Acetaminophen Hepatotoxicity, Fasting, and Ethanol-Reply

Dr Bonkovsky relates an interesting case in which a man developed severe hepatotoxicity after ingesting 1 to 3 g of acetaminophen per day for an acute illness. The enhanced toxicity was assumed to be caused by chronic underlying cardiopulmonary disease. In our study, there were no patients with significant underlying chronic cardiopulmonary disease. The patients in our study with clearly enhanced toxicity (ie, hepatotoxicity after consuming The letter from Drs Nelson and Temple emphasizes the relative safety of acetaminophen when used for limited periods of time, as directed. With this, we agree. On the other hand, aspirin and NSAIDs are also relatively safe