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Tylenol: 7 things you should know

Medically reviewed by Carmen Pope, BPharm. Last updated on July 28, 2023.

1. How it works

  • Tylenol is a brand (trade) name for acetaminophen and is used to relieve pain. Experts aren't sure exactly how acetaminophen works, but suspect it blocks a specific type of cyclo-oxygenase (COX) enzyme, located mainly in the brain.
  • Tylenol belongs to the class of medicines called analgesics (pain relievers); it is specifically a non-narcotic analgesic. It may also be called an antipyretic because it will bring down a fever.

2. Upsides

  • Effective for the temporary relief of minor aches, pains, and headaches. May be used in the treatment of many conditions such as arthritis, backache, colds, menstruation pain, muscle aches, and toothache.
  • Also, lowers a fever but does not control inflammation.
  • First choice for mild-to-moderate pain due to its efficacy, minimal toxicity, and low cost.
  • When used at low dosages, it lacks gastrointestinal side effects associated with NSAID pain relievers (does not cause ulcerations, bleeding, or perforations).
  • May be combined with strong opioids for the treatment of severe pain.
  • Available in a range of formulations including liquid, oral tablets, oral disintegrating tablets, chewable tablets, controlled-release tablets, dispersible tablets, injectable, and rectal preparations.
  • Tylenol is available as a generic under the name acetaminophen.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Rarely, may cause itchiness, constipation, nausea, vomiting, headache, insomnia, and agitation. May cause gastrointestinal side effects at high dosages.
  • The potential for liver damage exists, even at recommended dosages. The risk is increased with higher dosages, a shorter interval between doses, in people who drink three or more alcoholic drinks per day, when taken with other medications that also contain acetaminophen, and in patients with pre-existing liver disease.
  • An overdose of acetaminophen can damage your liver and cause death. Acetaminophen is often included in cold and flu remedies, and it may be easy to inadvertently double up on an acetaminophen dose.
  • Considered less effective for pain relief than NSAIDs but associated with a lower risk of side effects.
  • May not be suitable for some people including people who regularly consume three or more glasses of alcohol per day and those with liver disease.
  • May interact with some other medications including warfarin.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

  • Tylenol is an effective mild pain reliever with a low risk of side effects but the potential for liver damage exists, even at recommended dosages. The risk is increased with higher dosages, a shorter interval between doses, in people who drink three or more alcoholic drinks per day, when taken with other medications that also contain acetaminophen, and in patients with pre-existing liver disease.

5. Tips

  • May be administered without regard to food; although food may decrease any reported stomach upset.
  • Do not exceed the recommended dosage, because this may put you at risk of liver toxicity. Adults and teenagers who weigh at least 110 pounds (50kg) should not take more than 1000mg of acetaminophen in one dose or more than 4000mg in 24 hours. Children younger than 12 years should only take the dosage recommended to them on the label (this varies depending on their weight and age).
  • Always seek your doctor's advice before administering acetaminophen to children aged less than two. If you are giving pediatric liquid Tylenol, always use the dosing syringe provided, or another suitable properly calibrated measure. Do NOT use a kitchen teaspoon.
  • Be careful not to administer other products containing acetaminophen at the same time. Acetaminophen is often an ingredient in combination cold and flu remedies and may be listed as APAP in the ingredient list. Ask your pharmacist or doctor to check if any other medicines you are taking contain acetaminophen.
  • Contact your doctor if your symptoms worsen, if redness or swelling occurs in the painful area, if a fever lasts longer than 3 days (all ages), or for persistent pain (excluding sore throat) of longer than 10 days in adults, 5 days in children and adolescents, or 3 days for infants.
  • Contact your doctor immediately if you or your child have a severe sore throat that persists for longer than 2 days, or is followed by fever, rash, headache, nausea, or vomiting.
  • Men should not drink more than two alcoholic drinks a day and women no more than one alcoholic drink per day while taking Tylenol. Do not take Tylenol if you have severe liver disease or are allergic to acetaminophen, and talk to your doctor before taking Tylenol if you drink more than 3 alcoholic beverages a day.
  • Seek urgent medical attention if you develop pain in your upper abdomen, nausea, dark urine, loss of appetite, yellowing of the skin or eyes, or clay-colored stools. Stop taking Tylenol immediately if you develop a skin rash or redness that spreads and causes blistering and peeling.
  • Do not take Tylenol without your doctor's advice if you are pregnant. Ask your doctor before using Tylenol during breastfeeding.

6. Response and effectiveness

  • Tylenol's pain-relieving effects occur within 30-60 minutes of oral administration. Its effects last for three to four hours.

7. Interactions

Medicines that interact with Tylenol may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Tylenol. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does. Speak to your doctor about how drug interactions should be managed.

Common medications that may have a moderate interaction with Tylenol include:

  • anticonvulsants, such as fosphenytoin or phenytoin
  • barbiturates
  • busulfan
  • carbamazepine
  • dapsone
  • flucloxacillin
  • isoniazid
  • lamotrigine
  • phenylephrine
  • probenecid
  • warfarin.

Alcohol may enhance the liver toxicity of Tylenol.

Note that this list is not all-inclusive and includes only common medications that may interact with Tylenol. You should refer to the prescribing information for Tylenol for a complete list of interactions.


Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Tylenol only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Copyright 1996-2023 Revision date: July 28, 2023.