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.
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What are the side effects of Acetaminophen (Tylenol)?
Common Side Effects
Other Side Effects
- Nausea
- Headache
Serious Side Effects
- 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
Source: DailyMed
The following 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.
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.
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What are the 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.
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Acetaminophen (Tylenol) dosage forms
Typical dosing 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:
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.
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Interactions between Acetaminophen (Tylenol) and other drugs
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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
How much does Acetaminophen (Tylenol) cost?
Acetaminophen (Tylenol) contraindications
Taking other medications containing acetaminophen
What are alternatives to Acetaminophen (Tylenol)?
Short-term relief of minor aches and pains due to headache, muscle aches, minor arthritis pain, toothache, backache, the common cold, or menstrual cramps
Fever
Mild-to-moderate pain
Pain from rheumatoid arthritis (RA) or osteoarthritis (OA)
Pain from menstrual cramps
Ankylosing spondylitis (AS) (arthritis of the spine)
Polyarticular juvenile idiopathic arthritis (arthritis in children)
Tendonitis and bursitis
Pain
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References
Best studies we foundAmerican College of Obstetricians and Gynecologists. (2021). ACOG Response to Consensus Statement on Paracetamol Use During Pregnancy.
American College of Obstetricians and Gynecologists. (2020). Postpartum Pain Management.
Bauer, A.Z., et al. (2021). Paracetamol use during pregnancy — a call for precautionary action. Nature Reviews Endocrinology.
Centers for Disease Control and Prevention. (2022). Dietary Guidelines for Alcohol.
Drugs and Lactation Database (LactMed). (2023). Acetaminophen. National Institute of Child Health and Human Development.
Gerriets, V., et al.(2023). Acetaminophen. StatPearls.
Johnson & Johnson Consumer Inc. (2023). TYLENOL REGULAR STRENGTH- acetaminophen tablet [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). TYLENOL EXTRA STRENGTH- acetaminophen tablet, coated [package insert]. DailyMed.
Johnson & Johnson Consumer Inc. (2023). TYLENOL REGULAR STRENGTH- acetaminophen capsule, liquid filled. DailyMed.
Johnson & Johnson Consumer Inc. (2023). TYLENOL EXTRA STRENGTH- acetaminophen powder. DailyMed.
Johnson & Johnson Consumer Inc. (2023). TYLENOL FOR CHILDREN PLUS ADULTS- acetaminophen suspension [package insert]. DailyMed.
KnowYourDose.org. (n.d.). Common Medicines Containing Acetaminophen.
Likhitsup, A., et al. (2022). Medications and the Liver: Overview. American College of Gastroenterology.
Reference Manual of Pediatric Dentistry. (n.d.). Useful Medications for Oral Conditions.
Sharma, C. V., et al. (2013). Paracetamol: Mechanisms and updates. Continuing Education in Anaesthesia Critical Care & Pain.
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA has reviewed possible risks of pain medicine use during pregnancy.
U.S. Food and Drug Administration. (2016). FDA Drug Safety Communication: FDA warns of rare but serious skin reactions with the pain reliever/fever reducer acetaminophen.
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