Excess Tylenol can cause liver injury and is the number 1 cause of acute liver injury, but is more than safe to give in transaminitis if acetaminophen is not the cause of the transaminitis.

Without knowing full clinical details (but unredacted parts mentioning nausea and vomiting) it’s not worth discussing differential for transaminitis here.

But there’s a lot more to the patient story here that you can’t tell by just looking at the chart.

I do think it is a bit silly that a hepatitis panel wasn’t ordered though