As the news commentator used to say, "I have good news tonight." The good news is that the incidence of severe poisoning by paracetamol (British for the principal ingredient in Tylenol) is lessening.

The bad news is that physicians are still advising the use of Tylenol despite its risks, often without cautioning patients about it. And that the media has not noticed the danger despite previous reports in The New England Journal of Medicine.

Much of the poisoning comes about when "Paracetamol" is used to attempt suicide. Now the use of the drug whose ingredient acetaminophen is identical to Tylenol, is going down. Also with this decrease, "....the life-threatening 'acetaminophen]" reduction, which incidentally results from government-initiated restrictions, is resulting in fewer liver transplants. The substance is particularly toxic to the liver.

There are an estimated 70,000 overdose suicide attempts using this drug in the United Kingdom per year, and Lancet notes that "....as little as 10 grams may be sufficient to cause acute liver injury."

Should Tylenol be banned--or as in Britain--restricted? We have no opinion on that, but at the very least physicians should be aware of its dangers and surely counsel patients when they suggest its use for any purpose.

Tylenol Risks Paracetamol Risks Liver Injury Bibliography

The New England Journal of Medicine

The Lancet, June 10, 2000