Table of ContentsView AllTable of ContentsWhat Is Tylenol?Recommended DosingEffects on the LiverOverdose Treatment
Table of ContentsView All
View All
Table of Contents
What Is Tylenol?
Recommended Dosing
Effects on the Liver
Overdose Treatment
Tylenol is a popular, safe, and effective medication forfeverand pain. It has been available since the 1950s. Since it’s a common, well-known drug, it’s sometimes used carelessly, which can lead to liver damage. This article will explain what Tylenol is, how to take it safely, and how Tylenol impacts the liver and other organs.
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Tylenol contains the active drug acetaminophen. Acetaminophen is ananalgesic(pain reliever) andantipyretic(fever-reducer). It is often used to treat fever, headaches, sore throats, toothaches, and other causes of pain. It lowers body temperature due to its effects on thehypothalamus—the part of the brain that controls temperature.
How To Take Tylenol Safely
Tylenol makes several variations of acetaminophen, includingextra-strength, rapid-release gel capsules, tablets, liquid, dissolving packs, and other pain-relieving products.Acetaminophen is also found in cold and flu medicines, prescription medications mixed with other pain medications, and some sleep aids. If you take several different medications, it is essential to know if acetaminophen is in them so you remain within safe daily limits.
If you haveliver disease, speak with your healthcare provider before taking acetaminophen. Generally, patients with liver disease should take no more than 2,000 mg of acetaminophen within 24 hours. Individuals with severe liver disease may need to take less.
Additionally, medications can interact. So, if you take other drugs, herbs, orsupplements, understand if they can interact with Tylenol. Anti-coagulants (such as Warfarin) and alcohol are the two main substances that can negatively interact with Tylenol.
If you have a serious liver disease, talk to your healthcare provider about appropriate dosing and best alternatives for treatment of pain or fevers.
How Tylenol Affects the Liver
When Tylenol is taken in recommended doses, your body binds NAPQI to a substance called glutathione and excretes it in the urine. However, when you take too much Tylenol, the body becomes overwhelmed, potentiallyharming the liver’s main cells(hepatocytes).
This buildup can cause liver damage with much lower doses of Tylenol. Additionally, alcoholism can reduce the availability of glutathione, which is necessary to excrete NAPQI from the body safely. So, ideally, don’t drink and take Tylenol.
Tylenol can also impact other organs. In an acute overdose,renal (kidney) failureand pancreas inflammation (pancreatitis) may also be present alongside liver dysfunction.
Symptoms
Liver dysfunction may not present for 24 to 72 hours post-ingestion. It is essential to identify an overdose and begin treatment before a significant liver injury happens to avoid death or the need for aliver transplant.
Signs of Liver FailureAs liver function declines, you may experience one of several symptoms. Symptoms of liver failure include:Itchy skinJaundice (yellowing of the skin and whites of the eyes)Internal bleedingMental status changesEdemaAscites (abdominal swelling from fluid)Dark colored urineEasy bruisingIn an acute liver injury (such as a Tylenol overdose) where the liver fails quickly, symptoms may be more severe.
Signs of Liver Failure
As liver function declines, you may experience one of several symptoms. Symptoms of liver failure include:Itchy skinJaundice (yellowing of the skin and whites of the eyes)Internal bleedingMental status changesEdemaAscites (abdominal swelling from fluid)Dark colored urineEasy bruisingIn an acute liver injury (such as a Tylenol overdose) where the liver fails quickly, symptoms may be more severe.
As liver function declines, you may experience one of several symptoms. Symptoms of liver failure include:
In an acute liver injury (such as a Tylenol overdose) where the liver fails quickly, symptoms may be more severe.
How Tylenol Overdose Is Treated
Tylenol overdoseis common. In kids, it is usually due to parents accidentally giving the wrong dose. In teens and adults, it may be intentional through a self-harm attempt or accidental (i.e., combining several acetaminophen-containing medications when sick).
Treatment depends on timing. If an individual acutely consumes too much Tylenol and it is discovered within two hours of ingestion, a healthcare provider may administeractivated charcoaland draw an acetaminophen level.
N-acetylcysteineis the primary treatment for acetaminophen overdoses. If needed, a healthcare provider will continue administering it until acetaminophen levels are undetectable andliver enzymes return to normal.
A special chart, theRumack-Matthew nomogram, is used to determine acetaminophen levels and guide treatment. If the acetaminophen level plots below the chart’s threshold, long-term liver damage is unlikely. If levels are above the threshold, long-term liver damage is more likely, and treatment is initiated.
Ideally, acetaminophen levels are calculated at four hours post-ingestion and used to determine treatment. However, if waiting four hours could end up delaying treatment beyond eight hours, or a patient presents eight hours after an acetaminophen overdose, then treatment with N-acetylcysteine should be initiated.
Someacetaminophen formulations are extended-release. In these cases, it is ideal to plot two acetaminophen levels at four hours post-ingestion and then four to six hours after the first level is drawn. If both levels are below the treatment threshold, toxicity is unlikely.
If possible, a toxicologist is consulted. Additional treatments, such asdialysis, might be necessary in severe cases.
