Paracetamol Toxicity- An Overview

Abstract

Paracetamol (acetaminophen) is a safe, effective, well-tolerated and cheap analgesic and anti-pyretic drug with relatively few adverse effects when used at the recommended therapeutic dosage. It was first introduced in the year 1955 for its clinical application and since then, it is widely used almost throughout the world. In many countries the drug is readily available over-the-counter without the need of prescription. It’s easy availability and no need for prescription made it one of the commonest drugs used for suicidal or self harm purposes. Its toxicity was noticed in the 1960s [1]. Since then number of cases coming to the emergency department kept on increasing, especially in UK [2, 3]. It is also a frequent cause of poisoning in many other countries, including North America, Australia and New Zealand and several other countries in Europe [4-9]. Increasing number of the cases brought the idea of legalization of drug from over the counter policy to prescription only status. Following legislation in 1998 to limit pack sizes, beneficial effects on paracetamol-related mortality and morbidity were reported in England. Although following legislations to limit pack sizes, morbidity and mortality reduced, however strict measures are required to reduce breaches of sales guidelines [10, 11]. Role of media and internet should be more emphasized in awareness about hepatic failure due to paracetamol toxicity.