acetaminophen
Acetaminophen (Tylenol) is an over-the-counter (OTC) medication used to lower fever and relieve mild pain in adults and children. It's available in many strengths and formulations, such as tablets, chewable tablets, and liquid. In general, acetaminophen (Tylenol) works within 45 minutes when it's taken by mouth. This medication typically doesn't have many side effects. It's recommended to limit or avoid alcohol while taking acetaminophen (Tylenol) to lower your risk for liver problems.
What is Acetaminophen (Tylenol)?
What is Acetaminophen (Tylenol) used for?
- Mild pain
- Fever
How Acetaminophen (Tylenol) works
Acetaminophen (Tylenol) is an analgesic. The exact way the medication treats pain and fever isn't completely known. But it's thought to work by stopping the production of certain chemicals in your brain and nervous system.
Drug facts
Side effects of Acetaminophen (Tylenol)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
Side effects typically aren't common with this medication.
Less Common Side Effects
- Nausea
- Headache
Acetaminophen (Tylenol) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Allergic reactions: hives, rash, skin blisters, peeling skin, swelling of the lips or tongue, difficulty breathing
- Liver damage: swelling of your stomach, yellowing of your skin or the whites of your eyes, confusion, dark or brown urine
The following Acetaminophen (Tylenol) side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
Rare
Bloody or black, tarry stools
bloody or cloudy urine
fever with or without chills (not present before treatment and not caused by the condition being treated)
pain in the lower back and/or side (severe and/or sharp)
pinpoint red spots on the skin
sore throat (not present before treatment and not caused by the condition being treated)
sores, ulcers, or white spots on the lips or in the mouth
sudden decrease in the amount of urine
unusual bleeding or bruising
unusual tiredness or weakness
yellow eyes or skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Acetaminophen (Tylenol)
Pros
- Works well to relieve mild aches or pain and lower fever
- Can use in adults and children
- Available in a lower-cost generic and is available over the counter
- Comes in many different strengths and forms (e.g., tablet, capsule, chewable tablet, liquid, powder, suppository)
Cons
- Doesn't help with inflammation and swelling
- Might not work as well to treat moderate-to-severe pain
- Not the best option for people who drink alcohol often because of the risk of liver damage
Pharmacist tips for Acetaminophen (Tylenol)
- Make sure to follow your provider's instructions or the directions on the medication box. There are many strengths and formulations of acetaminophen (Tylenol), each with their own instructions on how to take the medication. Ask your provider or pharmacist if you're not sure how to take the specific acetaminophen (Tylenol) product you have.
- Take acetaminophen (Tylenol) with or without food. If it's hurting your stomach, try taking it with food to help.
- For acetaminophen (Tylenol) non-chewable pills: Swallow the non-chewable pills whole. Breaking, crushing, or chewing these pills will damage their special coating and affect how acetaminophen (Tylenol) gets absorbed into your body. Check with your pharmacist for recommendations if you or your child has trouble swallowing the pills.
- For acetaminophen (Tylenol) oral liquids or suspensions: Be sure to use a medication dose cup, spoon, or oral syringe to measure out your dose. Using household teaspoons might cause you to take the wrong amount of acetaminophen (Tylenol). Shake the suspension bottle well before each dose to mix the medication well. Store all liquid bottles of acetaminophen (Tylenol) at room temperature.
- For acetaminophen (Tylenol) dissolvable powder packets: The powder in these packets doesn't need to be mixed with water. Pour the berry-flavored powder directly onto your tongue, and let the medication dissolve (should take seconds).
- It's best to limit how much alcohol you drink while taking acetaminophen (Tylenol) to help prevent liver problems. Both alcohol and acetaminophen (Tylenol) can harm the liver.
- Avoid using multiple medications containing acetaminophen to help lower your risk for liver problems. Acetaminophen is found in many over-the-counter and prescription medications. Ask your provider or pharmacist if you're not sure if the medications you take contain acetaminophen.
- Tell your pharmacist or provider about all of your medications so they can make sure acetaminophen (Tylenol) is safe to take with your other medications. This is because acetaminophen (Tylenol) can interact with other medications. For example, taking warfarin (Coumadin) with acetaminophen (Tylenol) might put you at risk of bleeding.
- Stop using acetaminophen (Tylenol) and contact your provider if you experience any of the following: pain that gets worse or lasts more than 10 days (for adults) or 5 days (for children under 12 years); fever that gets worse or lasts more than 3 days; any new symptoms that appear; or any redness or swelling. These might be signs of a more serious medical condition.
- Store acetaminophen (Tylenol) up and away from children so they're less likely to reach and accidentally take the medication. If you think someone has accidentally taken too much acetaminophen (Tylenol), call a Poison Control Center right away at 1-800-222-1222.
