In today's world, acetaminophen is a remarkably popular over-the-counter drug. Most commonly known as paracetamol in many countries, this drug is classified as an analgesic (pain reliever) and an antipyretic (fever-lowering drug). However, as with any other drug, you need to know exactly how acetaminophen works, when it is indicated, as well as how to avoid its side effects and toxicity.
Although it is not exactly known how acetaminophen works, experts believe that this drug alleviates pain by increasing the person's pain threshold, the level by which the individual feels pain. When pain threshold is elevated, pain would have to be greater for a person to feel it.
As a fever-lowering agent (antipyretic), acetaminophen acts on the area of the brain that regulates body temperature. It particularly orders the brain's thermoregulation center to lower the temperature when it is elevated.
Although primarily indicated for the relief of fever and mild aches and pains, acetaminophen can also be used to treat pain due to mild arthritis. However, since this drug does not have an anti-inflammatory action, it does not relieve any forms of inflammation, swelling and redness. But acetaminophen is as effective as aspirin in relieving pain that is not due to inflammation.
Acetaminophen is an over-the-counter drug that comes in various forms. It is available as chewable tablets, coated caplets, gelcaps, geltabs, liquid suspensions, and even suppositories.
Do not take more of this medication than is recommended. An overdose of acetaminophen can damage your liver or cause death.
Know the amount of acetaminophen in the specific product you are taking.
Do not take this medication without a doctor's advice if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take acetaminophen. Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.
Ask a doctor or pharmacist if it is safe for you to take this medicine if you have liver disease or a history of alcoholism.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.
Stop using acetaminophen and call your doctor if:
you still have a fever after 3 days of use;
you still have pain after 7 days of use (or 5 days if treating a child);
you have a skin rash, ongoing headache, or any redness or swelling; or
if your symptoms get worse, or if you have any new symptoms.
Urine glucose tests may produce false results while you are taking acetaminophen. Talk to your doctor if you are diabetic and you notice changes in your glucose levels during treatment.
Store acetaminophen at room temperature away from heat and moisture. The rectal suppositories can be stored at room temperature or in the refrigerator.
You should not use acetaminophen if you are allergic to it.
Ask a doctor or pharmacist if it is safe for you to take acetaminophen if you have:
liver disease; or
a history of alcoholism.
Do not take this medication without a doctor's advice if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take acetaminophen.
It is not known whether acetaminophen will harm an unborn baby. Before using this medicine, tell your doctor if you are pregnant. Acetaminophen can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
Since acetaminophen undergoes metabolism in the liver, drugs that enhance the action of liver enzymes that break down acetaminophen can therefore lower the therapeutic levels of the drug. This can in turn reduce the therapeutic effects of acetaminophen. Drugs known to increase the action of liver enzymes include carbamazepine (Tegretol), and antituberculosis drugs isoniazid (INH, Nydrazid, Laniazid) and rifampin (Rifamate, Rifadin, Rimactane). Acetaminophen doses greater than recommended amount can cause toxicity to the liver and may lead to severe liver damage. This potential toxic effect of this drug in the liver is heightened when combined with alcohol or drugs that are also harful to the liver.
The intestinal absorption of acetaminophen is reduced by cholestyramine (Questran). This can lower the effects of acetaminophen. To avoid this, acetaminophen must be given 3 to 4 hours after cholestyramine or an hour prior to cholestyramine administration.
Acetaminophen may also enhance the blood thinning action of warfarin (Coumadin), when daily doses exceed 2,275 mg. It is therefore imperative to avoid administration of large acetaminophen doses during the course of warfarin treatment.
Most drugs are not safe to be taken during pregnancy. But women in all stages of pregnancy can take acetaminophen safely. In fact, it is the treatment of choice for short-term fever and minor aches and pains during pregnancy.
The use of acetaminophen in nursing mothers appears to be safe too, although the drug is passed into the breast milk in small quantities.
Acetaminophen in oral or rectal form has not been formally assigned to a pregnancy category by the FDA. It is routinely used for short-term pain relief and fever in all stages of pregnancy. Acetaminophen is believed to be safe in pregnancy when used intermittently for short durations.
All medicines may cause side effects, but many people have no, or minor, side effects. If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.
When used properly, acetaminophen rarely causes any side effect. However, this drug can cause liver damage when taken in excessive quantities. This serious adverse effect can also result when acetaminophen is used over a prolonged period, or simultaneously with alcohol or other drugs harmful to the liver. Chronic alcohol intake may further increase the risk of bleeding in the stomach.
If you do not have liver problems, the maximum dose of acetaminophen for adults is 4 grams per day (4000 milligrams). The maximum dose of acetaminophen for children is based on age/weight (check product package for details). Taking more than the maximum daily amount may cause serious (possibly fatal) liver damage. Get medical help right away if you have any of the following symptoms of liver damage: persistent nausea/vomiting, extreme tiredness, stomach/abdominal pain, yellowing eyes/skin, dark urine.
If you have liver problems, consult your doctor or pharmacist for a safe dosage of this medication.
Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Acetaminophen/Chlorpheniramine/Phenylephrine:
Dizziness; drowsiness; dry mouth, nose, or throat; headache; nausea; nervousness; trouble sleeping.
Seek medical attention right away if any of these SEVERE side effects occur when using Acetaminophen/Chlorpheniramine/Phenylephrine:
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; dark urine or pale stools; difficulty urinating; hallucinations; high blood pressure; rapid pulse; severe nervousness; stomach pain; tremors; unusual fatigue; yellowing of the skin or eyes.
This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects.
Acetaminophen overdose is one of the most common poisonings worldwide. People often think that acetaminophen, a pain-relieving medicine, is extremely safe. However, it may be deadly if taken in large doses.
