Tylenol (acetaminophen) is the most popular over-the-counter pain reliever in the United States and around the world. For more than half a century, millions of adults and children have used the drug to treat everything from headaches to fevers.

Tylenol helps countless people deal with pain and recover from illness. It is most effective in the treatment of minor aches and pains, but is also used for long-term chronic pain like arthritis.

Unfortunately, Tylenol also comes with some very serious risks. Because Tylenol is so widely available over the counter, many people assume it is harmless. This is not the case. The maximum dose in a 24-hour period is 4,000 mg, and accidental overdose is a serious problem. Taking too much Tylenol or other medications containing acetaminophen can cause hepatitis and liver failure.

Accidental Overdose

Consumers  may overdose on Tylenol without intending to. They may take two or more medications containing acetaminophen, without realizing it. For example, if someone has the flu, they may take cold medicine and Tylenol, or a decongestant and Tylenol.

What they may not realize is that both products contain acetaminophen, and that they have ingested far more than the maximum dosage. As these compounds build up in the body, the liver gets overloaded and begins producing a toxic compound called NAPQI. Too much NAPQI causes liver damage and can lead to death.

Patients who drink or take certain medications along with Tylenol are at greater risk for liver damage.

If you have any symptoms of liver problems, including dark urine or yellow skin, you should talk to a doctor immediately. Without a liver transplant, patients with acute liver failure are likely to die.

Liver Failure Leads to Lawsuits

Some lawsuits have been filed by patients who believe their liver failure resulted from insufficient warnings about the dangers of Tylenol, including one woman whose liver failed after she took normal doses while fasting, and a family whose 1-year-old died after taking infants’ Tylenol. Federal lawsuits against Johnson & Johnson subsidiary McNeil Laboratories are pending in the U.S. District Court for the Eastern District of Pennsylvania.

In response, the FDA has required manufacturers to limit the amount of acetaminophen in their products and add warnings about liver failure to the packaging.

Tylenol does have other side effects, including poor interactions with alcohol and the possibility that harmful toxins from the drug could pass from mothers to babies in the womb. Like many drugs, it can also cause nausea, rash or allergic reactions.

The best way to keep yourself safe is to be careful when choosing medications, monitor the amount of acetaminophen you ingest, and be aware of the risk of liver damage.

Jennifer Mesko joined Drugwatch.com in 2012. She keeps consumers informed about the dangerous side effects of drugs and medical devices.

Drug side-effects are one of the most commonly dealt with issues by NDs.  Many patients are unaware that everyday over-the-counter medications can cause mild and sometimes chronic problems, dangerous side-effects or contraindicate other medications.  This article on Tylenol comes to BCNA from Drugwatch, a portal website with a wide range of patient-focussed drug info.