Paracetamol if the most commonly abused substance in deliberate self-poisoning, due in part to it being widely available without prescription.
Despite widespread use and availability, paracetamol has a narrow safety margin compared to other over-the-counter analgesics. For example, the toxic dose of paracetamol is 10 times a therapeutic dose, whereas the toxic dose of ibuprofen is 60 times a therapeutic dose.
It has been estimated to be used in 6% of poisonings, implicated in 56% of cases of severe acute liver injury and acute liver failure and 7% of drug-induced liver injury.
Approximately 0.4% of paracetamol overdose cases are fatal. The three main factors making hepatotoxicity more likely are;
(i) larger overdoses
(ii) overdose with MR/ER paracetamol
(iii) delays to treatment.
Reference
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