Common questions about Acetaminophen (Tylenol)
In general, the maximum amount of acetaminophen you can take in a 24-hour period depends on your age. For people 12 years and older, the labeled maximum amount of acetaminophen is 4,000 mg per day. And for children younger than 12 years of age, the maximum amount of acetaminophen is 75 mg/kg of body weight (up to 4,000 mg) per day. Doses higher than these can cause liver damage. Keep in mind that certain acetaminophen (Tylenol) products have different maximum recommended doses on the manufacturer label, so it's important to check the packaging of the product you have. In addition, your provider might recommend a lower maximum daily dose than what's written on the label. For example, providers typically recommend people who are at high risk for liver damage (e.g., drink 3 or more alcoholic drinks per day, poor nutrition, history of liver problems) to take at most 2,000 mg of acetaminophen per day. If you're not sure how much acetaminophen you can safely take in a day, always ask a provider or pharmacist.
If you're 12 years or older, it's generally recommended that you use acetaminophen (Tylenol) for no more than 10 days. For children under 12 years old, it's recommended that they use the medication for no more than 5 days. Talk to a provider first before taking any more acetaminophen (Tylenol) if you or your child needs to use the medication for more than these specified number of days. If you're not sure how long you should take acetaminophen (Tylenol), always ask a provider or pharmacist.
It depends on the amount of alcohol you drink. It's typically safe to have one or two drinks around the same time that you take an occasional, recommended dose of acetaminophen (Tylenol). The CDC defines drinking a moderate amount of alcohol as up to 1 drink per day for women and up to 2 drinks per day for men. But, if you drink more than this, you're at higher risk for liver problems since both acetaminophen (Tylenol) and alcohol can harm the liver. If you drink alcohol and aren't sure if acetaminophen (Tylenol) is safe for you to take, ask your provider first before using the medication.
No. Acetaminophen (Tylenol) isn't considered an NSAID. Acetaminophen (Tylenol) doesn't lower inflammation and swelling throughout the body like NSAIDs do. NSAIDs work by blocking proteins called cyclooxygenase (COX) throughout the body, which play a role in causing inflammation. On the other hand, acetaminophen (Tylenol) is thought to only block COX in the brain and nervous system. This might explain why acetaminophen (Tylenol) doesn't help with swelling throughout the body. This also might explain why acetaminophen (Tylenol) doesn't have some of the risks that NSAIDs have, like bleeding, heart risks, or kidney problems.
It's generally considered safe to take both acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) or another NSAID together. They work a little differently to relieve pain and fever. Some providers might recommend to take both medications if either one alone isn't working to relieve pain. Keep in mind that acetaminophen (Tylenol) and NSAIDs each have their own risks. Acetaminophen (Tylenol) has a risk for liver damage, and NSAIDs have other serious, and potentially life-threatening risks (e.g., heart risks, kidney problems). Before using other pain medications with acetaminophen (Tylenol), speak with your healthcare provider to make sure it's safe for you to do so.
If you're pregnant, speak to your provider about using acetaminophen (Tylenol). Recently, researchers have suggested concern over acetaminophen (Tylenol) use during pregnancy and the risk for development problems in babies. But, both the American College of Obstetricians and Gynecologists and the FDA still consider acetaminophen (Tylenol) as a safe option to relieve pain and fever during pregnancy. The two organizations state that there isn't enough strong evidence to support the claims that acetaminophen (Tylenol) is harmful during pregnancy. As with any medication, it's always best to discuss with your provider about the risks and benefits of using acetaminophen (Tylenol) while pregnant.
If you're planning to breastfeed, speak with your provider about taking acetaminophen (Tylenol). In general, acetaminophen (Tylenol) is considered safe to take while breastfeeding. In fact, the American College of Obstetricians and Gynecologists recommends acetaminophen (Tylenol) as a good option for pain relief while nursing. A very small amount of acetaminophen (Tylenol) is found in breast milk, but the medication doesn't appear to cause side effects in breastfed babies. If you have any concerns about taking acetaminophen (Tylenol) while you're breastfeeding, talk to a provider or pharmacist.
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Risks and warnings for Acetaminophen (Tylenol)
Acetaminophen (Tylenol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver damage
- Risk factors: Drinking 3 or more alcoholic beverages a day | Taking other medications containing acetaminophen | Taking too much acetaminophen (Tylenol) | History of liver problems
Taking too much acetaminophen can cause severe and sometimes life-threatening liver damage. For adults, the maximum amount of acetaminophen is typically 4,000 mg per day, but it can be lower depending on your provider's instructions and your risk for liver damage. For children, ask your child's provider.
