Pain Medicine: Acetaminophen

As an alternative to aspirin, acetaminophen has been around a long time! The FDA approved acetaminophen in 1951. This medicine is both analgesic (pain reliever) and antipyretic (fever reducer).

You may know acetaminophen as: Tylenol and others — more than 200 medications include acetaminophen.

How does it work? Acetaminophen relieves pain by elevating the pain threshold — in other words, it takes more pain for you to feel the discomfort. Acetaminophen reduces fever by telling the heat regulating part of the brain to cool things down when the body’s temperature is above normal.

Acetaminophen is available in many different forms, including liquid suspension and chewable tables (usually for children and people who have difficulty swallowing pills), coated caplets, gelcaps and geltabs, and even suppositories. The average adult dose ranges between 325 and 650 milligrams every four to six hours. Read the label for dosage instructions; the maximum daily dose for adults is four grams. Acetaminophen combined with other drugs — like Tylenol with codeine, for example — is available by prescription.

For people with mild arthritis, acetaminophen is useful in relieving pain but doesn’t do anything for the underlying inflammation that causes the pain.

Side effects of acetaminophen are rare when it is used appropriately — acetaminophen as Tylenol is the most popular painkiller in the United States. Large doses, chronic use, and alcohol abuse can lead to liver damage. For a while, Tylenol had a great ad campaign running where one of the VPs of the company said basically: if you aren’t going to take Tylenol responsibly, I’d rather you didn’t take it at all. What a great message!

Are there any drug interactions when using acetaminophen? Be careful using acetaminophen if you are taking drugs to increase action of liver enzymes. The liver is responsible for metabolizing acetaminophen, and certain liver drugs can decrease the action of the painkiller.

Acetaminophen is safe to use in all stages of pregnancy and while nursing. It is a safe alternative to aspirin for treating fevers in infants.