Hepatology
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See the full rubric →Xenobiotic-Induced Liver Injury in the United States: A 25-Year Retrospective Analysis of National Poison Data System.
Clinical takeawayCounsel patients taking acetaminophen on the hepatotoxic risk and overdose potential, particularly those using over-the-counter analgesics. Screen for acetaminophen use when evaluating unexplained transaminitis or ALT/AST elevation >100 U/L, given acetaminophen-alone products now account for one-third to one-half of medication-related liver injury cases.
What it foundAcetaminophen-alone exposures increased 349-380% from 2000 to 2024 and now account for one-third to one-half of medication-related liver injury cases (defined by ALT/AST >100 U/L), while APAP-combination products declined 60-85%.
ContextAcetaminophen's role in drug-induced liver injury is well-known. This analysis documents a major epidemiologic shift: acetaminophen-alone products now dominate (33-45% of cases, up 349-380%) while combination products declined 60-85% following FDA restrictions in the early 2010s, indicating regulatory efforts to limit APAP in combination formulations have redirected risk to isolated products.
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Towers EB … Farah R · Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association · IF 16.2 · PubMed ↗