Speak to your provider before using acetaminophen (Tylenol) if you have liver problems since it can cause further damage to your liver. Limit or avoid drinking alcohol while taking this medication to prevent harm to the liver.
Signs of liver problems include dark urine, feeling tired, upset stomach or stomach pain, or yellowing of the skin or whites of the eyes. If you notice any of these symptoms, call your provider right away.
Accidental overdose
- Risk factors: Taking acetaminophen (Tylenol) with other acetaminophen-containing medications
There are many over-the-counter and prescription medications that contain acetaminophen as one of the active ingredients. Avoid using multiple medications containing acetaminophen. Doing so can raise your risk for an accidental overdose, which can lead to serious and sometimes fatal liver damage. Make sure you're keeping track of how much acetaminophen you're taking throughout the day. If you or someone you know might've taken too much or overdosed on acetaminophen (Tylenol), get medical help or contact a Poison Control Center (1-800-222-1222) right away.
Allergic skin reactions
Although rare, acetaminophen (Tylenol) can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using acetaminophen (Tylenol) and get medical attention right away.
Acetaminophen (Tylenol) dosage
Bottle of oral solution| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 473ml of 160mg/5ml | 1 bottle | $9.36 | $9.36 |
| 118ml of 160mg/5ml | 1 bottle | $3.33 | $3.33 |
Suppository| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 650mg | 6 suppositories | $3.86 | $0.64 |
| 325mg | 12 suppositories | $14.20 | $1.18 |
| 120mg | 12 suppositories | $6.07 | $0.51 |
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 325mg | 30 tablets | $3.01 | $0.10 |
Typical dosage for Acetaminophen (Tylenol)
There are several manufacturers that make acetaminophen (Tylenol) in different strengths and formulations (e.g., pill, chewable tablet, liquid, powder, rectal suppository). The dose will depend on your age, body weight (for children), the strength and formulation you're using, and your risk for liver problems.
Follow your provider's instructions or the directions on the medication box. Below are some examples of acetaminophen (Tylenol) formulations and their dosing instructions. Keep in mind that this list doesn't include all available acetaminophen (Tylenol) products.
-
Acetaminophen 325 mg (regular strength) capsule or tablet
- Age 12 years and older: The typical dose is 2 pills (650 mg) by mouth every 4 to 6 hours while symptoms last. Don't take more than 10 pills (3,250 mg) within a 24-hour period nor use for longer than 10 days unless instructed by your provider.
- Age 6 to under 12 years: The typical dose is 1 pill (325 mg) by mouth every 4 to 6 hours while symptoms last. Don't take more than 5 pills (1,625 mg) within a 24-hour period nor use for longer than 5 days unless instructed by your child's provider.
- Age under than 6 years: Ask your child's provider.
-
Acetaminophen 500 mg (extra strength) caplet, gelcap, or dissolvable powder packets
- Age 12 years and older: The typical dose is 2 pills or powder packets (1,000 mg) by mouth every 6 hours while symptoms last. Don't take more than 6 pills (3,000 mg) within a 24-hour period nor use for longer than 10 days unless instructed by your provider.
- Age under than 12 years: Ask your child's provider.
-
Acetaminophen 160 mg/5 mL oral suspension: Each 5 mL contains 160 mg of acetaminophen.
- Age 12 years and older: The typical dose is 20 mL by mouth every 4 hours while symptoms last. Don't take more than 5 doses (100 mL) within a 24-hour period nor use longer than 10 days unless instructed by your provider.
- Age 2 to under 12 years or weigh 24 to 95 pounds: The dose depends on your child’s age and body weight, so please check for detailed instructions on the packaging. The typical dose ranges from 5 mL to 15 mL by mouth every 4 hours while symptoms last. Don't give your child more than 5 doses nor use for longer than 5 days unless instructed by your child's provider.
- Age under 2 years or weigh less than 24 pounds: Ask your child's provider.
Read the articles below for more information on:
- Dosages for difference acetaminophen formulations
- Acetaminophen dosages for adults
- Acetaminophen dosages for children
Acetaminophen is also available as an injection into the veins (also called intravenous or IV). This injectable form of acetaminophen is given by a healthcare provider in the hospital.
Interactions between Acetaminophen (Tylenol) and other drugs
More on Acetaminophen (Tylenol) interactions
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acenocoumarol
- Carbamazepine
- Fosphenytoin
- Lixisenatide
- Phenytoin
- Warfarin
- Zidovudine
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Acetaminophen (Tylenol) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Acetaminophen (Tylenol) will not be safe for you to take.
- Taking other medications containing acetaminophen
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