Alcoholism, nonprescription drug and hepatotoxicity. The risk from unknown acetaminophen ingestion.

An alcoholic patient developed severe hepatitis and renal failure after ingesting the contents of a 300 ml. bottle of Nyquil for its ethanol content. This illness was presumably related to the 6 gm. of acetaminophen contained in this nonprescription preparation. Although hepatic damage with or without renal failure is usually described after a massive overdose of acetaminophen, the changes in drug metabolism induced by chronic ethanol consumption may increase the risk for acetaminophen toxicity. The large number of nonprescription acetaminophen-ethanol preparations available should be considered in evaluating an alcoholic patient seen with acute hepatic and renal dysfunction.