acetaminophen / diphenhydramine
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) is a combination medication used to help relieve minor aches and pains. It also helps you sleep when your aches and pains are making it hard for you to sleep. Tylenol PM Extra Strength (acetaminophen / diphenhydramine) is available over the counter.
What is Tylenol PM Extra Strength (acetaminophen / diphenhydramine)?
What is Tylenol PM Extra Strength (acetaminophen / diphenhydramine) used for?
Short-term relief of occasional headaches, minor aches, and minor pains that cause trouble sleeping
How Tylenol PM Extra Strength (acetaminophen / diphenhydramine) works
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) is a combination of two medications.
Acetaminophen is an analgesic. It stops the production of certain chemicals in your brain, which can help relieve pain.
Diphenhydramine is an antihistamine. It blocks a chemical in your body called histamine that boosts wakefulness. By blocking histamine, diphenhydramine causes drowsiness and helps you sleep.
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What are the side effects of Tylenol PM Extra Strength (acetaminophen / diphenhydramine)?
Common Side Effects
- Sleepiness
- Dizziness
- Dry mouth
Other Side Effects
- Headache
- Constipation
- Trouble urinating
- Blurry vision
Serious Side Effects
- Serious skin reaction: skin reddening, blisters, rash
- Liver damage: severe stomach pain, yellowing of skin or eyes, nausea, vomiting, loss of appetite
- Accidentally taking too much medication (signs of an overdose): tiredness, flushed skin, skin that's warm to the touch, vision changes, confusion
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
- Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss
- Trouble passing urine
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Constipation
- Drowsiness
- Headache
- Nausea
- Upset stomach
Pros and cons of Tylenol PM Extra Strength (acetaminophen / diphenhydramine)
Pros
Works within 30 minutes
Combines two medications for convenience
Taken once a day
Available over the counter and as a lower-cost generic
Cons
Not the best option for long-term use
Might not be safe for people 65 and older or people who drink alcohol regularly due to higher risk of side effects
Might not be safe for people with certain medical conditions (e.g., liver, urinary, or breathing problems; glaucoma) due to risk of worsening these problems
Can't use in children younger than 12 years of age
Pharmacist tips for Tylenol PM Extra Strength (acetaminophen / diphenhydramine)
You can take Tylenol PM Extra Strength (acetaminophen / diphenhydramine) with or without food. If it upsets your stomach, try taking the medication with food.
If you're using a liquid solution of Tylenol PM Extra Strength (acetaminophen / diphenhydramine), use a medication dose cup or an oral syringe to measure your dose. Don't use household spoons, because they aren't accurate and might cause you to take the wrong dose.
Store the liquid solution of Tylenol PM Extra Strength (acetaminophen / diphenhydramine) at room temperature.
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) can make you sleepy or dizzy during the day, which can affect your ability to focus, think, or react. Don't drive until you know how the medication affects you.
Some Tylenol PM Extra Strength (acetaminophen / diphenhydramine) liquid products contain sodium. Ask your provider if it's okay to use a product with sodium if you have a history of heart problems and are supposed to be on a low-salt diet.
Stop using Tylenol PM Extra Strength (acetaminophen / diphenhydramine) and contact your provider if you experience any of the following: 1) your pain worsens or lasts more than 10 days; 2) your sleeplessness lasts more than 2 weeks; 3) fever lasting more than 3 days; 4) redness or swelling; or 5) any new symptoms appear. Contact your provider because these might be signs of a more serious medical condition.
Tell your provider or pharmacist about all the medications you're taking, especially if you're taking warfarin (Coumadin), other pain relievers, fever reducers, or sleep medications. They can make sure Tylenol PM Extra Strength (acetaminophen / diphenhydramine) is safe for you to take.
Don't start any new medications while taking Tylenol PM Extra Strength (acetaminophen / diphenhydramine), especially other medications with acetaminophen or antihistamines without talking to your provider or pharmacist first. Doing so can raise your risk of severe liver damage.
Frequently asked questions about Tylenol PM Extra Strength (acetaminophen / diphenhydramine)
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What are the risks and warnings for Tylenol PM Extra Strength (acetaminophen / diphenhydramine)?
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) 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 Tylenol PM Extra Strength (acetaminophen / diphenhydramine) | History of liver problems
Taking too much acetaminophen can cause liver damage that can be permanent and life-threatening. For adults, the maximum amount of acetaminophen is 3 or 4 grams in a 24-hour period, depending on your provider's instructions. For children, ask your child's provider.
