Acetaminophen; Be on Guard for Your Liver

What is acetaminophen?

Acetaminophen is one of the most commonly used pain relief medications in Canada. Taken as directed by the labeling on over-the-counter (OTC) products or as instructed by your dentist or physician in prescription products, it is a safe and effective medication for relieving pain and reducing fever.

Acetaminophen is the generic name for the active ingredient in many common brand name medications such as Tylenol. It is also often combined with other medications in many OTC products for the relief of cold symptoms, and allergies. In addition to the many OTC formulations of Acetaminophen, it is also one of the ingredients in numerous prescription medications such as Tylenol #3, Percocet, Tramacet and Oxycocet, where it is combined with a narcotic. In the US it is sometimes called APAP and in the UK it is called Paracetamol.

What are concerns with aceteaminophen?

A major concern with acetaminophen is that too much can cause liver damage which can range from minor liver injury, with the only evidence being an abnormal liver function blood test, to serious liver damage with the worst case scenario being complete liver failure and death.

The current recommended maximum daily dose for acetaminophen is 4 grams (4000 mg) in a 24 hour period. It is not difficult at all to reach or exceed that amount in a single day. For example if you were to take 2 regular strength Tylenol tabs every 4 hours over a 24 hour period you are already at 3900 mg. Add just one more pill or another product such as Nyquil (which contains 500 mg of acetaminophen) and you have an overdose.

How much should I be taking?

It is also important to consider that the maximum recommended dose of 4000 mg per day is for the average adult. Children must have their dosage reduced according to their age and weight. The elderly and people with preexisting liver disease need to have their dosage reduced as well since they are at higher risk for liver damage.

It is also recommended to avoid drinking alcohol while taking acetaminophen, since this too can also put you at higher risk for liver toxicity. The best way to avoid running into problems with medications is to take them as directed on the label or the prescription provided by your doctor or dentist.

If you are taking more than one type of medication be sure to read the ingredients so you know what and how much you are getting. If you have any doubt as to whether you are using your medication safely, consult with a pharmacist or the doctor who prescribed the medication.

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