Is acetaminophen as safe as we believe. How does it compare to other pain relievers. What are the potential risks associated with its use. Can it cause liver damage or skin reactions. How can we use acetaminophen safely.

The Prevalence of Acetaminophen Use in the United States

Acetaminophen, also known as paracetamol or APAP, is ubiquitous in American households. It’s the go-to medication for various ailments, from headaches to back pain. Found in over 600 over-the-counter (OTC) and prescription medications, including popular brands like Tylenol and Vicodin, acetaminophen’s widespread use is a testament to its perceived safety and efficacy.

But just how common is acetaminophen use? According to the Consumer Healthcare Products Association (CHPA), approximately 52 million Americans – or 23% of adults – use a medication containing acetaminophen each week. This staggering statistic underscores the importance of understanding the true nature of this widely consumed drug.

The Perceived Safety Profile of Acetaminophen

For years, acetaminophen has been hailed as one of the safest over-the-counter medications available. Unlike nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen doesn’t increase the risk of stomach or heart problems. This makes it a preferred choice for those who can’t tolerate NSAIDs.

Moreover, healthcare providers often recommend acetaminophen as one of the few pain relievers generally safe for use during pregnancy. A 2010 study from the Centers for Disease Control and Prevention (CDC) found no increased risk of major birth defects when acetaminophen was used in the first trimester of pregnancy.

Unveiling the Hidden Risks: Recent Research Findings

Despite its reputation for safety, recent studies have begun to question the benign nature of acetaminophen. A review published in the Annals of the Rheumatic Diseases concluded that the potential risks of acetaminophen have been “underestimated.” Some studies suggest that the drug could increase the risk of cardiovascular events and mortality.

These findings have sparked a reevaluation of acetaminophen’s safety profile. Are we overlooking potential dangers in our reliance on this common medication? Let’s delve deeper into some of the well-established and surprising risks associated with acetaminophen use.

The Liver Damage Dilemma: Acetaminophen’s Most Well-Known Risk

Liver damage stands out as the most recognized risk of acetaminophen use, primarily arising from overdose. After ingestion, most of the drug is metabolized by the liver and excreted through urine. However, a portion is converted into a toxic metabolite that can harm liver cells. Excessive acetaminophen intake significantly elevates the risk of liver damage, potentially leading to fatal outcomes in severe cases.

How serious is this risk? According to the Food and Drug Administration (FDA), acetaminophen was the leading cause of acute liver failure in the U.S. between 1998 and 2003. Almost half of the liver failure cases during this period resulted from accidental overdose. The FDA further reports that during the 1990s, unintentional acetaminophen overdose was responsible for approximately:

• 56,000 emergency department visits
• 26,000 hospitalizations
• 458 deaths each year

Why is accidental overdose so common? The widespread presence of acetaminophen in various OTC and prescription drugs at different doses makes it easy to inadvertently consume too much, especially when using multiple acetaminophen-containing medications simultaneously.

Current Guidelines and FDA Actions

To mitigate the risk of liver damage, current guidelines recommend not exceeding 4,000 milligrams of acetaminophen daily. To put this into perspective, a single Extra Strength Tylenol tablet contains 500 milligrams, highlighting how quickly one could approach the maximum recommended dose.

In response to these concerns, the FDA took action in 2011, requesting prescription drug manufacturers to voluntarily limit the amount of acetaminophen in each tablet or capsule to no more than 325 milligrams. By 2014, only half of the manufacturers had complied, prompting the FDA to initiate proceedings to withdraw approval of prescription combination drugs containing more than 350 milligrams of acetaminophen.

Surprising Skin Reactions: A Rare but Serious Concern

While liver damage is a well-known risk, fewer people are aware of the potential for severe skin reactions associated with acetaminophen use. Several studies have linked acetaminophen to severe skin allergies, prompting the FDA to issue a warning in 2013.

What does the data show? The FDA Adverse Event Reporting System (FAERS) revealed that between 1969 and 2012, 107 cases of severe skin reactions occurred in the U.S., resulting in:

• 67 hospitalizations
• 12 deaths

While these cases are rare, they underscore the importance of being aware of all potential risks associated with acetaminophen use. The FDA warning highlighted that acetaminophen can, in rare instances, cause potentially fatal skin reactions, including Stevens-Johnson Syndrome.

