Tylenol (Acetaminophen): Side Effects, Uses, Interactions, Warnings

Tylenol (Acetaminophen)

Generic Name: Acetaminophen

Brand Names: Tylenol (Acetaminophen)

Ingredients: Acetaminophen

Drug Class: Analgesic and Antipyretic

Controlled Status: Not a Controlled Substance

Availability: Prescription Medication and Over the Counter

What is Tylenol (Acetaminophen)? 

Tylenol, with the generic name Acetaminophen, is a widely used over-the-counter medication known for its pain-relieving and fever-reducing properties. It is classified as an analgesic and antipyretic. Tylenol is available in various forms, including tablets, capsules, liquid, and more. It is commonly used to reduce elevated body temperature (fever) and alleviate minor pain stemming from various conditions such as the common cold, allergies, or other breathing illnesses (such as sinusitis, bronchitis), influenza (flu), headaches, muscle aches, arthritis, menstrual cramps and fevers associated with these ailments.

What is Tylenol (Acetaminophen) Used for?

Tylenol, or Acetaminophen, is primarily used as a pain reliever and fever reducer. It is commonly employed to alleviate minor aches, such as headaches, muscle pain, and toothaches, as well as to reduce fever associated with various illnesses, including the common cold or flu. Secondary uses of Tylenol may include its application in the management of conditions like arthritis and to ease discomfort after vaccination. 

Additionally, it is occasionally used to relieve pain following surgical procedures, although this use is less common. However, the specific use and dosing of Tylenol should be determined under the guidance of a healthcare provider, taking into consideration an individual’s medical condition and needs, to ensure its safe and effective use.

How does Tylenol (Acetaminophen) Work?

Tylenol (Acetaminophen) is grouped with NSAIDs (nonsteroidal anti-inflammatory drugs) because it can inhibit two isoforms of cyclooxygenase, known as COX-1 and COX-2, both of which play a role in the synthesis of prostaglandins (PG). Prostaglandins are responsible for triggering the sensation of pain. Acetaminophen’s ability to reduce fever is likely linked to its direct impact on the heat-regulating centers in the brain, which leads to peripheral vasodilation, increased sweating and the reduction of body heat.

Tylenol (Acetaminophen) Dosage

Dosing recommendations for Acetaminophen, which is available in various forms, are contingent on factors such as body weight and age.

There are multiple forms and potencies of Tylenol dosages, including Tylenol chewable tablets (80 mg, 100 mg, 160 mg), Tylenol tablets (325 mg, 500 mg, 600 mg, 1000 mg), oral suspension (160 mg/5 mL), Tylenol drops (50 mg/1.25 mL, 80 mg/0.8 mL), Tylenol Intravenous (IV) Injection (160 mg/mL), Tylenol Dissolvable Packets (160mg /Powder Pack), and Tylenol Suppository (Rectal Use Only) (80 mg, 120 mg, 325 mg, 650 mg).

Regarding adult dosages, the typical recommended dosage is for managing fever and relieving pain. Conversely, when it comes to pediatric dosages, the recommendations pertain to fever and pain management. It’s essential to adhere to these guidelines meticulously to ensure the appropriate treatment for each specific condition.

In certain cases, dose adjustments may be necessary to accommodate individuals with particular medical conditions. Renal dose adjustments involve modifying the prescribed dosage for patients with kidney-related issues, while liver dose adjustments entail adapting the dose for individuals with liver-related conditions. These modifications are crucial to ensure that the medication is both effective and safe for patients with these specific health concerns. Always consult a healthcare professional to determine the appropriate dose adjustments for your condition.

The recommended dosing interval is every 4 to 6 hours as needed, with a maximum of four doses within a 24-hour period. The duration of treatment should be determined by a healthcare provider.

For adults, the maximum daily dosage is 4000 mg/day (tablet) or 80 ml (oral suspension), and the treatment duration is at the discretion of a healthcare professional. In the case of children, the maximum daily dose depends on their age, weight, and the specific dosage form, and the treatment duration should be established by a healthcare professional.