Tylenol overdose is an emergency. Fortunately, an antidote for Tylenol overdose exists and is called N-acetylcysteine. This antidote is most effective when given within eight hours of Tylenol overdose, and it can help preventliver failure.
Summary
When taken in the amounts recommended on the label for a short period (i.e., for an occasional headache or while you have theflu), Tylenol is generally considered safe unless you have an underlying health condition. However, Tylenol is bad for your liver if too much is taken.
If you or someone you know overdoses on Tylenol, seek emergency medical care immediately for treatment.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Burtscher M, Gatterer H, Philippe M, et al.Effects of a single low-dose acetaminophen on body temperature and running performance in the heat: a pilot project.Int J Physiol Pathophysiol Pharmacol.2013;5(3):190-193.Shimodaira T, Mikoshiba S, Taguchi T.Nonsteroidal anti-inflammatory drugs and acetaminophen ameliorate muscular mechanical hyperalgesia developed after lengthening contractions via cyclooxygenase-2 independent mechanisms in rats.PLOS ONE.2019;14(11):e0224809.TYLENOL®.Proper Tylenol® dosage for adults.U.S. Food and drug administration.Don’t overuse acetaminophen.American College of Gastroenterology.Medications & liver.UpToDate.Patient education: Warfarin (beyond the basics).National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Acetaminophen.Merck Manual Consumer Version.Acetaminophen poisoning - injuries and poisoning.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.Dart RC, Mullins ME, Matoushek T, et al.Management of acetaminophen poisoning in the US and Canada: a consensus statement.JAMA Netw Open. 2023;6(8):e2327739-e2327739.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Burtscher M, Gatterer H, Philippe M, et al.Effects of a single low-dose acetaminophen on body temperature and running performance in the heat: a pilot project.Int J Physiol Pathophysiol Pharmacol.2013;5(3):190-193.Shimodaira T, Mikoshiba S, Taguchi T.Nonsteroidal anti-inflammatory drugs and acetaminophen ameliorate muscular mechanical hyperalgesia developed after lengthening contractions via cyclooxygenase-2 independent mechanisms in rats.PLOS ONE.2019;14(11):e0224809.TYLENOL®.Proper Tylenol® dosage for adults.U.S. Food and drug administration.Don’t overuse acetaminophen.American College of Gastroenterology.Medications & liver.UpToDate.Patient education: Warfarin (beyond the basics).National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Acetaminophen.Merck Manual Consumer Version.Acetaminophen poisoning - injuries and poisoning.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.Dart RC, Mullins ME, Matoushek T, et al.Management of acetaminophen poisoning in the US and Canada: a consensus statement.JAMA Netw Open. 2023;6(8):e2327739-e2327739.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Burtscher M, Gatterer H, Philippe M, et al.Effects of a single low-dose acetaminophen on body temperature and running performance in the heat: a pilot project.Int J Physiol Pathophysiol Pharmacol.2013;5(3):190-193.Shimodaira T, Mikoshiba S, Taguchi T.Nonsteroidal anti-inflammatory drugs and acetaminophen ameliorate muscular mechanical hyperalgesia developed after lengthening contractions via cyclooxygenase-2 independent mechanisms in rats.PLOS ONE.2019;14(11):e0224809.TYLENOL®.Proper Tylenol® dosage for adults.U.S. Food and drug administration.Don’t overuse acetaminophen.American College of Gastroenterology.Medications & liver.UpToDate.Patient education: Warfarin (beyond the basics).National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Acetaminophen.Merck Manual Consumer Version.Acetaminophen poisoning - injuries and poisoning.National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.Dart RC, Mullins ME, Matoushek T, et al.Management of acetaminophen poisoning in the US and Canada: a consensus statement.JAMA Netw Open. 2023;6(8):e2327739-e2327739.
Burtscher M, Gatterer H, Philippe M, et al.Effects of a single low-dose acetaminophen on body temperature and running performance in the heat: a pilot project.Int J Physiol Pathophysiol Pharmacol.2013;5(3):190-193.
Shimodaira T, Mikoshiba S, Taguchi T.Nonsteroidal anti-inflammatory drugs and acetaminophen ameliorate muscular mechanical hyperalgesia developed after lengthening contractions via cyclooxygenase-2 independent mechanisms in rats.PLOS ONE.2019;14(11):e0224809.
TYLENOL®.Proper Tylenol® dosage for adults.
U.S. Food and drug administration.Don’t overuse acetaminophen.
American College of Gastroenterology.Medications & liver.
UpToDate.Patient education: Warfarin (beyond the basics).
National Institute of Diabetes and Digestive and Kidney Diseases.LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Acetaminophen.
Merck Manual Consumer Version.Acetaminophen poisoning - injuries and poisoning.
National Institute of Diabetes and Digestive and Kidney Diseases.Symptoms & causes of cirrhosis.
Dart RC, Mullins ME, Matoushek T, et al.Management of acetaminophen poisoning in the US and Canada: a consensus statement.JAMA Netw Open. 2023;6(8):e2327739-e2327739.
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