ReviewBritish journal of clinical pharmacology2016
Can paracetamol (acetaminophen) be administered to patients with liver impairment?
Review in British journal of clinical pharmacology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 98 citations in OpenAlex.
- Study of glutathione S-transferase levels in patients receiving intravenous paracetamol perioperatively: A randomized controlled trial.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2018Trial
- A systems pharmacology model for paracetamol overdose and treatment.Journal of pharmacokinetics and pharmacodynamics · 2026Article
- Unveiling Hepatic Protein Alterations in Neonatal and Infant Biliary Atresia.Clinical pharmacology and therapeutics · 2026Article
- Balancing benefit and risk: clinical considerations in the use of acetaminophen, non-steroidal anti-inflammatory drugs, and dexamethasone for perioperative multimodal analgesia.The Korean journal of pain · 2025Review
- Quantitative Systems Toxicology Modeling of Acetaminophen Pharmacokinetics and Hepatic Biomarkers After Overdoses of Extended-Release and Immediate-Release Formulations in Adults With Chronic Alcohol Use or Low Glutathione.CPT: pharmacometrics & systems pharmacology · 2025Article
- Article
- Changing Prevalence of Medication Use in People with Cirrhosis: A Retrospective Cohort Study Using Pharmaceutical Benefits Scheme Data.Drugs - real world outcomes · 2023Article
- Acetaminophen: A Liver Killer or Thriller.Cureus · 2023Review
- Paracetamol prescriptions in older people hospitalized in a French geriatric hospital.Health science reports · 2023Article
- Pregnancy, delivery, and postpartum period in infantile liver failure syndrome type 2 due to variants inJIMD reports · 2023Article
- An Updated Review on the Metabolite (AM404)-Mediated Central Mechanism of Action of Paracetamol (Acetaminophen): Experimental Evidence and Potential Clinical Impact.Journal of pain research · 2023Review
- Multimodal Analgesia in the Aesthetic Plastic Surgery: Concepts and Strategies.Plastic and reconstructive surgery. Global open · 2022Article
- Critical Update on the Diagnosis and Management of COVID-19 in Advanced Cirrhosis and Liver Transplant Recipients.Journal of clinical and translational hepatology · 2021Review
- Implementation and outcome of an electronic tool for detection of paracetamol overdose in a tertiary care hospital.International journal of clinical pharmacy · 2021Article
- Managing medicines in alcohol-associated liver disease: a practical review.Australian prescriber · 2021Review
- Clinical features and potential mechanism of coronavirus disease 2019-associated liver injury.World journal of clinical cases · 2021Review
- Caveolin-1 Alleviates Acetaminophen-Induced Fat Accumulation in Non-Alcoholic Fatty Liver Disease by Enhancing Hepatic Antioxidant AbilityFrontiers in pharmacology · 2021Article
- Medication safety in patients with hepatic impairment: A survey of community pharmacists' knowledge level and their practice in caring for these patients.British journal of clinical pharmacology · 2020Article
- Aqueous Partition of Methanolic Extract ofNutrients · 2019Article
- Mitochondrial Damage and Biogenesis in Acetaminophen-induced Liver Injury.Liver research (Beijing, China) · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although 60 years have passed since it became widely available on the therapeutic market, paracetamol dosage in patients with liver disease remains a controversial subject. Fulminant hepatic failure has been a well documented consequence of paracetamol overdose since its introduction, while short and long term use have both been associated with elevation of liver transaminases, a surrogate marker for acute liver injury. From these reports it has been assumed that paracetamol use should be restricted or the dosage reduced in patients with chronic liver disease. We review the factors that have been purported to increase risk of hepatocellular injury from paracetamol and the pharmacokinetic alterations in different pathologies of chronic liver disease which may affect this risk. We postulate that inadvertent under-dosing may result in concentrations too low to enable efficacy. Specific research to improve the evidence base for prescribing paracetamol in patients with different aetiologies of chronic liver disease is needed.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.