Acute liver failure caused by paracetamol overdosing is twice as common in the UK as in other European countries, a study of data from the mid-2000s has revealed.
The study – published in the British Journal of Clinical Pharmacology – found that overall, paracetamol overdoses accounted for a sixth of all cases of acute liver failure resulting in transplant (ALFT) in European countries between 2005 and 2007.
However, rates of paracetamol overdose related ALFT varied massively between countries and were highest in Ireland and the UK.
For example, Ireland had 49 cases and the UK 10 cases per 1,000 tons of paracetamol sold – compared with an average of six.
Just three paracetamol related ALFT cases occurred in France, four in the Netherlands and one in Italy – while Greece and Portugal recorded no overdose-related ALFTs.
By contrast there was little variation in non-overdose related cases of ALFTs. The study authors said this suggested there is an overall higher rate of paracetamol overdose in the UK and Ireland than elsewhere, rather than more cases of severe overdose.
Lead researcher Professor Sinem Ezgi Gulmez, associate professor of pharmacology at the University of Bordeaux, France, said: ‘Overall, we found a six-times higher risk in Ireland and a two-fold higher risk in the UK compared to the average of the countries participating in the study.’
Professor Gulmez added: ‘Since we do not have event rates for overdoses not leading to liver failure, we cannot conclude anything about the rates of non-ALFT overdoses in the different countries, but indicators point to more common use of paracetamol for self-poisoning in these countries.’
Br J Clin Pharm 2015; available online 28 May
