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Acetaminophen – While Commonly Deemed Safe, This Drug Has Been Found to Pose Many Health Risks

The most widely used pain drug could potentially be one of the most dangerous.

The Risks Associated with Acetaminophen is Real

An estimated 50 million individuals within the United States—alone—use medications containing the drug acetaminophen each and every single week. Worldwide, acetaminophen is considered to be the most commonly used and popular drug for pain. In terms of over-the-counter (OTC) and prescription medications that are currently available on the market, acetaminophen is an ingredient in over 600 different products. 

These include medications designed to alleviate pain, aid in the control of allergy symptoms, assist in reducing complications experienced with colds and influenza, cough syrups, and even sleeping aids. Since its official introduction under the brand name of Tylenol® in the year of 1955 within the United States, it has been deemed a “safe” drug. Recent studies and extensive research of medical records now reveal that acetaminophen may pose a high danger to those that take large doses and/or use the drug on a long-term basis. 

Popular Over-the-Counter Medications Containing Acetaminophen

  • Actifed®
  • Benadryl®
  • Contac®
  • Dayquil®
  • Excedrin®
  • Formula 44®
  • Goody’s®
  • Midol®
  • Robitussin®
  • Sudafed®
  • Tylenol®
  • Vicks®
  • Zicam®

Common Prescription Medications Containing Acetaminophen

  • Butalbital
  • Endocet®
  • Hydrocet®
  • Lortab®
  • Oxycodone
  • Percocet®
  • Phenaphen®
  • Sedapap®
  • Tramadol
  • Tylenol® with Codeine
  • Ultracet®
  • Vicodin®
  • Zydone®

If acetaminophen is an ingredient used in medication, it will likely be listed by name; however, it is also known as “paracetamol” or as “APAP.” In over-the-counter medications containing acetaminophen, the word “acetaminophen” is commonly listed on the front as well as in the section that highlights the active ingredients. In prescription medications, it may be listed as “acetaminophen,” “paracetamol,” “APAP,” or a shorter variation of the word “acetaminophen,” such as “acetam.” If you are concerned about whether or not a medication contains this drug, ask your doctor and/or pharmacist. 

Acetaminophen Forms and Shapes

Acetaminophen comes in a wide variety of forms and in several different shapes. In both over-the-counter medications and prescription medications, it may come in the following forms:

  • Caplets
  • Chewable Tablets
  • Dissolving Strips
  • Gel Tablets
  • Liquids
  • Power
  • Suppositories
  • Tablets

Depending on the medication, the shape of acetaminophen varies. To date, the following covers the unique shape characteristics of the drug:

  • 8-Sided
  • Capsule
  • Elliptical-Shaped
  • Round

Neurologist and pain management specialist deems Tylenol® a dangerous drug.

Dr. Hausknecht, who is a neurologist and a pain management specialist in the State of New York, stated: “Tylenol is, by far, the most dangerous drug ever made.” In an interview where he was asked to explain why he made this statement, he expounds on the fact that every year, a large amount of people within the United States take the acetaminophen-containing medication Tylenol® and experience an overdose—be it accidental or intentional—that results in a high morbidity and morality rate. 

Furthermore, the National Institutes for Health claims that the drug acetaminophen is the leading cause of acute-based liver failure within the United States. In an examination of deaths that occur each year from the consumption of acetaminophen, it was found that the drug is the culprit in nearly 500 cases. Additionally, medical records have established that 78,000 people in the United States have visited an emergency room after overdosing on the drug and another 33,000 a year are a direct result of taking medications or overdosing on medications containing acetaminophen. 

Benefits outweigh risks when taking recommended dosage of acetaminophen.

Before outlining the risks associated with acetaminophen, it is important to explain that, if this drug is taken in the recommended dosage, the benefits far outweigh the overall risks. Millions upon millions take this drug without experiencing any complications; however, those that take more than the recommended dosage and take medications containing the drug are more likely to suffer from health-related consequences. 

The vice president of the medical affairs and the clinical research departments at McNeil, Ed Kuffner, has stated: “It’s important for people to know that every medicine has risks.” He went on to explain that if a person fails to follow the recommended dosage, they place themselves in a position to suffer from those risks. 

The Toxicity of Acetaminophen

The drug acetaminophen is one that has a very low therapeutic index. Essentially, this means that the standard recommended dosage is very close to the amount that it takes to overdose. This is why it has such a high toxicity level and is considered to be dangerous. Currently, the recommended dosage is 4 grams per day. This is equivalent to 4,000 mg a day. Currently, the extra strength product of Tylenol® is 500 mg per pill. This means that if you take 8 pills in a day, you are taking the current daily recommended dosage; however, if you exceed that, you are placing yourself at risk for health issues.

