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Dr Andre MacLean (1,2) discovered the protective effect of methionine, a
sulphur containing amino acid, when fed with large quantities of
paracetamol administered to rats. Since then its use and that of other
sulphur containing amino acids or their derivatives, by separate
administration, for treatment of paracetamol poisoning have been advocated
and refined (3). At least one preparation of paracetamol (4), also
containing methionine, has been brought to market. Experiences with this
preparation have been described (5) and include descriptions of the
toxicity of methionine, including drowsiness, nausea, flatulence and
headache. A warning of the possibility of adverse effects, inducing cardio
vascular injury, of chronic use of methionine additives was included.
Certainly, unpublished personal experimentation (before modern ethical
restrictions were applicable) in consumption of therapeutic (1g ) doses of
paracetamol, accompanied by 100mg of oral methionine per dose, lead to
early abandonment of the experiment due to excessively offensive
flatulence and social discomfort. I suspect that this is the true reason
for failure of inclusion of methionine in “over the counter” preparations
and will continue to block well-meaning attempts, by physicians, at
supplementary prophylactic therapy for the many and for the sake of the
very few.
1. McLean AEM. Prevention of paracetamol poisoning. Lancet 1974, i,
729.,
2. Maclean AEM, Day PA. The effect of diet on the toxicity of
paracetamol and the safety of paracetamol-methionine mixtures. Biochem
Pharamacol 1975, 24, 37-42
3. Crome P, Volans GN, Goulding R, Vale JA, Widdop B. Oral methionine
in the treatment of severe paracetamol (acetaminophen) overdose. Lancet
1976; ii, 829-30
5. C.L. Sheen, J.F. Dillon1, D.N. Bateman2, K.J. Simpson3 and T.M.
MacDonald, Paracetamol toxicity: epidemiology, prevention and costs to the
health-care system , Quarterly Journal of Medicine (2002), 95, 609-619
Competing interests:
None declared
Competing interests:
No competing interests
31 March 2006
Janusz Knepil
Principal Biochemist (Toxicology)
Biochemistry Department, Gartnavel General Hospital, 1053 Great Western road, Glasgow. G12 0YN
Social indignation, oral methionine and paracetamol
Dear Sir,
Dr Andre MacLean (1,2) discovered the protective effect of methionine, a
sulphur containing amino acid, when fed with large quantities of
paracetamol administered to rats. Since then its use and that of other
sulphur containing amino acids or their derivatives, by separate
administration, for treatment of paracetamol poisoning have been advocated
and refined (3). At least one preparation of paracetamol (4), also
containing methionine, has been brought to market. Experiences with this
preparation have been described (5) and include descriptions of the
toxicity of methionine, including drowsiness, nausea, flatulence and
headache. A warning of the possibility of adverse effects, inducing cardio
vascular injury, of chronic use of methionine additives was included.
Certainly, unpublished personal experimentation (before modern ethical
restrictions were applicable) in consumption of therapeutic (1g ) doses of
paracetamol, accompanied by 100mg of oral methionine per dose, lead to
early abandonment of the experiment due to excessively offensive
flatulence and social discomfort. I suspect that this is the true reason
for failure of inclusion of methionine in “over the counter” preparations
and will continue to block well-meaning attempts, by physicians, at
supplementary prophylactic therapy for the many and for the sake of the
very few.
1. McLean AEM. Prevention of paracetamol poisoning. Lancet 1974, i,
729.,
2. Maclean AEM, Day PA. The effect of diet on the toxicity of
paracetamol and the safety of paracetamol-methionine mixtures. Biochem
Pharamacol 1975, 24, 37-42
3. Crome P, Volans GN, Goulding R, Vale JA, Widdop B. Oral methionine
in the treatment of severe paracetamol (acetaminophen) overdose. Lancet
1976; ii, 829-30
4. Paracetamol + Methionine: Pameton. Drug Ther Bull (1987) 25, 99 –
100
5. C.L. Sheen, J.F. Dillon1, D.N. Bateman2, K.J. Simpson3 and T.M.
MacDonald, Paracetamol toxicity: epidemiology, prevention and costs to the
health-care system , Quarterly Journal of Medicine (2002), 95, 609-619
Competing interests:
None declared
Competing interests: No competing interests