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These patients tended to be older than patients who intentionally poison themselves.4 Paracetamol hepatotoxicity in those older than 40 years is associated with an increased risk of fulminant hepatic failure, death or liver transplantation.4,5 An analysis of 67 cases of “therapeutic misadventure” with paracetamol found that 60% of patients with accidental paracetamol poisoning had taken no more than 6 g paracetamol per day, and 40% had not exceeded the recommended maximum dose of 4 g per day.6 Risk factors for developing hepatic toxicity under these circumstances include prolonged fasting,7 regular excessive alcohol intake,6 or concurrent use of drugs that induce cytochrome P450 (CYP450), especially CYP450 2E1

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