Cardiovascular Concerns: Emerging Evidence of Heart Risks

Recent research has begun to shed light on a potentially overlooked risk of acetaminophen use: cardiovascular problems. While acetaminophen has long been considered safer for the heart compared to NSAIDs, new studies suggest this may not be entirely accurate.

A large-scale study published in the European Heart Journal – Cardiovascular Pharmacotherapy in 2022 found that regular use of acetaminophen was associated with an increased risk of heart attack and stroke in people with high blood pressure. The study followed over 30,000 individuals with hypertension for an average of three years.

Key Findings of the Study

• Regular acetaminophen users had a 20% higher risk of heart attack
• The risk of stroke was 35% higher in regular users
• Overall cardiovascular events were 29% more likely in those using acetaminophen regularly

While these findings don’t prove causation, they raise important questions about the long-term cardiovascular safety of acetaminophen, particularly for individuals with pre-existing heart conditions or high blood pressure.

Mental Health and Behavioral Effects: An Unexpected Connection

In recent years, researchers have begun to explore a surprising potential effect of acetaminophen: its impact on mental health and behavior. Several studies have suggested that acetaminophen may influence our emotions and decision-making processes in subtle but significant ways.

Emotional Blunting

A study published in the journal Psychological Science found that acetaminophen may reduce our ability to feel positive emotions. Participants who took acetaminophen reported less strong emotions when viewing both pleasant and unpleasant photographs, compared to those who took a placebo.

Risk-Taking Behavior

Another study, published in the journal Social Cognitive and Affective Neuroscience, suggested that acetaminophen might increase risk-taking behavior. Participants who took acetaminophen were more likely to engage in high-risk activities in a computer game than those who took a placebo.

Empathy Reduction

Research published in the journal Social Cognitive and Affective Neuroscience found that acetaminophen may reduce our ability to empathize with others’ pain. Participants who took acetaminophen showed less empathy for others’ physical and social pain compared to those who took a placebo.

While these studies are preliminary and more research is needed, they raise intriguing questions about the potential psychological effects of a drug many of us consume regularly without much thought.

Pregnancy and Childhood Development: Long-Term Considerations

While acetaminophen is often considered one of the safer pain relief options during pregnancy, recent research has raised concerns about potential long-term effects on childhood development.

ADHD and Autism Spectrum Disorders

A large study published in JAMA Psychiatry in 2019 found a link between prenatal acetaminophen exposure and an increased risk of attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children. The study, which included data from over 130,000 mother-child pairs, found that:

• Children exposed to acetaminophen prenatally had a 20% higher risk of being diagnosed with ADHD
• The risk of ASD was 30% higher in children with prenatal acetaminophen exposure

It’s important to note that this study shows an association, not causation. However, it highlights the need for further research into the long-term effects of acetaminophen use during pregnancy.

Genital and Reproductive Development

Some studies have also suggested a potential link between prenatal acetaminophen exposure and effects on genital and reproductive development. A study published in the journal Human Reproduction found that prolonged use of acetaminophen during pregnancy was associated with a higher risk of cryptorchidism (undescended testicles) in male offspring.

While these findings are concerning, it’s crucial to balance them against the known risks of untreated pain or fever during pregnancy. Pregnant women should always consult with their healthcare provider before making decisions about medication use.

Safe Use of Acetaminophen: Guidelines and Precautions

Given the potential risks associated with acetaminophen use, it’s crucial to use this medication safely and responsibly. Here are some guidelines and precautions to keep in mind:

Dosage Guidelines

• Adhere to the recommended maximum daily dose of 4,000 milligrams for adults
• Be aware of all sources of acetaminophen in your medications, including combination drugs
• Use the lowest effective dose for the shortest duration necessary

Avoid Alcohol

Combining acetaminophen with alcohol can increase the risk of liver damage. If you consume alcohol regularly, discuss acetaminophen use with your healthcare provider.

