Aminotransferase Elevations in Healthy Adults

• Methods: 145 Adults received 4 gm Acetaminophen alone or in combination with opiates daily for 2 weeks

• Incidence of ALT Elevations X 3 vs placebo 31-44%

• Incidence of ALT Elevations X 5 vs placebo 19%

• Highest ALT Acetaminophen Alone 575

• Highest ALT Acetaminophen with Opiates 636

• Trough Acetaminophen Levels did not exceed therapeutic levels in any subject

• All elevated levels returned to normal after acetaminophen discontinued

• (Watkins et al JAMA 2006, 296: 87-93)