Use Caution with Tylenol

Tylenol is the brand name of a drug with the generic name of acetaminophen. While people are familiar with Tylenol, they may not know that its component name is acetaminophen. This is important because acetaminophen is found in over 600 Over- the-Counter (OTC) products and prescription medications such as cold and headache remedies as well as in prescription products such as Vicodin (hydrocodone) and Percocet (oxycodone.)  Would it surprise you to know that acetaminophen is also found in some formulations of Alka-Seltzer-plus, Dayquil, Nyquil, Dimetapp, Mucinex or Theraflu? 

Acetaminophen is an important drug and its effectiveness in relieving pain and fever is widely known. It is important to note that this drug is generally considered safe when used according to the directions on its labeling.  But taking more than the recommended amount can cause liver damage, ranging from abnormalities in liver function blood tests, to acute liver failure and even death.

Overuse of acetaminophen is a leading cause of active liver failure. 50% of liver failure from acetaminophen is unintentional and resulted from the consumer taking more than the recommended daily amount in a 24 hour period due to not knowing what products contained acetaminophen. (The current limit in 24 hours is 4,000 mg but there is a push to reduce that amount to 3,500 mg.) Using alcohol while taking acetaminophen can also contribute to liver failure. For example, unintentional overuse can occur when someone takes a cold medicine and acetaminophen (Tylenol) or a prescription pain medication with a cold medicine, not realizing that they are double-dosing. Under a 2009 Food and Drug Administration (FDA) regulation, manufacturers must place the word “acetaminophen” on the front of the package of all OTC products that contain it and/or on the drug facts label on the container and packaging.  As of 2011, a new FDA regulation limited the amount of acetaminophen allowed in prescription medications to 325 mg per dose. It also required that a “Boxed Warning” appear on all prescription products that contain acetaminophen which will highlight the potential risk for severe liver injury. You may not notice the signs and symptoms of liver damage right away because they take time to appear. Or you may mistake early symptoms of liver damage, such as loss of appetite, nausea and vomiting, for something else like the flu. Liver damage can develop into liver failure or death over several days.

There can also be a rare, but potentially fatal skin reaction from acetaminophen. Contact your health care provider right away if you see signs of peeling, blistering, reddening or detached skin.

Understand that acetaminophen is generally safe when taken as directed! It is the misuse/overuse that causes health issues.  To lower your risk of liver damage:

• Read the labels and warnings of all medications that you take. Look for the word “acetaminophen.” It will sometimes appear as APAP on prescription medications.
• Make sure you follow dosing directions and never take more than directed.
• Discuss taking acetaminophen with your doctor. Alcohol consumption or liver disease place you at greater risk of liver damage from acetaminophen, even when taking the recommended dose.
• Never take more than directed, even if your pain or fever isn’t any better.
• Never take more than one medicine that contains acetaminophen. Check the active ingredients of all your medicines to make sure you are taking no more than one medicine containing acetaminophen. Acetaminophen may be abbreviated many ways: APAP, AC, Acetaminophn, Acetaminoph, Acetaminop, Acetamin or Acetam.
• When giving acetaminophen to children, follow the above instructions, and

be sure to give the right dosage for your child’s weight while using the correct preparation.  Most current formulations have standardized dosages to 160 mg/5 ml for liquids.  

• Use a measuring spoon designed for giving medicines, not one you would use for cooking. 

For written information on this topic, District residents (Bethany, Hamden, North Haven and Woodbridge) can contact QVHD, 203 248-4528 or request on line, www.qvhd.org.  You can also visit “Know Your Dose.org” for more information. Go to www.qvhd.org and click on the Facebook and Twitter icons to like us and follow us!