Acetaminophen or Paracetamol, often called Tylenol, is one of the most common medications
taken.
But because it is so common, many of us don't realize the danger that this medication can
pose.
In this video we'll go over it's safe use as well as the consequences if you don't.
Hi everybody, I'm Dr. Erik Richardson a board certified Family Practice physician.
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Today we are going to be talking about one of the most common medications that we use
to treat pain and fever.
In the United States as well as some other countries, it is referred to as Acetaminophen
or Tylenol but in other areas of the world Paracetamol.
This is a medication that has been around for a long time.
IN fact it was first developed in 1887 but wasn't really proven to be safe and used in
any significant scale until the 1950's.
But despite how long it's been around we still don't have a definite idea on how exactly
it works.
Overall it is felt that when it is broken down in the body, certain parts of it are
converted to chemicals that block the way the brain perceives pain.
The most common uses of acetaminophen or paracetamol are to help in the treatment of pain as well
as in the reduction of fever.
The biggest benefit of Tylenol over all the other pain medication including opioids and
anti inflammatories is that when taken at proper doses it is much safer.
And this is key, because when taken above the recommended doses this can be a very dangerous
medication.
The maximum recommended dose for an adult is 4000 mg a day.
To put that in perspective, your typical extra strength Tylenol is 500mg per pill so most
people can take 2 tablets at a time up to 4 times a day.
This is definitely something that you should review with your pharmacist or doctor for
your particular case, but on the short term this is generally felt to be safe.
For my patients, if they are needing to take it for any prolonged amount of time, I recommend
that they stick to no more than 3000 mg a day.
For children we do it a little different.
We base their dose upon their weight.
For infants under 2 months, I generally don't recommend that you give them any medication
without consulting your doctor.
It's not that they can't have it, it's just that infants under two months who have a fever,
need to be evaluated quickly by their doctor or in the emergency room.
It's best not to give medication for that except under the direct advice of your doctor.
For infants over two months and children under 12 years the typical recommended dose is 10-15
mg/kg every 4-6 hours with a max dose of 75 mg/kg/day or 1gm every 4 hours and 4 gm a
day.
Children over 12 usually can follow the same adults dosing.
OK, now when we talk about taking acetaminophen it's important to remember that the recommend
dose needs to take into account all different sources.
Acetaminophen is put in many different medications.
We find it over the counter as straight Tylenol, as well as different multi symptom cold remedies.
We also find it in over the counter sleep aids.
There are several different prescription medications for different types of pain that also have
Tylenol in it like different oxycodone, hydrocodone and codeine type products.
Common headache medications like fiorocet also contain it.
It's important to be aware of what kinds of medications you are taking when on Tylenol
so you don't go over that maximum dose.
If you are unsure, talk to your doctor or pharmacist and review what you are taking.
The main reason we stress not going over the maximum dose of Tylenol is that it can be
extremely toxic to the liver in the event of an overdose.
Tylenol is processed through the liver, when you take in too much it can override the liver's
ability to work and cause significant damage leading to possible liver failure and in some
cases death.
In severe cases the only way to save somebody's life after this kind of damage is getting
a liver transplant.
So who needs to be most careful with taking acetaminophen?
Well, it's those who already have a compromised liver.
These are those who have chronic liver disease like hepatitis C, cirrhosis and especially
those who drink a lot of alcohol.
If you find yourself in these categories then you really need to be careful and avoid taking
it unless directed otherwise by your doctor.
If you feel like you may have taken too much Tylenol contact your local poison control
hotline or go to the emergency room as time is of the essence.
There are medications that we can give that can help prevent damage to the liver from
Tylenol but to be most effective it needs to be given within the first 8 hours to have
the best chance.
A Tylenol overdose is not something that you want to wait around on.
So we've focused a lot on the liver mainly because that is the biggest concern we typically
have with this medication.
There are other things that you should be aware of.
In the past few years there was a requirement by the FDA to list the risk of a certain severe
skin reaction called Stevens Johnson's syndrome.
There is also studies going on in relation to the risk of acetaminophen and potential
for increasing children's risk to asthma.
So far it hasn't been felt to be anything that we need to be significantly concerned
about, but as more studies are done we may learn more.
We've discussed several things that can be concerning in regards to taking acetaminophen,
but overall, this is still, for most cases, the safest medication that we have in trying
to treat pain or fevers.
You don't have the same problems with kidney damage, stomach ulcers, increased risk of
heart disease that you can get with anti-inflammatories like ibuprofen or naprosyn.
It's felt to be safe in children as well as the preferred pain relief for women who are
pregnant.
Acetaminophen or paracetamol are a great first line treatment for pain and fever.
They aren't perfect and have their limitations but are a great thing for most people to try
first when you need something for pain.
The main thing I want you to take from this video though is a better understanding of
why you need to avoid going over the maximum recommended dose.
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Well, until next time, this is FamilyMed with Dr. Richardson, and remember, take care of
your body because it's the only one you have.