You should not take more than 4000 mg of acetaminophen a day. Taking more, especially 7000 mg or more, can lead to a severe overdose if not treated. Some symptoms of Acetaminophen overdose include:
Abdominal pain; appetite loss; coma; convulsions; diarrhea; irritability; jaundice; nausea; sweating; upset stomach; vomiting; and death
Note: Symptoms may not occur until 12 or more hours after the acetaminophen was swallowed.
If an overdose is suspected, seek immediate medical attention.
Since acetaminophen is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of acetaminophen can be fatal.
The first signs of an acetaminophen overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, and confusion or weakness. Later symptoms may include pain in your upper stomach, dark urine, and yellowing of your skin or the whites of your eyes.
Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP. Avoid drinking alcohol. It may increase your risk of liver damage while taking this medicine.
Due to its efficacy in treating fever and minor pain; coupled with its safety in children and pregnant women, acetaminophen or paracetamol can be considered as one of the greatest discoveries in the field of medicine and pharmacology. And the convenience of getting it without prescription is indeed something to be appreciated. We simply ought to be responsible in its use to maximize the benefits while avoiding its harmful side effects.
The following reviews have been selected:
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Condition: Fever
Reviewer: Yayagirl, 45-54 Female, 9/18/2007 12:22:26 AM
Comment:
Tylenol is the only OTC pain reliever/fever reducer that I can use now that I have had gastric bypass surgery. NSAIDs are too harsh on the revised gut structure of a Roux en Y patient. It has been three years since my surgery and I have relied completely on Tylenol for relief of headache pain. I also take the Tylenol PM product after a particularly rough physical day when I have body aches and need help falling asleep. It does the trick every time. I rely on Tylenol.
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Review by Anonymous:
User Rating: 9.0
Tylenol (acetaminophen) for Pain: Only over the counter pain med I can take with Crohn's disease. All other pain killers have some degree of aspirin in them. For those with stomach diseases acetaminophen (Tylenol) is the only thing we can take.
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Condition: Head Pain
Reviewer: 25-34 Female, 10/10/2009 1:13:19 AM
Comment:
Acetaminophen does nothing for my headaches. It's good for fevers, and that's about it. It does not help swelling go down like aspirin or IB. AND acetaminophen is NOT as safe as most people think it is!! If you take it a lot it causes liver damage and ulcers (that's holes in your stomach people!). If you take it with alcohol it causes liver damage so don't take it to prevent a hangover. If you take it in high doses for a long time it can worsen arthritis when you get older. Just some warnings since people seem to think they can use as much as they want.
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Review by jenn26:
User Rating: 10
acetaminophen for Fever: I always use Tylenol when my kids have a fever, it works great!
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Condition: Head Pain
Reviewer: Jen, 35-44 Female, 10/30/2007 6:34:38 AM
Comment:
This is a pill I first take for headache and LL SORTS OF PAIN. I even give this to my kids. I don't experience any sourness in the stomach.. I also prescribe it over the phone for relatives who ask for fever and pain relief. It is so safe that I take it without having eaten anything.
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Review by Quorrah:
User Rating: 9.0
Tylenol (acetaminophen) for Fever: Pain: not very effective. No side effects, easy to use. Fever: definitely a 10. Always helps. This got a high rating due to the fever-reducing.
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Condition: Pain associated with Arthritis
Reviewer: tenuli, 45-54 Female, 9/17/2007 10:27:05 PM
Comment:
I was taking Tylenol for knee pain (especially at bedtime) for a few years. Sometimes I would have to take it upon awakening or even during the day, but I really needed it at night. I was disappointed that its action didn't last longer. But I continued to use Tylenol; because I thought it was probably the safest thing to do to treat the pain, even though I sometimes had to take it several times throughout the day. I never went over the recommended daily dosage. Now, however, my doctor won't let me use it at all. She was concerned about its affect on my liver function and had me stop it completely. My liver function tests have stabilized since I stopped taking the Tylenol. I now take Aleve. It takes fewer doses, lasts longer and hasn't caused the problems with my liver.
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Review by reneefrendewey:
acetaminophen for Pain: Tylenol PM helps me so much with my pain at night because at night my back pain is the worst and every once in a while I take a Tylenol PM and I feel great and can sleep well and I also feel better the next couple days.
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Condition: Backache
Reviewer: , 11/20/2007 1:25:37 PM
Comment:
This med worked very well for me. I have continuous pain from depression and this help make the pain go away, well at least the body pain. It does not help with mental issues.
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Review by Anonymous:
Tylenol 8 Hour (acetaminophen) for Pain: Excellent for relief of pain. The best over the counter medication I have used for pain.
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Condition: Backache
Reviewer: dblackburn, 45-54 Female, 10/26/2007 5:44:50 AM
Comment:
I find aceteminophen works best for muscle tension related pain, such as backache or tension headache. I particularly use it if I'm having trouble sleeping due to my neck and shoulders being tense from stress or work at the computer.
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Condition: Other
Reviewer: AmKariz06, 19-24 Female, 1/23/2008 5:56:39 AM
Comment:
I would be cautious taking Acetaminophen (Tylenol) if you hav a family history of, or you yourself have an autoimmune disease. My cousin developed Lupus which eventually cleared upon stopping the use of this drug. And I myself was taking it for joint and muscle pain, my dad has rheumatoid arthritis, and autoimmune diseases run rampant on his side of the family, and I believe that the use of Acetaminophen exacerbated my symptoms and was the cause of my developing erythema nodosum. I stopped taking the Tylenol and in a little more than a month my symptoms subsided, and I could walk again. I'm not 100% sure that the Tylenol caused my condition, (pretty sure)however, I just wanted to throw this out there so that anyone this may apply to can speak with their Dr. and discuss the possibility of such reactions. Take care everyone.
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