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We were pleased to find that our article stimulated discussion on the important topic of acetaminophen use in the alcoholic patient.¹ Our study investigated the effects of multiple maximal therapeutic dosing of acetaminophen in alcoholic patients in a controlled and randomized manner. The study was powered to detect very small differences in aspartate aminotransferase and alanine aminotransferase levels: no statistical difference was found between the acetaminophen and placebo groups at any time point.

Since acetaminophen is used by about 45 million people in the United States each week,² it is striking that so few cases of alleged acetaminophen hepatotoxicity associated with therapeutic doses in alcoholic patients have been reported over the past 40 years. The few reports published have serious omissions and conflicting data, which question their validity. Drs Soll and Sees³ also noted the weaknesses of these case reports. Although some of these patients may have ingested acetaminophen with . . . [Full Text of this Article]

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