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Enough people have suffered liver damage after using or abusing acetaminophen (Tylenol) that the potential danger of using this common pain reliever when there is liver disease is well known. But acetaminophen is also dangerous in kidney disease.

Wesley suffered peculiar complications when he pulled a muscle in his groin.

Just taking Tylenol relieved the pain, but after a day or so he began to feel incredibly itchy. His whole body seemed to itch all the time. Wesley could move and feel his feet, but they felt heavy. Then they began to swell. And soon Wesley noticed swelling in his fingers and arms and eyelids, too, and made it to an emergency room just before he collapsed.

Like 56,000 people per year in the United States alone, Wesley had suffered acute acetaminophen poisoning. And like 26,000 Americans every year, Wesley had to be hospitalized to deal with the symptoms of acetaminophen toxicity. 

Fortunately, due to prompt treatment, Wesley was not one of the 500 Americans who die each year after taking Tylenol and similar pain relievers.

What Is Acetaminophen?

Acetaminophen, known as paracetamol in the United Kingdom and most countries in the British Commonwealth, is a popular, inexpensive, and effective non-steroidal anti-inflammatory medication for relief of pain and fever. Acetaminophen is sold under dozens of brand names. The most common brand of acetaminophen in the United States is Tylenol, but the medication is also available over the counter in tablets, gel caps, and liquid form branded as: 

  • Actifed®
  • Alka-Seltzer Plus Liquid Gels®
  • Anacin®
  • Cepacol®
  • Contac®
  • Coricidin®
  • Dayquil®
  • Dimetapp®
  • Dristan®
  • Excedrin®
  • Feverall®
  • Formula 44®
  • Goody’s® Powders
  • Liquiprin®
  • Midol®
  • Nyquil®
  • Panadol®
  • Robitussin®
  • Saint Joseph® Aspirin-Free
  • Singlet®
  • Sinutab®
  • Sudafed®
  • Theraflu®
  • Triaminic®
  • TYLENOL® Brand Products
  • Vanquish®
  • Vicks®
  • Zicam®

Acetaminophen is also sold under various house brands, and appears as part of prescription pain relievers such as oxycodone, hydrocodone, Endocet, Percocet, and Tramadol.

The effects of acetaminophen on the liver are well known. Acetaminophen poisoning necessitates more liver transplants and kills more people than hepatitis B or hepatitis C. But the effects of acetaminophen on the kidneys are not as well known either by doctors or by the public.

What Does Acetaminophen Do to the Kidneys?

Acetaminophen is converted into a non-toxic compound by the liver. Detoxifying acetaminophen requires the use of enzymes which are only available in limited amounts. If these enzymes are busy detoxifying other substances, such as alcohol, they are not available to detoxify the pain reliever.

Whether the liver succeeds in detoxifying acetaminophen or not, it sends it on to the kidneys. There the chemical combines with the antioxidant glutathione.

In its toxic form, acetaminophen can use up almost all of the glutathione present in the kidneys, leaving very little glutathione to protect the kidneys from inflammation. Kidney cells can become inflamed from the inside out, and die. When enough kidney cells die, the organ ceases to function--and dying cells themselves emit more inflammatory compounds which damage still more healthy cells around them. 

Young children who consume as little as 75 mg of acetaminophen (one pill) can suffer kidney damage. Adults often can tolerate 100 times as much of the medication, but consuming alcohol with an acetaminophen-based drug such as Tylenol increases the risk of kidney damage by as much as 400%. Having a good workout, popping a Tylenol or a Vanquish or an Anacin for sore muscles, and popping the top on a cold beer sometimes is a deadly combination.

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