drug poisoning in the United States.

If acetaminophen is so dangerous, why have consumers not been properly warned until now? Medication is used for everything. The more medicine being consumed, the higher the risk for drug-induced toxicity. Acetaminophen is not by any means the only drug that can lead to liver damage, but it is one of the most widely used drugs that can do so. There is a broad category of drugs that can potentially cause liver problems, ranging from simple pain relievers to drugs used for high cholesterol. Certain risk factors believed to cause a higher risk of drug-induced liver disease in adults include obesity, pregnancy, chronic alcohol consumption, and many more.

References:

http://www.lef.org/protocols/appendix/otc_toxicity_01.htm  

http://www.liverdisease.com/medications_hepatitis.html  

http://www.merck.com/mmpe/sec03/ch024/ch024c.html