Doctors aware of Tylenol-related liver risk - but is the public getting the message?

ANN ARBOR, MI - The message that a common pain reliever can have uncommonly bad effects on the liver under certain conditions seems to have reached most physicians, a new study finds. Now, the challenge lies in getting the word out to their patients and the public.

The newly published study surveyed physicians to assess how well they understand the potentially liver-damaging effects of acetaminophen, commonly sold as Tylenol or as an ingredient in other medications. The results are published in this month's Journal of Clinical Outcomes Management by researchers from the University of Michigan Health System and School of Public Health.

Acetaminophen can lead to potentially fatal liver damage if taken in large doses - either intentionally in a suicide attempt or unintentionally in a prolonged attempt to quell pain - or if taken in conjunction with alcohol, certain other medications or fasting, or by people with existing liver problems. Intentional overdoses are the most common cause of such liver problems, but other causes are gaining notice.

The survey also looked at physicians' understanding of how to treat acetaminophen-related liver problems, their knowledge about how common such problems are, and their attitudes toward recommending liver transplants for those whose livers had been damaged by acetaminophen.

"It appears that most doctors' knowledge is good, with more than 95 percent of them aware of certain risk factors, though there's still room for improvement," says Robert Fontana, M.D., assistant professor of internal medicine at UMHS and senior author of the report. "We should encourage physicians to talk with their patients about all the risk factors, while at the same time, finding more ways to educate the public about this avoidable risk."

While acetaminophen products are safe for most people when used as directed, its toxic effect on the liver can be dramatic under certain conditions. The drug can hamper the liver, or even cause

Contact: Kara Gavin
University of Michigan Health System

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