Check for Drug Interactions

Acetaminophen can interact with other medications. Always inform your healthcare provider about all medications you’re taking, including OTC drugs and supplements.

Be Cautious with Chronic Use

If you find yourself needing to use acetaminophen regularly for extended periods, consult with your healthcare provider. There may be underlying issues that need addressing or alternative pain management strategies to consider.

Monitor for Side Effects

Be aware of potential side effects, including rare but serious ones like skin reactions. If you experience any unusual symptoms after taking acetaminophen, seek medical attention promptly.

Special Considerations for Pregnancy

If you’re pregnant or planning to become pregnant, discuss the use of acetaminophen with your healthcare provider. They can help weigh the potential risks and benefits based on your individual situation.

By following these guidelines and staying informed about the latest research, we can continue to benefit from the pain-relieving properties of acetaminophen while minimizing potential risks. As with any medication, the key lies in informed, responsible use under the guidance of healthcare professionals.

Is it as safe as we think?

Whether in your handbag, a drawer at home, or your desk at work, chances are you have acetaminophen on hand, just in case headache or back pain strikes. It is the most widely used pain relief medication in the United States, and it is also considered one of the safest. But recently, its perceived safety has come into question.

Share on PinterestAround 23 percent of Americans use a medication containing acetaminophen each week.

Acetaminophen, also known as paracetamol or APAP, is a drug commonly used to alleviate mild to moderate pain and reduce fever. It is present in more than 600 over-the-counter (OTC) and prescription medications, including Tylenol and Vicodin.

Headache, muscle aches, back pain, toothache, colds, menstrual pain, and arthritis are among the numerous conditions acetaminophen is used for.

According to the Consumer Healthcare Products Association (CHPA), each week, around 23 percent of adults in the U.S. – or 52 million Americans – use a medication containing acetaminophen.

At recommended doses, acetaminophen is considered one of the safest OTC medications.

Unlike other common pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen does not raise the risk of stomach or heart problems, making it a go-to medication for people who are unable to tolerate NSAIDs.

What is more, healthcare providers consider acetaminophen as one of the few pain relievers that is generally safe to use during pregnancy; a 2010 study from the Centers for Disease Control and Prevention (CDC) found the drug causes no increased risk of major birth defects when used in the first trimester of pregnancy.

But, as with all medications, there are risks, and researchers are finding that the risks of acetaminophen use may be more serious than we realize.

Last year, a review published in Annals of the Rheumatic Diseases concluded that the possible risks of acetaminophen have been “underestimated,” with some studies suggesting the drug could raise the risk of cardiovascular events and mortality.

In this spotlight, we take a look at some of the well-established risks of acetaminophen use, as well as some that may come as a surprise.

Liver damage is perhaps the most well-known risk of acetaminophen use, and such damage can arise through overdosing on the drug.

After taking acetaminophen, most of the drug is metabolized by the liver and excreted through urination. However, some of the drug is converted into a toxic metabolite that can harm liver cells. Taking too much acetaminophen raises the risk of liver damage, and in severe cases, it can lead to death.

According to the Food and Drug Administration (FDA), between 1998-2003, acetaminophen was the leading cause of acute liver failure in the U.S., and almost half of liver failure cases during this period were a result of accidental overdose.

Furthermore, the FDA state that, during the 1990s, unintentional acetaminophen overdose was responsible for around 56,000 emergency department visits, 26,000 hospitalizations, and 458 deaths each year.

Because acetaminophen is present in such a wide range of OTC and prescription drugs at varying doses, it can be quite easy to accidentally take too much, particularly if using multiple acetaminophen-containing medications at once.

Current guidelines recommend taking no more than 4,000 milligrams of acetaminophen daily. Considering a single Extra Strength Tylenol tablet contains 500 milligrams, it is easy to see how one may accidentally overdose on the drug.

What is more, acetaminophen-induced liver damage occurs slowly, often going unnoticed until it is too late, so people may think that taking a little extra acetaminophen than recommended is posing no harm.

