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Paracetamol is the most common cause of liver failure in the US. Its toxicity threshold is somewhere around 4g/day for an adult.

I remember that my wife once bought an over the counter cold drug in Italy that had > 1g per pill.

So we should be aware that it's very easy to overdose this particular drug.

More info: https://www.ncbi.nlm.nih.gov/books/NBK441917/



> Its toxicity threshold is somewhere around 4g/day for an adult.

I was surprised it was that low, but I think you misread/misremembered. From your link:

> Toxicity is likely to develop in adults at:

>12 g over a 24 hours, or 7.5 to 10 g in a single dose, or Doses 350mg/kg

The 4g/day is the dosage threshold, but it seems they set it to 1/3 of the toxicity threshold.


Right, the 4g/day number is the amount that should be safe for any relatively healthy adult (minus whatever is making them take the medicine). I should hope it isn't too close to the number where you can cause permanent damage.


It's become fashionable to fearmonger about it lately, but I agree, it's safe to assume the makers wouldn't tolerate the liability that would come with a single extra dose above the given instructions causing that kind of harm.


Yeah, toxic at 2.5x therapeutic level. Crazy in an OTC.


> Paracetamol is the most common cause of liver failure in the US.

This is also a bit misleading, it’s the most common cause of acute liver failure which is overall quite rare in developed countries. The most common need for transplants are still by far progressive chronic liver diseases leading to cirrhosis.


Yeah I’ve noticed that a lot of cold/flu remedies that have potential for drug abuse have huge amounts of acetaminophen adddes such that if you took both the flu medication and some tylenol, or you took multiple medications you’d be risking killing your liver. I worry that this is intentional.




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