Consumer Reports says that common prescription and over-the-counter painkillers, including Tylenol (acetaminophen) could be potentially fatal. While it may catch most people off guard to hear Tylenol’s active ingredient in an article that also includes drugs like OxyContin, there is a growing awareness of life-threatening side effects linked to Tylenol.

According to Consumer Reports, there are the dangers associated with the painkillers, with both over-the-counter and prescription alike. Controlled substances like OxyContin, Percocet, and other members of the opiate family (which includes heroine), not surprisingly, are linked to almost 17,000 deaths per year, with 30 people requiring emergency medical care for overdoses for every related death.

But what may come as surprise is that Tylenol’s active ingredient, used in many over-the-counter drugs with a widespread reputation for safety, is linked to over 80,000 emergency room visits from liver failure. In fact, acetaminophen is the leading cause of acute liver failure in the country.

One of the main problems with acetaminophen is that it does not take much more than the recommended dose to cause liver problems. Acetaminophen is toxic because of the way the body breaks it down.

The liver breaks acetaminophen down into smaller molecules, some of which are more toxic than acetaminophen itself. Under normal circumstances, the body breaks these toxic chemicals down quickly enough to avoid liver problems, but if a person has a physiological quirk, or they ingest more than the recommended amount, they can suffer liver damage and liver failure, a serious, painful medical emergency then can be fatal — or take months of recovery for survivors. This means that exceeding the recommended maximum dose, even slightly, can trigger liver toxicity.

A related problem is that acetaminophen is very common, and sold under different names. According to Consumer Reports, acetaminophen is the active ingredient in over 600 over-the-counter drugs.

The U.S. Food and Drug Administration (FDA) states that a patient shouldn’t take more than 4,000 milligrams of acetaminophen in a 24-hour period. Consumer Reports created a graphic for their article showing that combining Tylenol, NyQuil, and Walgreens generic nighttime pain reliever can easily exceed 4,000 milligrams of acetaminophen in a 24-hour period, since all of these different drugs contain acetaminophen. Since consumers may not realize that different brands of medicine are using the same drug, they may accidentally “double up” and surpass the safe dosage of the drug.

To combat this, the FDA has mandated that prescription acetaminophen-based drugs use no more than 325 milligrams of acetaminophen to avoid liver damage and liver failure.

However, this guideline does not apply to over-the-counter drugs that include acetaminophen, with top-sellers like Tylenol Extra Strength containing as much as 500 milligrams of acetaminophen.

Consumer Reports calls on the FDA to simplify labels and restrict the dosage of OTC acetaminophen-based drugs like Tylenol to 325 milligrams to make it easier to avoid accidental overdose and liver failure.

The individual Tylenol liver damage lawsuits from around the country have been grouped together in a Pennsylvania court. This process is called a multidistrict litigation or MDL. In MDLs, the court system groups similar lawsuits together to streamline the legal process. This prevents duplication of efforts within the legal system, saving time, money, and resources for everyone involved.

The Tylenol Liver Damage MDL is In re Tylenol (Acetaminophen) Marketing, Sales Practices, and Products Liability Litigation, MDL No. 2436, in the U.S. District Court for the Eastern District of Pennsylvania.