With this in mind, in 2011, the FDA asked prescription drug manufacturers to voluntarily limit the amount of acetaminophen in each tablet or capsule to no more than 325 milligrams, in order to reduce consumers’ risk of accidental overdose.

As of 2014, the organization reported that just half of prescription drug manufacturers had voluntarily complied with the request, prompting them to launch proceedings to withdraw approval of prescription combination drugs containing more than 350 milligrams.

Additionally, the FDA recommend that healthcare providers consider prescribing combination drugs containing less than 350 milligrams of acetaminophen per dose.

A number of studies have associated acetaminophen use with severe skin allergies, and the FDA Adverse Event Reporting System (FAERS) revealed that between 1969-2012, 107 such cases occurred in the U.S., resulting in 67 hospitalizations and 12 deaths.

Share on PinterestIn rare cases, acetaminophen can cause severe skin reactions.

As such, in 2013, the FDA issued a warning that acetaminophen use, in rare cases, can cause a number of potentially fatal skin reactions, including Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).

“FDA’s actions should be viewed within the context of the millions who, over generations, have benefited from acetaminophen,” said Dr. Sharon Hertz, deputy director of FDA’s Division of Anesthesia, Analgesia and Addiction. “Nonetheless, given the severity of the risk, it is important for patients and healthcare providers to be aware of it. ”

In 2011, a study published in the Journal of Clinical Oncology uncovered a link between regular acetaminophen use and increased risk of certain blood cancers.

The study, which reviewed the painkiller use of more than 64,000 men and women aged 50-76, found that individuals who used acetaminophen four or more times a week for at least 4 years were at a twofold risk of some blood cancers, including lymphoma and leukemia.

However, study co-author Emily White, of the Fred Hutchinson Cancer Research Center in Seattle, WA, noted that the risk of such cancers was still small among regular, long-term acetaminophen users, at around 2 percent over a 10-year period.

Despite acetaminophen use during pregnancy being considered generally safe, a number of studies have suggested this may not be the case.

In February this year, a study that found expectant mothers who used acetaminophen were more likely to have children who developed asthma by the age of 3 years.

The researchers – including Dr. Maria Magnus of the Norwegian Institute of Public Health in Oslo, Norway – say the findings are of public health importance, uncovering the possible adverse effects of acetaminophen use in pregnancy.

However, they say the results do not warrant changes to current acetaminophen recommendations for use during pregnancy, which state that pregnant women should consult with their doctor prior to using the drug.

But asthma is not the only risk that may arise with acetaminophen use in pregnancy.

Earlier this month, MNT reported on a study that uncovered a link between prenatal exposure to acetaminophen, autism, and attention deficit hyperactivity disorder (ADHD).

From an analysis of more than 2,600 pregnancy women, the researchers found that women who used acetaminophen in the first 32 weeks of pregnancy were 30 percent more likely to have offspring with attention impairments at the age of 5, which are often seen in children with autism or ADHD.

Additionally, the researchers – including study co-author Jordi Julvez of the Center for Research in Environmental Epidemiology (CREAL) in Barcelona, Spain – found that boys prenatally exposed to the drug were more likely to have clinical symptoms of autism.

Taking to MNT, Julvez said he believes doctors need to better inform patients – particularly expectant mothers – about the potential risks associated with acetaminophen use.

“We need to tell them this possibility [of developmental problems in offspring] and to be cautious on its use, maybe taking the least possible dose and also only when it is strictly necessary,” he told us.

The majority of healthcare providers and researchers are in agreement that there is a widespread perception that acetaminophen – primarily because of its popularity and availability – is a largely harmless medication.

“I think that the public does not consider carefully the possible health risks [of acetaminophen use]; only recently has this possibility been proved by epidemiological studies. I think we need to reconsider that paracetamol use is not risky at all.”

Jordi Julvez

It should be noted, however, that in many cases, the benefits of acetaminophen – when taken in the correct doses – outweigh the risks.

