Alcoholics or people with chronic liver disease shouldn't take acetaminophen...even therapeutic doses.

  Many health care providers were taught that moderate to heavy drinkers of alcohol are at risk for hepatotoxicity with therapeutic doses of four grams or less per day of acetaminophen. In fact, this claim has been coined with the term "alcohol-acetaminophen syndrome." And packages of acetaminophen sold in the US are labeled with warnings of liver failure in patients who "consume 3 or more alcoholic drinks every day."

  Chronic alcohol ingestion induces the liver's metabolism of acetaminophen...increasing its conversion to hepatotoxic metabolites. Plus glutathione, which helps neutralize the toxic metabolites, may be depleted in chronic alcoholics.

  But most cases of hepatotoxicity in alcohol drinkers have been due to ingestion of excessive amounts, not therapeutic doses. In fact, all prospective studies show that therapeutic doses of acetaminophen are not toxic in alcoholic patients.