Is Tylenol Safe?

Albert Barber | posted August 03, 2009 |

Acetaminophen is the most widely used medication in the United States. It is supplied as a single ingredient in such brands as Tylenol, and in combination with many other non-prescription and prescription drugs. If you have questions about products containing acetaminophen you should seek the advice of your physician or pharmacist. 

Acetaminophen is safe and effective when used as directed for mild to moderate pain from arthritis to headaches, and to reduce fever in children and adults.  In fact, acetaminophen is arguably the safest pain reliever on the market in the United States.  Other pain relievers such as ibuprofen (Motrin, Advil), naproxyn (Aleve), and similar drugs may have significant side effects on blood pressure and kidney and heart function, especially in the elderly.  Recent guidelines from the America Geriatric Society recommend that these drugs be used only rarely in the elderly, and then only at the lowest effective dose for the shortest possible duration. 

However, when total daily doses of acetaminophen exceed 4000mg liver damage can occur. Therefore, for patients with liver disease or a history of significant alcohol use, the maximum tolerated dose of acetaminophen may be much lower at around 2000mg per day. Because of the number of extra strength and combination products containing acetaminophen and its availability in both non-prescription and prescription drugs, many consumers and some health care providers fail to recognize that the total daily doses are exceeding these recommended daily maximum doses. 

Three advisory committees to the Food and Drug Administration (FDA) met in late June to discuss the growing number of cases caused by overuse of acetaminophen. Emergency rooms have reported 56,000 visits a year of liver failure and 100 overdose deaths a year, because of acetaminophen.  They made several recommendations including:

1. Reduce the maximum recommended daily intake of acetaminophen from 4000mg per day to around 2600-3200mg per day
2. Reduce the maximum recommended single dose from 1000mg (2 extra strength Tylenol) to 650mg (2 regular strength Tylenol)
3. Require that only one concentration of liquid acetaminophen be marketed to avoid confusion and accidental overdose, especially
    in children
4. Remove prescription drugs in combination with acetaminophen (Percocet, Vicodin, Darvocet) from the market. 

You should always seek the advice of your physician or pharmacist with questions about products containing acetaminophen, including safe doses and the best medication for your condition.