In order to reduce the possible risks of acetaminophen use, the National Institutes of Health (NIH) offer some recommendations:

• Do not take more than one acetaminophen-containing product at one time
• Take the drug exactly as directed on the prescription or package label
• Do not take more than 4,000 milligrams of acetaminophen daily
• Inform your doctor if you have liver disease or a history of the condition
• Avoid using acetaminophen if you consume more than three alcoholic drinks each day
• If pregnant, consult your doctor before taking acetaminophen
• If you think you may have taken too much acetaminophen, contact your doctor immediately, even if you are feeling well.

Learn how acetaminophen use might reduce empathy.

Uses, Complications, Recalls and Warnings

The popular pain reliever Tylenol is found in more than 600 prescription and over-the-counter medications. While Tylenol is relatively safe when taken at the correct dosage, ingesting too much of the drug can lead to serious complications, including liver failure.

What Is Tylenol?

Tylenol (acetaminophen) is the most popular over-the-counter (OTC) pain relief medication used in the U.S. and around the world. Acetaminophen is the active ingredient in Tylenol and the generic name of the drug that is commonly found in other medications.

The drug was first sold in 1955 as Tylenol Elixir for Children, and today millions of American adults and children use the drug every week for common ailments such as head and body aches, colds, and fevers. In fact, according to the Consumer Healthcare Products Association, about 52 million consumers in the U.S. use products containing Tylenol each week.

Manufactured by Johnson & Johnson subsidiary McNeil Laboratories, the drug generates more than $1 billion a year. It is marketed as an effective painkiller that is safer than non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen, which are associated with stomach discomfort or bleeding.

Tylenol Uses

Tylenol belongs to a class of drugs called analgesics and antipyretic agents. An analgesic relieves pain. An antipyretic reduces fevers. For more than 50 years, doctors have recommended Tylenol for both uses.

Unlike other analgesics like aspirin and ibuprofen (Advil, Motrin), Tylenol does not treat inflammation. It is most effective for minor aches and pains but can be used safely for long-term chronic pain such as arthritis. In fact, the American College of Rheumatology recommends Tylenol to treat arthritis, and it is especially useful in types of arthritis that are not accompanied by inflammation, like osteoarthritis.

Common Side Effects of Tylenol

Tylenol on its own is a non-prescription or over-the-counter medication. While prescription medications are required to include certain prescribing information, such as common side effects, non-prescription medications like Tylenol do not typically contain the same information. Therefore, much of the information regarding side effects provided for the over-the-counter medication refers to serious side effects of Tylenol, usually because of overdose.

Common Side Effects of Acetaminophen Include:

• Constipation (infrequent or difficult to pass bowel movements)
• Agitation
• Headaches
• Insomnia (trouble falling asleep or staying asleep)
• Vomiting

Serious side effects of acetaminophen are rare when taken as directed. It’s typically well-tolerated in both adults and children.

Findings from one 2022 clinical research trial suggested that regular daily intake of 4 g acetaminophen increased systolic blood pressure in individuals with hypertension by about 5 mm Hg compared with a placebo. The study concluded that this increase in cardiovascular risk calls into question the safety of regular acetaminophen use in similar situations.

Complications Associated with Tylenol

Tylenol is associated with serious complications in the cases of overdose and long-term use, including liver damage and rare but dangerous skin reactions. It is the leading cause of acute liver failure in the U.S., and the drug in some cases has led to fatalities. The active ingredient in Tylenol, acetaminophen, accounts for more than 100,000 calls to poison centers, roughly 60,000 emergency-room visits and hundreds of deaths each year in the U.S. In England, it is the leading cause of liver failure requiring transplants.

“Acetaminophen is a dangerous drug,” Dr. John Brems, professor of surgery and chief of intra-abdominal transplantation at Loyola University in Chicago told ABC News. “Many of these patients took acetaminophen in addition to alcohol. I end up transplanting three to four patients per year, and two to three die before we can transplant them. It is probably the most dangerous OTC drug in this country.”

However, while a study from the University of Edinburgh published in February 2022 did find risk of increased blood pressure from long-term use, Dr Iain MacIntyre, the lead investigator and a consultant in clinical pharmacology and nephrology at NHS Lothian, noted, “This is not about short-term use of paracetamol for headaches or fever, which is, of course, fine – but it does indicate a newly discovered risk for people who take it regularly over the longer term, usually for chronic pain. ”

Taking Tylenol during pregnancy may increase the risk of children developing autism or attention-deficit/hyperactivity disorder, or ADHD. Current research is limited, and the results are mixed.

