Health Conditions and Other Medications
If you take blood thinners (anticoagulants), for example Coumadin (warfarin), seizure medication, especially Tegretol (carbamazepine), Dilantin(phenytoin), or phenobarbital, phenothiazines, INH(isoniazid), or other pain, fever, or cough or cold medication, be sure to ask your doctor if it is OK to also take Tylenol or other acetaminophen.
According to the Hepatitis C Project, the active ingredient in Tylenol, acetaminophen, can be found in approximately 200 other medications. As mentioned above, the range for a safe dosage of Tylenol is very narrow. This means that if you take more than one medication, it is essential to read the labels for each one of them to be sure that you are getting acetaminophen only once. The risk of overdose effects is amplified if you drink or have chronic alcoholism, or other liver disease.
Many people store medications, including Tylenol, in their bathroom medicine chest, or in the kitchen, near the faucet. But to keep this medication in good working order, it is best to store it away from heat and moisture. Keep the pills in the bottle it came in, and make sure the bottle is tightly closed.
It is very important to keep Tylenol and other acetaminophen products away from a child’s reach, as taking it inappropriately can do irreparable harm.
If your Tylenol is outdated or you no longer need it, throw it away. But first ask your pharmacist the proper way to do so.
Although it is widely used, Tylenol works in a very narrow margin of safety. If you take too much, your liver may become toxic very quickly. Unfortunately, the amount of Tylenol that causes liver toxicity is different from person to person, and some researchers think that problems can occur at the dosage amount listed on the label. This is especially true if you drink or have chronic alcoholism. If you are at all unsure how much Tylenol or acetaminophen to take, or if you should take it at all, ask your doctor.
If you doctor has you taking Tylenol regularly and you miss a dose, take as soon as you remember. But if it is almost time for the next dose, just wait. In any case, don’t double dose.
Taken in proper doses, acetaminophen, the active ingredient in Tylenol utilizes a chemical “pathway” in the liver to break down the medication and metabolize it. When you take more than you should, the chemical pathway gets overwhelmed, as if there were too much “traffic” in the pathway. When this happens, medication molecules are rerouted to a different chemical pathway. The alternate route breaks the drug down differently than does the primary route; one of the big differences between the chemical pathways is that the alternate route creates toxic by-products that kill liver cells.
Acetaminophen. Drugs.com. Jan 2008.
Acetaminophen. Medline Plus. October 1 2007. Rumack, B. Acetaminophen misconceptions. Hepatology. July 2004
Van Mil, A., Janssens, A. Acetaminophen use by chronic alcohol abuser: a therapeutic dose may be too much for the liver. Ned Tijdschr Geneeskd. March 16 2002.
Kuffner, e. Dart, R. Bogdan, G., Hill, R. Casper, E. Darton, L. Effect of maximal daily doses of acetaminophen on the liver of alcoholic patients: a randomized, double-blind, placebo-controlled trial. Arch Intern Med Oct 8 2001
Seirafi, M., Iten, A., Hadengue, A. Acetaminophen: hepatotoxicity at therapeutic doses and risk factors. Rev Med Suisse. Oct 17 2007.
Kuffner, E. et al. The effect of acetaminophen (four grams a day for three consecutive days) on hepatic tests in alcoholic patients--a multicenter randomized study BMC Med. 2007 May 30;5:13.
Dart, R., Baily, E. Does therapeutic use of acetaminophen cause acute liver failure? Pharmacotherapy. 2007 Sep;27(9):1219-30.
Larson, A. Clin Liver Dis. 2007 Aug;11(3):525-48, vi. Related Articles, Acetaminophen hepatotoxicity.
Polson J, Lee WM. AASLD position paper: the management of acute liver failure.
Franciscus, A. Highleyman, L. Acetaminophen and Your Liver HCSP Fact Sheet. Hepitits C Support Project.