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Acetaminophen by far the most common drug causing liver damage requiring transplant
Medpage Today
RIDGEWOOD, NJ — Acetaminophen leads the list of drugs implicated in liver damage requiring transplantation, although antiepileptics are more lethal, according to a new study.
Analysis of records from a transplant database found that patients with acetaminophen-induced injury were also more likely to be on life support than patients with liver failure caused by the next most common culprits, antituberculosis drugs, antiepileptics, and antibiotics (82%, versus 44% to 70%, P<0.0001), according to Ayse L. Mindikoglu, MD, of the University of Maryland in Baltimore and colleagues.
The investigators reported in the July issue of Liver Transplantation.
Their report was issued just days after an FDA advisory panel recommended a “black box” warning for prescription combination drugs that contain acetaminophen. The panel also recommended that the maximum single adult dose be reduced from 1,000 mg to 650 mg, and that the maximum daily dose be reduced from its current level of 4,000 mg.
The findings emerged from a retrospective cohort study of the United Network for Organ Sharing database, which includes almost all liver transplants in the U.S.
The records show that between October 1987 and December 2006, there were 661 liver transplantations for drug-induced injury.
A total of 567 were adults. The median age was 36, and the majority were female and white.
The implicated agents were:
Acetaminophen in 265 (40%) Antituberculosis drugs in 50 (8%) Antiepileptics in 46 (7%) Antibiotics in 39 (6%)