Timeline of FDA Tylenol Actions:

• 2009

  FDA issued guidelines for adding overdose information to products.

• 2011

  The agency confirmed the link between acetaminophen and liver damage and added a black box warning, the agency’s strongest warning, to the label of prescription products containing the drug.

• 2011

  FDA asked drug manufacturers to limit the strength of acetaminophen in prescription drug products to 325 mg.

• 2011

  The agency added a warning highlighting the potential for allergic reactions (e. g., swelling of the face, mouth, and throat, difficulty breathing, itching, or rash) to the label of all prescription drug products that contain acetaminophen.

• 2013

  FDA released a safety warning about acetaminophen and rare but serious skin reactions.

• 2014

  The agency announced its intent to take steps to withdraw approval of prescription combination drug products containing more than 325 mg of acetaminophen.

• 2015

  FDA announces findings from review of acetaminophen use during pregnancy.

Tylenol Use During Pregnancy

The FDA reviewed possible risks of acetaminophen use during pregnancy and released its findings in a January 2015 Drug Safety Communication.

According to the safety communication, two U.S. studies indicate that 65 to 70% of pregnant women in the U. S. reported using acetaminophen anytime during pregnancy.

One study reported an increased risk between acetaminophen use in pregnancy and ADHD in children. Women reporting any acetaminophen use in pregnancy were also significantly more likely to have a child with a hyperkinetic disorder diagnosis or a child who used ADHD medications, compared to unexposed women.

Associations for all outcomes were strongest for acetaminophen use in multiple trimesters and for more than 20 weeks during pregnancy, the FDA noted.

The FDA said the study had a number of methodologic limitations and concluded, the weight of evidence is inconclusive regarding a possible connection between acetaminophen use in pregnancy and ADHD in children.

Since then, other studies have reported mixed results. A 2022 meta-analysis found an association between Tylenol and adverse neurodevelopmental outcomes.

Acetaminophen is still the safest known drug to take during pregnancy for problems like fever and pain, said Dr. Salena Zanotti, an OB/GYN at Cleveland Clinic. When you’re pregnant it’s riskier to have an untreated fever than it is to take acetaminophen.

People have filed Tylenol lawsuits claiming the drug caused children to develop autism and ADHD. A class-action lawsuit is moving through the court system under Judge Denise Conte.

Lawsuit Information

ADHD and autism spectrum disorder are among the injuries being named in Tylenol lawsuits.

View Lawsuits

Tylenol Recalls

Tylenol faced a string of recalls from 2009 to 2012. Some Tylenol products didn’t return to store shelves until 2013.

In 2009, McNeil recalled many Tylenol brands because a chemical for treating wood made it into the medicine, causing nausea, vomiting and diarrhea. In 2011, it expanded the recall to include several more lots of the medication. The recall involved tens of thousands of Tylenol products and prompted Johnson & Johnson to close a manufacturing plant. Furthermore, the FDA stepped in to supervise quality control measures at three plants. In 2012, McNeil recalled nearly 600,000 bottles of infant Tylenol for faulty dosing systems that could result in babies receiving too little or too much medicine.

Chicago Tylenol Murders

The drug was also linked to several murders in 1982 called the Chicago Tylenol Murders. Several people in Chicago died after taking Extra Strength Tylenol caplets that were laced with cyanide. McNeil was not implicated in the murders because the bottles came from different factories, and all seven deaths took place in the Chicago area, ruling out the possibility of tampering during production.

After the murders, Johnson & Johnson sent warnings to hospitals and distributors, stopped all advertising and Tylenol production and recalled approximately 31 million bottles. The murders remain unsolved.

Other Examples of Tylenol Recalls

Tylenol Forms and Doses

Tylenol is available in tablet, chewable tablet, capsule, suspension or solution (liquid), extended-release (long-acting) tablet and orally disintegrating tablet forms and as a suppository for rectal use. There is also an intravenous form of acetaminophen that is used in hospital settings.

