Don’t Panic! Tylenol is still OK.

sick_childIf you’re reading this, chances are you have acetaminophen (Tylenol is the product name) in your medicine cabinet. In fact, you probably have lots of it in several over-the-counter and prescription medicines, and it’s likely you don’t know exactly which ones contain it. It has been the most widely used fever reducer and pain reliever for years.

Acetaminophen came on the market as Tylenol Elixir for Children in 1955, and soon surpassed aspirin in the pain relief market for both adults and kids. We all assume it’s perfectly safe. You probably gave it to your kids to banish their first fever, to blunt teething pain, and to treat just about any discomfort that came down the pike. It works great, and when used as directed the drug is not hazardous.

The problem begins when you get too much of a good thing. Acetaminophen is now in so many products that it is relatively easy to take more than the recommended limit. Every year about 400 people die and 42,000 are hospitalized as a result of acetaminophen poisoning. It has what’s known as a ‘narrow therapeutic range’, which means that the dose needed to effectively reduce pain or fever isn’t that much lower than the toxic dose. The current maximum recommended adult dose is 4 grams daily (this is likely to be reduced to 3.25 grams in the coming months), and serious toxicity begins at about 7 grams.

It’s not hard to reach that dose if, let’s say, you take some Tylenol for a headache, then awhile later take some cold and cough medicine (many contain acetaminophen), and then take some Tylenol PM to help you sleep.

Acetaminophen is broken down in the liver, and is toxic to liver cells at high doses. An overdose causes no immediate symptoms, but can lead to liver failure over the course of several days. There is treatment for acetaminophen poisoning, but it’s only effective before the damage is done. Once liver failure occurs, transplant is the only cure.

So don’t toss all your Tylenol, just be careful. If you or your child is taking multiple OTC or prescription medications, read the labels so you know if acetaminophen is included, and how much. Don’t take more than the recommended dose. More is NOT better. If you’re concerned that you’ve taken more than is safe, call your local poison control immediately (the national number is 1-800-222-122).

“It would be a real shame if people in reading these stories got the idea that acetaminophen is not safe,” said Dr. Paul Watkins, director of the Institute for Drug Safety Sciences at the Hamner Institutes and the University of North Carolina. “It’s totally safe when taken as directed. The problem is that people end up unknowingly taking much more than recommended.”

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Ellen and Rachel are two old friends and “expert” mamas—one a pediatrician and one a family therapist—with fifty years of parenting experience between them.

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