Children’s Tylenol Suspension, with the generic name acetaminophen, contains 160 mg per 5mL. The recommended dosage is to administer a repeat dose every 4 hours while symptoms persist, but it’s crucial to avoid giving more than 5 doses within a 24-hour period. The specific dose is determined by the child’s age and weight, ensuring a tailored approach for safe and effective relief.

The Tylenol with Codeine dosage, with the generic name acetaminophen (300mg) and codeine phosphate (30mg), has a maximum allowable 24-hour dose limit. For codeine phosphate, the maximum dosage within a 24-hour period is 360 mg, while for acetaminophen, the maximum dose should not exceed 4,000 mg. These dosage limits are essential to ensure the safe and appropriate use of this medication.

What are the Side Effects of Tylenol (Acetaminophen)?

The common side effects associated with this medication include nausea, with a prevalence of 34% in adults and 5% or greater in pediatric patients. Additionally, headaches are reported in 1-10% of cases, while vomiting is observed in 15% of adults and 5% or more in pediatric patients. Constipation and itching both have a prevalence of 5% or greater, and diarrhea, sweating, dizziness, tiredness, and pruritus fall within the 1-10% range.

On the other hand, there are some serious side effects that should be closely monitored. These include the potential for liver damage and failure, as well as respiratory problems like pneumonitis. Dermatological concerns such as toxic epidermal necrolysis and Stevens-Johnson syndrome also require careful attention due to their severity. It is crucial to consult a healthcare professional if any of these serious side effects are suspected or if common side effects persist or worsen.

What Happens if I Miss a Dose?

Tylenol (Acetaminophen) is used on an as-needed basis, there may not be a specific dosing schedule to follow. However, if you are using this medication on a regular basis and happen to miss a dose, please take it as soon as you recollect. If your next scheduled dose is approaching, it is advisable to forget the missed dose instead of taking additional medication to compensate for it.

What Happens if I Overdose? 

A Tylenol (Acetaminophen) overdose follows a distinct progression with four phases:

• Phase I: This phase occurs within the initial 24 hours after consuming an excessive amount of acetaminophen. Common symptoms during this phase include nausea, fatigue, loss of appetite (anorexia), vomiting, paleness (pallor) and profuse sweating (diaphoresis).
• Phase II: Typically, this phase sets in approximately 24 to 72 hours after acetaminophen ingestion. Symptoms may involve right upper quadrant abdominal pain, along with nausea and vomiting. People may also experience a rapid heartbeat and low blood pressure.
• Phase III: Beginning around 72 to 96 hours after taking Tylenol (Acetaminophen), this phase signifies the onset of severe liver failure or liver damage. Symptoms can include jaundice (yellowing of the skin or eyes), low blood sugar (hypoglycemia), bleeding issues (coagulopathy) and impaired brain function due to toxins. Multiple organ failure and even death may occur at this stage.
• Phase IV: This phase applies to individuals who survive Phase III. The recovery period extends from four days to up to three weeks, during which the symptoms gradually subside.

In case of a medical emergency, please seek immediate medical assistance or contact the Poison Help Line at 1-800-222-1222. Information is also available online at poisonhelp.org. Nevertheless, if you are experiencing severe symptoms, please do not hesitate to dial 911 (or your Local Emergency Number) immediately or proceed to the nearest emergency room for immediate medical attention. Your safety and well-being are paramount.

Pros and Cons of Tylenol (Acetaminophen)

Pros	Cons
Effective for mild pain and fever	Ineffective for inflammation and swelling
Suitable for adults and children	Less effective for moderate to severe pain
Available in affordable generic form	Not recommended for frequent alcohol consumers (risk of liver damage)
Comes in various strengths and forms	–

Interaction Between Tylenol (Acetaminophen) and other Drugs

• Ketoconazole
• Levoketoconazole
• Alcohol
• Benzocaine
• Benzydamine
• Busulfan
• Carbamazepine
• Chloramphenicol
• Dapsone
• Dasatinib
• Fosphenytoin
• Imatinib
• Ipilimumab
• Isoniazid
• Lamotrigine
• Lidocaine
• Pramoxine
• Prilocaine
• Primidone
• Probenecid
• Rifampin
• Sorafenib
• Tetracaine
• Vaccines
• Isoniazid (Inh)
• Phenothiazines 
• Warfarin
• Coumadin
• Jantoven
• Phenobarbital
• Phenytoin (Dilantin)
• Carbamazepine (Tegretol)

What are the Risks and Warnings for?

