NMA: Nonprescription Medicines Academy

Meta-Analysis: Acetaminophen Has Minimal Effects on Serum ALT Levels in Drinkers

October 17th, 2012

In a systematic review and meta-analysis of randomized, placebo-controlled trials that included 551 moderate-to-heavy alcohol users, daily administration of acetaminophen at or near the maximum recommended dose (4 g/day) had minimal effects on serum alanine aminotransferase (ALT) levels when measured on study day 4.

The systematic review identified six randomized, placebo-controlled trials that enrolled subjects who consumed ethanol, received acetaminophen in therapeutic doses up to 4 g/day, and had serum ALT level measurements. Five of the six articles reported ALT levels on study day 4 for subjects who received acetaminophen (total of 551 subjects) or placebo (350 subjects); these data were included in the meta-analysis. The difference in mean change from baseline ALT levels between the acetaminophen and placebo groups on day 4 was 0.0 U/L (95% CI, −0.2–0.1 U/L). There were no reports of liver dysfunction, liver failure, or death in any of the trials, even when acetaminophen was used during the theoretically most vulnerable period.

Pharmacotherapy. 2012;32:784-91. Epub 2012 Jul 31.