Hepatotoxicity due to overdoses of acetaminophen (also known as paracetamol) has become an important problem. 1 , 2 Previous reports have defined two distinct clinical syndromes. When patients attempting suicide ingest large amounts of acetaminophen, acute liver failure associated with multiorgan failure, nephrotoxicity, and occasionally pancreatitis may develop unless antidotes are given. 3 , 4 This pattern is the most common cause of acute liver failure in the United Kingdom. A second pattern, apparently more prevalent in the United States, is observed in alcoholic or fasting patients who ingest smaller amounts of acetaminophen only to relieve pain and in whom alcohol use or starvation . . .