Q: I always take Tylenol® for fever or headaches because it doesn’t seem to upset my stomach as ibuprofen does. I thought that Tylenol® was safe because my doctor always recommended it for my children. My sister-in-law insists that Tylenol® is dangerous. Who’s right, my doctor, or my sister-in-law?
You are both right. Tylenol® is quite safe to take as long as you pay close attention to HOW MUCH you take and are careful to avoid taking too much of it.
Tylenol® was first used as a pain reliever in 1893. Due to concerns about its ability to cause liver damage, it was cautiously used until 1949, when it became a widely accepted alternative to aspirin.
Today, acetaminophen is the most popular non-prescription painkiller sold in the United States. It is considered safer than ibuprofen or naproxen, but only IF you don’t take too much.
The best way to take Tylenol®or acetaminophen safely is to watch the TOTAL amount you take over the day and always stay below the maximum recommended dose. For healthy adults, the Food and Drug Administration (FDA) recommends no more than 4000mg per day of acetaminophen.
That’s equivalent to twelve regular strength acetaminophen pills at 325mg each, eight extra-strength pills at 500mg each, or six extended-release tablets at 650mg.
If you are over 60 years old, the FDA recommends a daily limit of 3100mg. This is equal to nine regular strength 325mg tablets, six extra-strength 500mg pills, or four extended-release 650mg pills.
Most people who develop liver failure from acetaminophen never realize they are in danger until the damage is done. A big part of the problem is the popularity of acetaminophen with drugmakers. Acetaminophen is an ingredient of over 200 over-the-counter products and the popular prescription analgesics Vicodin® and Norco®.
You’ll find acetaminophen in non-prescription remedies for allergy, sinus problems, cough, cold and flu symptoms, and sleeplessness. In 2005 alone, consumers in the United States purchased more than 17 billion doses of non-prescription products containing acetaminophen.
Over-the-counter remedies are not the only places you can find acetaminophen. The popular prescription pain medicines Vicodin® and Percocet® contain a potent narcotic pain reliever plus acetaminophen. Since 1997, Vicodin® has been one of the most frequently dispensed prescription drugs in the United States. Its combination of acetaminophen and hydrocodone accounted for 11 billion doses filled by American pharmacies in 2005.
The word acetaminophen doesn’t easily fit on a prescription label. Instead, the abbreviation APAP or ACET is used.
Here are 4 ways to stay safe when taking Tylenol® or acetaminophen:
- Know the maximum dose that is safe to take.
Be aware of the maximum daily amount of acetaminophen or Tylenol® that’s safe for you to take. For healthy adults, this is 4000mg (8 Extra-Strength tablets or gelcaps) over 24 hours, but for others, it is lower. Ask your doctor or pharmacist if you aren’t sure.
- Keep track.
Stay aware of how much acetaminophen you are taking. Check the label to find out if acetaminophen is present in the medicine bottle. If you take prescription pain medicine, watch for the abbreviation APAP or ACET, and ask your pharmacist how much acetaminophen is in each pill.
- Don’t double up.
Avoid taking more than one medicine containing acetaminophen at a time.Taking both non-prescription and prescription products containing acetaminophen at the same time puts you at risk of getting too much.
If you have pain medicine prescriptions from more than one medical provider such as a dentist, surgeon, ER doctor, or urgent care center, you could be getting too much acetaminophen.
- Keep your liver healthy.
If you drink alcohol, do it ONLY in moderation. If drink alcohol and have liver disease, you should avoid taking Tylenol® altogether. When in doubt, ask your doctor or pharmacist about how much acetaminophen per day is safe for you to take for fever, aches, or pain.
