![]() ![]() NSAIDs are typically used to relieve mild to moderate pain related to a variety of conditions (Conaghan 2012 Goldman 2011 Mayo Clinic 2011).Īcetaminophen, also called paracetamol, is not an NSAID, but a distinct analgesic and fever reducing drug with a similarly broad usage (Amar 2007 Harvard Medical School 2006).Īcetaminophen overdose is the leading cause of acute liver failure in the developed world (Larson 2005 Craig 2010), accounting for more than 56,000 emergency room visits, 26,000 hospitalizations, and 450 deaths per year in the U.S. Non-steroidal anti-inflammatory drugs (NSAIDs) are a diverse group of drugs with analgesic, anti-inflammatory, and antipyretic (fever-reducing) properties. Natural interventions such as zinc-carnosine, licorice, and Boswellia serrata may protect against the gastrointestinal side effects of NSAIDs.Other natural interventions that may protect against acetaminophen toxicity include curcumin, polyphenols such as resveratrol and green tea extract, coenzyme Q10, several botanicals such as Ginkgo biloba and garlic, and others.Silymarin, a mixture of compounds from milk thistle, has been shown to protect against acetaminophen toxicity and may be more effective than NAC if treatment is delayed after overdose. Several carotenoids, including lutein and lycopene, have been shown in animal models to exert protective effects against acetaminophen toxicity. Selenium deficiency may decrease the acetaminophen dose necessary to produce toxicity, and coadministration with NAC may be more effective than NAC alone. Selenium is a cofactor for enzymes that synthesize glutathione and detoxify acetaminophen. One animal study showed comparable efficacy of SAMe and NAC after acetaminophen overdose. Levels of SAMe, a derivative of methionine, are decreased in the presence of acetaminophen. Methionine, a precursor to glutathione and other cellular antioxidants, may be used as an alternative to NAC. Taking at least 600 mg NAC anytime acetaminophen is used may help prevent liver toxicity. High dose NAC is a conventional treatment for acetaminophen overdose. What Natural Interventions May Be Beneficial for Acetaminophen and NSAID Toxicity? Combining NSAIDs with gastroprotective agents in single-tablet formulations.What are Emerging Therapies for Acetaminophen and NSAID Toxicity? Gastroprotective agents to prevent or treat gastric ulcers (eg, proton pump inhibitors ).If acute liver failure occurs, intensive supportive therapy or liver transplantation may be required. ![]()
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