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Q J Med 2002; 95: 609-619
© 2002 Association of Physicians

Commentary

Paracetamol toxicity: epidemiology, prevention and costs to the health-care system

C.L. SHEEN, J.F. DILLON1, D.N. BATEMAN2, K.J. SIMPSON3 and T.M. MACDONALD

From the Medicines Monitoring Unit, and 1 Department of Gastroenterology, Ninewells Hospital, Dundee, and 2 Scottish Poisons Information Bureau and 3 Scottish Liver Transplant Unit, Royal Infirmary, Edinburgh, UK

Paracetamol has been used as an analgesic and antipyretic for many years, with toxicity first noted in the 1960s. Since then the incidence of poisoning has increased, and paracetamol is now the most common drug in self-poisoning, with a high rate of morbidity and mortality. The use, abuse and ways of reducing paracetamol toxicity are reviewed, but in view of the potential for harm, serious consideration should be given to changing the legal status of paracetamol, possibly to a prescription-only medicine.

Address correspondence to Dr C.L. Sheen, Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee DD1 9SY. e-mail: chris{at}memo.dundee.ac.uk


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