Q: I’m grateful for being able to email you because I just heard on television that Tylenol has a new warning on the bottle because the product contains acetaminophen. I take this OTC all the time and don’t know why we are just hearing about this. Can you fill in any details?
A: Yes, I can. Tylenol is an over-the-counter pain reliever and fever reducer that has been taken successfully by millions of people for many years. It is used to treat colds, fevers, arthritis, headaches, muscle aches and pains and a host of other conditions. As a general rule, the product is well-tolerated when taken according to packaging directions. Side effects are rare; however, they can occur and may include hives, throat pain, bloody or tarry stool, cloudy urine, fever, back pain, and more. Symptoms of overdose may include nausea, vomiting, loss of appetite, diarrhea, and stomach pain.
The recommended amount of acetaminophen, on average, for individuals weighing 50 kg and over is 1000 mg every six hours or 650 mg every four hours up to a maximum daily dose of 4000 mg a day. So, where do the problems come in? It occurs when individuals have a bad toothache on a weekend, their arthritis kicks up and they cannot get in to see the doctor for several days, or when they bend over incorrectly and end up writing in pain with a bad back. They think they know how much acetaminophen they need to take to control the pain, so they double up. Further, those individuals who consume three or more alcoholic drinks per day should not use Tylenol according to their website.
Tylenol is not the only product that contains acetaminophen. It is one brand only and there are countless other products on the market with the same ingredient. Having said this and while rare, there are possible reactions that can occur with excessive intake of acetaminophen. They include rash, blisters and widespread damage to the skin’s surface. Acetaminophen is also one of the ingredients in pain relievers that can lead to sudden liver failure. Two years ago the FDA took steps to further reduce the risk of liver injury from acetaminophen by asking all makers of prescription products to limit acetaminophen to 325 mg per capsule. Then it required all prescription acetaminophen products to include a boxed warning that called attention to the risks. This was done after the federal government placed pressure on the manufacturers to act on the threat of drug abuse.
So, let’s take this a step further. A physician may have prescribed Vicodin or Percocet because of your excruciating back pain, or following a medical procedure you had, or for other reasons. You happily go home and take the drug and pop some acetaminophen, as well. Well, Vicodin is a combination of hydrocodone and acetaminophen. Percocet is a combination of oxycodone and acetaminophen, making it rather easy to exceed the RDA acetaminophen limits.
A warning label has been on all acetaminophen packaging to give consumers a heads up to help avoid the product from being taken in excess. The problem is that it is written in such small print, it is extremely difficult to read. So, Tylenol stepped up to the plate and made the statement on the bottle cap, making it difficult to ignore. There’s no need to panic or to discontinue using Tylenol. The warnings are there to alert users that this and every other product should be taken according to packaging directions. Don’t put yourself at risk by playing Russian roulette. It’s simply not worth the gamble.
Readers who are interested in related information can order Dr. Gott’s Health Report “Consumer Tips on Medicines” by sending a self-addressed, stamped number 10 envelope and a $2 US check or money order to Peter H. Gott, MD Health Report, PO Box 433, Lakeville, CT 06039. Be sure to mention the title or print an order form from www.AskDrGottMD.com.