Most formulations are available in several dose amounts, usually from 300 mg to 1000 mg. It comes in prescription and nonprescription strengths. However, the strength of acetaminophen in prescription drug products is limited to 325 mg per request by the FDA.

The maximum indicated dose in a 24-hour period should not exceed 4,000 mg for most patients. Taking more than 4,000 mg of Tylenol a day puts users at risk of liver failure. Experts say anyone taking Tylenol long-term for chronic pain should consider having liver function tests once or twice a year.

Child-Specific Product

To administer the medicine to children, use the child-specific product with a dosing cup or dropper that comes with it. Teaspoons found in the home vary in size and their use to administer Tylenol could overdose or underdose a child. You may need to shake the liquid before each use.

Chewable Tablet

The Tylenol Meltaways chewable tablet softens in the mouth to make it easier to chew. Chew the tablet thoroughly before swallowing it.

Meltaways

Meltaways are orally disintegrating tablets. Place the tablet in your mouth and either wait for it to dissolve or chew it before swallowing.

Extended–Release Tablets

Extended-release tablets are meant to be swallowed whole. Do not split, chew, crush or dissolve these tablets before swallowing.

Tylenol Facts

Please seek the advice of a medical professional before making health care decisions.

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Check with your doctor or pharmacist about the correct and safe use of medicines \ ConsultantPlus

Check with your doctor or pharmacist for information about the correct and safe use of medicines

Antivirals can sometimes help reduce flu symptoms. Most people do not need these antiviral medications to fully recover from the flu. However, people who are at high risk of getting serious complications from the flu, or who have severe flu and need to be hospitalized, may benefit from antivirals. Antivirals may be used for patients 1 year of age and older. Ask your doctor if you need to take antiviral drugs.

Influenza infection can lead to a bacterial infection or occur simultaneously with a bacterial infection. Therefore, some individuals will also need to take antibiotics. A more severe or prolonged illness, as well as an illness that improved and then worsened, may be indicators that the patient has a bacterial infection. Talk to your doctor if you have any concerns.

Warning! Do not give aspirin (acetylsalicylic acid) to children or teenagers with the flu – it can cause a rare but serious illness called Reye’s syndrome.

– Check the label of over-the-counter cold and flu medicines for aspirin content.

– Adolescents with influenza should take non-aspirin medications such as acetaminophen (Tylenol(R)) and ibuprofen (Advil(R), Mortin(R), Nuprin(R)) to relieve the flu.

– Children under 4 years of age should not be given cold medicine without first consulting a doctor.

– The safest treatment for flu symptoms in children under two years of age is to use a humidifier on a “cool mist” setting and use a blower to suck out any accumulated mucus.

– Fever and pain can be treated with acetaminophen (Tylenol(R)) or ibuprofen (Advil(R), Motrin(R), Nuprin(R)) or non-steroidal anti-inflammatory drugs. Examples of such drugs include:

Generic Brand Name

Acetaminophen Tylenol(R) (Tylenol)

Ibuprofen Advil(R) (Advil), Mortin(R) (Motrin), Nuprin(R) (Nuprin)

Naproxen Aleve

– Over-the-counter cold and flu medications used according to package directions may help relieve some symptoms, such as cough and nasal congestion. It is important to remember that these drugs do not reduce the ability of a sick person to infect other people.

– Check the product label to see if the medicines contain acetaminophen or ibuprofen before taking an additional dose of these medicines – do not take a double dose of the medicine! Patients with kidney or stomach problems should first consult their doctor before taking any non-steroidal anti-inflammatory drugs.

Talk to your doctor if you are already taking over-the-counter or prescription drugs that are not related to flu.

A scary story about the simplest and safest drug

I read about Tylenol at work, the most popular drug in America, it is in every home, in every first aid kit; if someone has a headache or someone has a cold, Tylenol will be the first thing they drink. Here, I decided to share. I will share not from the point of view of a pharmacist, because I am not one, but from the search and marketing point of view and a little bit of just common sense (I hope). Let me briefly explain what’s going on.

