What you should know about acetaminophen (Tylenol)

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Acetaminophen is currently the most popular painkiller in the United States. Americans take over 8 billion pills (tablets or capsules) of Tylenol each year.

Acetaminophen is a very effective pain-killing and fever-reducing drug. It is also a very safe drug as long as the recommended dosage is not exceeded. In fact, the use of acetaminophen instead of aspirin to treat fevers in infants has greatly reduced the occurrence of Reye’s syndrome, an often fatal form of liver failure.

Acetaminophen controls pain and fever but does not reduce inflammation, as does aspirin and the other widely consumed nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Advil, Motrin, generics) and naproxen. But unlike NSAIDs, acetaminophen does not irritate the stomach and intestinal lining. That means a person who cannot tolerate NSAIDs can still take acetaminophen. It’s an important drug for controlling chronic pain in older adults.

However, an overdose of acetaminophen (Tylenol) can destroy half of a person’s liver cells in less than a week, and the window of overdose is much narrower than that of the other NSAIDs. The body breaks down most of the acetaminophen in a normal dose and eliminates it in the urine. But some of the drug is converted into a byproduct that is toxic to the liver. If you take too much—all at once or over a period of days—more toxin can build up than the body can handle. The maximum daily dosage is 3900 milligrams.

Just remember:

Follow dosing directions and never take more than directed; even a small amount more than directed can cause liver damage.
Don’t take acetaminophen for more days than directed.
Don’t take more than one medicine that contains acetaminophen at a time. For example, your risk of liver damage goes up if you take a medicine that contains acetaminophen to treat a headache, and while that medicine is still working in your body, you take another medicine that contains acetaminophen to treat a cold. And remember, drugs like Percocet, Vicoden also contain acetaminophen, so be careful with stacking you meds. Here is a list of medications that contain acetaminophen. If Tylenol is your primary painkiller, please keep this list handy to avoid an overdose.