The need-to-know information about Acetaminophen



Pearls and Fun Nuggets

1. Acetaminophen (Tylenol) is a super common, over-the-counter medication that’s used primarily to treat mild PAIN😩 and FEVER 🔥

2. It is NOT an anti-inflammatory medication like Ibuprofen, meloxicam, etc. For patients with orthopedic injuries (sprained ankles, strained muscles, etc.), Tylenol may still be given to treat pain, but it will do nothing to reduce the swelling ☝

3.  Acetaminophen is in EVERYTHING! 🌎 It’s the main ingredient in Alka-Seltzer, Nyquil, and many other cold/flu medications.  It’s also in many migraine medications like Excedrin and it’s mixed in with opiate medications as well.  Hydrocodone + Acetaminophen = Vicodin.  Oxycodone + Acetaminophen = Percocet

4. It’s TOXIC to the liver 😰  It takes a good bit though.  The max recommended dose every day is 4,000mg.  A toxic level for most adults is between 7,000mg-10,000mg.  However, as we determined earlier, it can be easy to overdose unknowingly by taking other medications that contain acetaminophen. If overdosed, Acetaminophen won’t kill you right away….it can take up to a week! ⏳

5. The antidote for acetaminophen toxicity is N-Acetylcysteine (NAC) 💉 To put simply, it works by binding to the toxic byproducts of the acetaminophen in the liver and allowing it to be safely cleared out.  You probably won’t have access to this drug in the field setting, but it’s good to know that this is what the patient needs!

Patient Perspectives

“I use it a few times per week for pain flares with my chronic pain. It seems to work better than extra strength and longer. I don’t need to rely on my oxycodone as much now that I take this for some pain flares. That being said, not every pain flare is the same and I end up still using one of my oxycodone. I’m allowed up to 4 per day, but now I take one or two since I started to use Tylenol 8 hour. I use the store brand of it too and it works just as well.”

“In the early nineties I was taking Tylenol for severe headaches. We had first responders in our workplace that pushed me to larger strengths and doses. “You’re a big guy, you need it, you can take it.” Don’t listen. Never go over the recommended dose for your weight, It will permanently damage your liver. My liver transplant was Dec. 19, 1996.”

“Had high fever, took 2 Tylenol extra strength and fever broke within 1/2 hour. You’ll sweat a lot as fever breaks but that’s normal per my doctor.”


Brandon Simpson, PA-C
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