Liver failure is a medical emergency, and can kill if not treated right away. The condition is often associated with alcohol abuse, hepatitis, or acute conditions, but drug-induced conditions are becoming a major concern in the country. In fact, organ damage caused by Tylenol use has become a leading cause of the condition in the U.S., and the problem has become widespread enough that the FDA is reviewing how acetaminophen is marketed and packaged to consumers. The growing incidence rate of acetaminophen-induced organ damage has sparked a round of lawsuits as well, most of them filed against Johnson & Johnson.

What are some drugs that can cause liver failure?

Acetaminophen causes more incidents of the condition than any other drug available on the market
. In this way, it can be more dangerous than many illegal drugs. And yet, acetaminophen remains one of the most popular painkillers in the U.S., available since 1959 without a prescription. In adults, anywhere from 7 to 10 grams of acetaminophen in a 24 hour period is capable of causing damage, though there have been a few cases where people suffered harm from less. The maximum recommended dosage of the drug is about 4 grams in that same period, which can easily be exceeded by people in significant pain. For children, the threshold is typically much less, though it depends on body weight. The damage caused by acetaminophen is dose dependent, in that the greater the dose taken, the more likely it will cause damage, and the more severe that damage will be.

Statins can also cause liver failure in patients, though the damage is usually not permanent and may even present without symptoms. Statins are highly popular drugs and are widely prescribed to lower bad cholesterol in patients, so it is a concern among doctors.

Some antibiotics and medications used to treat heart arrhythmias, such as amiodarone and isoniazid, are also capable of liver failure
, though doctors who prescribe known risky drugs typically monitor their patients for any signs of damage.

Antabuse, a medication used to treat alcoholism, can also result in induced hepatitis, which can lead to acute organ failure. In some cases, the condition worsens enough that the patient requires an organ transplant.

In general, though, it is acetaminophen that is the medication of concern in this area, and the attention it is receiving from the FDA and the courts reflects this. In 2011, the FDA finally confirmed and acknowledged the relationship between acetaminophen and liver failure, forcing pharmaceutical companies to limit the amount of acetaminophen in their products to 325 mg. It also requires prescription medication manufacturers to add additional warnings about the condition on their products, but for reasons that are not fully understood, the FDA did not require over-the-counter drug manufacturers to strengthen the warnings on their packaging. That’s a concern, because the vast majority of cases involve non-prescription versions of acetaminophen. In fact, the public knows little about how acetaminophen-induced organ damage presents and how to respond, also due to poor warnings and safety literature.

For these reasons, Johnson & Johnson faces hundreds of lawsuits from people harmed by Tylenol. A drug sold on its safety, it is often anything but.