Overuse of acetaminophen is a leading cause of liver failure. It is important to use acetaminophen as directed and not to assume that, because it is an over-the-counter drug, more can be taken. A recent study blamed overdose of acetaminophen for up to half the cases of acute liver failure in the United States. Another recent study involving 22 U.S. hospitals found that cases of acute liver failure due to accidental or intentional overdoses of acetaminophen rose from 28 percent to 51 percent between 1998 and 2003.

Acetaminophen is generally gentler on the stomach than aspirin. However, in some patients, acetaminophen can cause upset stomach. To help avoid this problem, patients may be advised to take acetaminophen with meals or milk. It is important to note that caffeine increases the effect of acetaminophen.

Unlike aspirin, acetaminophen does not have antiplatelet effects (platelets are essential for blood clotting) and is not associated with Reye’s syndrome (a rare but potentially fatal condition that affects all organs of the body). However, it can have other adverse health effects. Patients should call their physician immediately if they experience:

• Jaundice. Yellowish discoloration of the whites of the eyes, skin and mucous membranes that may indicate liver damage from toxic doses of acetaminophen.
  
  
• Hypoglycemia. An abnormally low level of glucose (blood sugar). Symptoms include trembling, hunger, headache, confusion, rapid heart rate and blurred vision.
  
  
• Hemolytic anemia. Anemia resulting from the abnormal destruction of red blood cells. Symptoms include chills, fatigue, shortness of breath and rapid heart rate.
  
  
• Skin rash. A change in the skin which affects its appearance or texture.