I’ve had patients voicing their concerns recently about a “recall” of Tylenol products.
I use the terms Tylenol (the most recognized brand name) and acetaminophen (the chemical name) interchangeably here. A U.S. Food and Drug Administration panel recently made several recommendations concerning Tylenol and products containing acetaminophen. Again, these are only recommendations and are not written into law at this time.
The FDA recommendations are as follows:
- That prescription Vicoden (hydrocodone and acetaminophen) and Percocet (oxycodone and acetaminophen) be banned from further use.
- That over-the-counter products that contain acetaminophen (there are literally hundreds of such medications) carry stronger warning labels.
- Reduce the maximum over-the-counter strength of a Tylenol pill from 500 milligrams to 350 mg.
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What’s at issue here is the fact that acetaminophen, in high doses, can cause liver damage, and in very high doses can cause liver failure and death. This problem usually occurs when patients take more than the recommended daily dose of Tylenol or when they take Tylenol plus another drug that also contains Tylenol, such as Theraflu or Nyquil, thus unknowingly exceeding the recommended dose.
Since it is well-known that alcohol also has a negative affect on the liver, the combination of alcohol and Tylenol has an even greater negative impact on the liver.
Tylenol has been around for decades and has been consumed by millions of people worldwide for the relief of pain and fever. I believe that when taken in recommended doses, it is safe and effective.
The alternatives to Tylenol, such as aspirin or anti-inflammatory drugs such as ibuprofen, have their own risks in terms of stomach bleeding. The decision to take either Tylenol or an aspirin product is a matter of risk versus benefit. You may wish to speak with your doctor about this.
I agree with the panel’s findings and recommend the following:
- Tylenol or its various products should not be used if one consumes more than two alcoholic drinks per day.
- The maximum single adult dose should be no greater than 650 mg ( two 350 mg tablets).
- The maximum daily dose should be less than the currently recommended dose of 4,000 mg. I propose taking no more than 2,800 mg per day, which is equal to taking two 350 mg tablets every six hours.
- Always carefully read the label on any over-the-counter medication to see if acetaminophen is one of the ingredients.
Be careful, but not fearful, of Tylenol. For treating pain or fever, it is a very useful medication when used properly.
Terry Hollenbeck, M.D., is an urgent-care physician at Santa Cruz Medical Foundation in Scotts Valley. A doctor with 34 years’ experience, he invites health-related questions at va**********@sb*******.net. Information in this column is not intended to replace professional advice. For any medical concern, consult a qualified practitioner.