Johnson and Johnson, manufacturers of Tylenol (brand name for acetaminophen, aka paracetamol; the most popular painkiller and anti-inflammatory drug in the States, sold at any pharmacy without a prescription, in almost any form: tablets, capsules, mixture; there is children’s Tylenol, Tylenol ” pi-em “(from English. PM , lat. post meridiem , “after noon”) with sleeping pills and a bunch of other varieties) are periodically judged by comrades who have received liver failure from an overdose of the drug. In especially severe cases, relatives judge, since the sufferers themselves did not get off with liver failure and can no longer judge anyone. In addition to the purely technical aspects necessary for the work, it became simply interesting to me who is to blame: J. and J. have been poisoning people for so many decades, or is it not just that?

Tylenol, a seemingly harmless pain reliever, antipyretic, and anti-inflammatory drug, has several problems. Firstly (and here J. and J. are wrong), it is difficult to calculate the dosage for children. Usually it is given from the calculation of the age and weight of the child, which is somewhat confusing. Secondly, Tylenol increases the risk of asthma by almost 50% (weak source, I would be grateful for something more solid). Thirdly, the instructions on the packaging are not always clear: for example, the content of acetaminophen is indicated on a package of 2 tablets, people think that this is all together, but in fact – the dosage is for only one tablet. But with adults…

There may be objective reasons. It is difficult to predict side effects if a person already has, say, liver problems. It is still unclear what dosage is safe. So, J. and J. produce tablets with a maximum content of the active ingredient of 500 mg and the maximum dose is considered to be 4,000 mg per day for an adult. The FDA has recently insisted that paracetamol be limited to 325 mg per tablet/capsule and not exceed 3,000 mg per day in total. However, much more often… A person has been taking Tylenol for years. Or – ate Tylenol with another acetaminophen-containing drug. Or drink alcohol. And suddenly – problems with the liver.

It seems that people simply do not read what is written on the packaging. And there is usually a maximum dose indicated. I don’t remember if they write about interactions with other drugs (in America for some reason there are no instructions for tablets, as in Russia, with a detailed description of pharmacology, etc.), but the active ingredient is clearly indicated. Well, you might think … You might guess that eating Tylenol for years for headaches is somehow wrong, something is not right here. Don’t eat, you think? Also how they eat.

Here are a few comments on an article from resource4thepeople.com (a site with legal information on injuries and injuries “for dummies”):

I have been taking pain killing drugs for many years with tylenol in them; my blood work came back with elevated liver enzymes <…>

I have taken Tylenol for many years and never thought I would go through this. I have seen many Doctors that have told me that I have high liver levels. Was actually hospitalized for Liver Failure. I had been taking Tylenol & Tylenol PMs for years…

I was actually hospitalized in 2008 for Liver Failure. I had been taking Tylenol & Tylenol PMs for years…

HAVE TAKEN ACETEMETAPHEN with Hydrocodone for The Last 5 YRS <...>

looked at the most popular Google queries, according to Google Keyword Tool:

What IS ACETAMINOPHEN, What ARE ARE ACETAMINO Phen, acetaminophen is – presumably, those are looking for those who read the name of the active ingredient on the package and decided to find out what he was drinking.

But further… Acetaminophen with codeine (and various combinations of these words in different order and with different prepositions/conjunctions) – they seem to be often prescribed together. Codeine is a weak opiate used as a pain reliever and cough medicine. Sold by prescription as a drug.

Next in number of requests per month is the dosage of acetaminophen. And right after – ibuprofen and acetaminophen (and similar combinations of words). Comrades, why do you need paracetamol with ibuprofen?

Another popular request is acetaminophen and oxycodone . As with codeine (oxycodone, also an opiate used as a pain reliever), they are sometimes prescribed together. Not because oxycodone with paracetamol somehow works better; it’s just that people who need such a strong painkiller, as a rule, have a whole bunch of other symptoms, including inflammatory ones. Or – also a possible option – a person tries to drown out chronic pain with Tylenol, and then moves on to something more serious.