Speak to your provider before using Tylenol PM Extra Strength (acetaminophen / diphenhydramine) if you have liver problems, since it can cause further damage to your liver. Also avoid drinking alcohol while taking Tylenol PM Extra Strength (acetaminophen / diphenhydramine), since this combination can harm your liver too.
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.
Sleepiness
Risk factors: Drinking alcohol while taking Tylenol PM Extra Strength (acetaminophen / diphenhydramine) | Taking other medications that cause sleepiness | Age 65 and older
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) can make you very sleepy, which can affect your ability to focus, think, or react. This side effect is more likely to happen or be more intense if you're over 65 years old, drink alcohol while taking this medication, or take other medications that cause sleepiness (e.g., opioids, benzodiazepines, sleep medications). Don't drive or operate machinery until you know how this medication affects you.
Worsening of medical conditions
Risk factors: Liver problems | Glaucoma | Breathing problems (e.g., emphysema, long-term bronchitis) | Urinary conditions
Don't take Tylenol PM Extra Strength (acetaminophen / diphenhydramine) if you have any of the risk factors listed above unless your provider said it's safe to do so. Taking Tylenol PM Extra Strength (acetaminophen / diphenhydramine) can worsen your condition(s) and cause serious side effects. Make sure your provider knows about all medical conditions you have or have had in the past before starting Tylenol PM Extra Strength (acetaminophen / diphenhydramine).
Allergic skin reactions
Although rare, Tylenol PM Extra Strength (acetaminophen / diphenhydramine) can cause serious skin reactions, such as rash, blisters, skin reddening, or skin peeling. If you notice changes in your skin, stop using Tylenol PM Extra Strength (acetaminophen / diphenhydramine) and get medical attention right away.
Accidental overdose
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) contains an analgesic (acetaminophen) and an antihistamine (diphenhydramine), which are found in many other over-the-counter products. Using more than one medication containing acetaminophen or an antihistamine (including antihistamines used on the skin) can lead to an accidental overdose and cause serious side effects. These serious side effects include liver failure, seizures, hallucinations (seeing things that aren't real), or even death. Tell your provider or pharmacist about the medications you take or plan to take before starting Tylenol PM Extra Strength (acetaminophen / diphenhydramine). Also don't start any new medications while taking Tylenol PM Extra Strength (acetaminophen / diphenhydramine) without talking to your provider or pharmacist. They can make sure your medications are safe for you to take.
To prevent an accidental overdose, read package labels carefully. Check to see if the product you have contains any acetaminophen or antihistamines. If you're not sure, ask your provider or pharmacist.
Early signs of taking too much acetaminophen include vomiting, right-sided stomach pain, and severe dizziness. Taking too much diphenhydramine can also cause tiredness, dry mouth, flushed skin, high body temperature, irregular heartbeat, and confusion. If you think you or a loved one has accidentally taken too much Tylenol PM Extra Strength (acetaminophen / diphenhydramine), acetaminophen, or diphenhydramine, get medical help or contact the Poison Control Center (1-800-222-1222) right away.
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) dosage forms
Typical dosing for Tylenol PM Extra Strength (acetaminophen / diphenhydramine)
There are several manufacturers and brand names of this medication. The dose might differ slightly depending on which manufacturer and formulation of the medication you're using.
Be sure to check the medication box for specific instructions. In general:
Pills (Tylenol PM Extra Strength, generic)
Each pill contains 500 mg of acetaminophen and 25 mg of diphenhydramine.
Adults and children 12 years and older: The typical dose is 2 pills by mouth at bedtime. Don't take more than 2 pills in a 24-hour period.
Children under 12 years old: Don't use. Ask your child's provider about other options.
Liquid solution (Tylenol PM Extra Strength, generic)
Each 30 mL contains 1,000 mg of acetaminophen and 50 mg of diphenhydramine.
Adults and children 12 years and older: The typical dose is 30 mL (2 tablespoonfuls) by mouth at bedtime. Don't take more than 30 mL in a 24-hour period.
Children under 12 years old: Don't use. Ask your child's provider about other options.
How much does Tylenol PM Extra Strength (acetaminophen / diphenhydramine) cost?
Tylenol PM Extra Strength (acetaminophen / diphenhydramine) contraindications
Take with any other medication containing acetaminophen or diphenhydramine
Severe allergy to acetaminophen or diphenhydramine
What are alternatives to Tylenol PM Extra Strength (acetaminophen / diphenhydramine)?
Short-term relief of occasional headaches, minor aches, and minor pains that cause trouble sleeping
Trouble falling asleep and staying sleeping due to minor aches and pains
Trouble falling asleep and staying sleeping due to minor aches and pains
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