Tylenol (Acetaminophen) and Allergy Warning

According to the U.S. Food and Drug Administration (FDA), acetaminophen use can, in rare instances, lead to severe skin reactions. These reactions may occur either during the initial use of acetaminophen or with subsequent usage of Tylenol ((Acetaminophen).

The potential skin reactions associated with acetaminophen include:

• Acute Generalized Exanthematous Pustulosis (AGEP): This is a rare and severe skin condition characterized by the sudden development of numerous small pustules on the skin. It can be accompanied by fever and other systemic symptoms.
• Stevens-Johnson Syndrome (SJS): SJS is a rare but serious skin disorder that can result in the development of painful, blistering rashes. It often begins with flu-like symptoms and progresses to severe skin detachment and damage.
• Toxic Epidermal Necrolysis (TEN): TEN is an even more severe and rare skin disorder. It involves the widespread detachment of the skin, leading to large areas of skin loss. It is a medical emergency and can be life-threatening.

Tylenol (Acetaminophen) and Alcohol Warning

Combining acetaminophen and alcohol is not considered safe. When used together, they can potentially irritate the stomach and in more severe instances lead to the development of ulcers, internal bleeding and liver damage.

Tylenol (Acetaminophen) and Birth Control Needs

If you have concerns about the risk of pregnancy while using acetaminophen, it is crucial to discuss this matter with your healthcare provider. If you or your partner are sexually active and there is a possibility of pregnancy, your doctor can offer advice on appropriate birth control methods to consider while you are using acetaminophen.

Warning with People with Certain Health Conditions

Liver Disease

Consuming an excessive amount of acetaminophen can result in severe and potentially life-threatening liver damage. If you have a history of liver issues, it’s vital to consult with your healthcare provider before using acetaminophen, as it can worsen existing liver damage. 

Warning with other Groups

Tylenol (Acetaminophen) and Breastfeeding

Tylenol (Acetaminophen) is a suitable option for pain relief and reducing fever in nursing mothers. The levels of acetaminophen found in breast milk are considerably lower than the doses typically administered to infants. Adverse effects in breastfed infants due to acetaminophen use appear to be uncommon. It is recommended to consult with your healthcare provider or pharmacist before taking acetaminophen while breastfeeding.

Tylenol (Acetaminophen) and Pregnancy

There has been some research suggesting a possible link between taking Tylenol (Acetaminophen) during pregnancy and an increased risk of children developing autism or attention-deficit/hyperactivity disorder (ADHD). However, it’s important to note that the evidence on this topic is not conclusive and more research is needed to establish any causal relationship.

Pregnant individuals should always consult with their healthcare providers before taking any medication, including acetaminophen, to carefully weigh the potential benefits and risks.

Expiration, Storage and Disposal

Do not use your Acetaminophen medication after the expiration date indicated on the packaging. 

For acetaminophen oral liquid, it should be stored within the temperature range of 59°F to 86°F (15°C to 30°C). Avoid placing it in the freezer and be sure to keep it away from direct light.

Acetaminophen chewable tablets and oral tablets can be stored at around 77°F (25°C). If you need to temporarily store them while traveling, a temperature range of 59°F to 86°F (15°C to 30°C) is acceptable. However, refrain from storing them in places with high humidity.

Acetaminophen oral capsules should be stored at a temperature between 68°F and 77°F (20°C to 25°C), while oral powder can be kept at room temperature.

Ensure that all forms of acetaminophen in oral preparations are stored in a tightly sealed container. Avoid storing them in areas prone to dampness or moisture, such as bathrooms.

The recommended and responsible way to dispose of medication is to contact your local waste disposal company or participate in a medication take-back program. You can find additional information on proper medication disposal to ensure safe and environmentally-friendly disposal practices. If Tylenol (Acetaminophen) has expired or is no longer required, it should not be flushed down the toilet.

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What are the Alternatives of Tylenol (Acetaminophen) ?

• Aspirin
• Ibuprofen (Advil, Motrin)
• Naproxen (Aleve, Anaprox)

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