If you consume alcohol and do not get the proper nourishment, even taking the recommended dosage may prove to be dangerous to the liver. This drug should never be taken with or after drinking any type of alcoholic beverage as its risks increase dramatically. This is because when one drinks alcohol, the liver is working to break down the substance within the body. Because of this, the liver is not able to dispose of the drug. 

As a result, hepatotoxicity or damage to the liver may occur as a direct result of the drug. For those that do not consume alcohol and get the proper nourishment, taking regular doses of acetaminophen a day of 5,000 mg could result in a high level of damage to the liver. While just two more extra strength pills a day from a Tylenol® product may seem harmless, it is, in fact, quite dangerous. 

Skin Allergies Linked to Acetaminophen Usage

Several individuals have suffered from skin reactions after taking products containing acetaminophen. While the actual number of cases are relatively low—just 107 between the years of 1969 and 2012—these resulted in a total of 67 people being hospitalized and a total of 12 deaths. The Federal Drug Administration issued a warning in the year of 2013 that acetaminophen could result—in rare cases—in the development of skin reactions that could be potentially fatal. 

These reactions include, but are not limited to, toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). If you experience any of the following symptoms after taking acetaminophen, you should see your medical provider or visit an emergency room as quickly as possible:

  • The development of flu-like symptoms
  • Blisters developing on the skin
  • Changes in the pigment of the skin
  • The development of bruising or scarring on the skin of unknown cause
  • Vision problems

Several Potential Risks Associated with Taking Acetaminophen During Pregnancy

Throughout its existence, acetaminophen has been considered to be safe for use during pregnancy; however, several studies have concluded that this may not be true:

  • In February 2016, a study which Dr. Maria Magnus from the Norwegian Institute of Public Health was part of evaluated the adverse effects associated with acetaminophen usage among expectant mothers. The findings concluded that those that used the drug while pregnant were more likely to give birth to children that would be medically diagnosed with asthma by 3-years-old.
  • In July 2016, MNT released a report stating that there is a direct link between taking the drug during pregnancy and having a child born with autism or attention deficit hyperactivity disorder. Out of all of the women studied—a total of 2,600—those that took the drug while pregnant were up to 30 percent more likely to give birth to a child that would suffer from some type of attention impairment by the time they reached the age of 5.
  • A study conducted by the Center for Research in Environmental Epidemiology in the city of Barcelona in Spain found that boys who were exposed to the drug acetaminophen while in the womb were at higher risk for developing and displaying the clinical-based symptoms associated with autism.

To date, the U.S Food and Drug Administration has not released any warnings for pregnant women and the consumption of acetaminophen because they consider the above-listed findings/risks to be too limited; however, they do express the fact that taking pain relief medications while carrying a child should be carefully considered and should only be done with a doctor’s consent and direction. 

Blood Cancer Development Linked to Acetaminophen Usage

In the year of 2011, the publication called the Journal of Clinical Oncology released information from a study that evaluated nearly 65,000 individuals ages 50 to 76 that concluded that long-term use of the drug acetaminophen could increase the risk of developing certain types of blood cancers, of which the two most common were leukemia and lymphoma. Individuals that took the drug at least four times each week over a period of at least four years were at the highest risk for developing some type of blood cancer. 

Acetaminophen and Liver Damage

The most well-known complication associated with acetaminophen is the risk for developing liver cancer. When a person takes this drug, it is metabolized by the liver. It is then excreted from the body through the urination process. A small portion of this drug is converted into a metabolite that is considered to be toxic and has the ability to harm the cells that are within the liver. 

The FDA recorded the cases of liver failure reported between the years of 1998 and 2003 and concluded that the drug acetaminophen was the leading cause for the liver failing within those in the United States. They continued their findings by reporting that at least half of every case of liver failure within the nation stemmed from an accidental overdose of acetaminophen. If taken on a long-term basis, immediate signs of liver damage may not make themselves known until it is considered to be too late for treatment. 

Immediate Signs of Acetaminophen Poisoning and the Onset of Liver Failure

In terms of acetaminophen poisoning and the onset of the failure of the liver, there are four distinct phases, as outlined by medical professionals. If you or someone you know has ingested acetaminophen and experiences these signs, you should seek help as quickly as possible. The complete failure of the liver may occur within just 3 days or 72 hours of taking the drug. The following outlines each of the four phases and provides basic information of each:

  • Phase IThis phase occurs within the first 24 hours of taking acetaminophen-containing products. Individuals may become pale, suffer from nausea, start to sweat a lot, and may even start to vomit.
  • Phase IIThis phase occurs after the first 24 hours. The individual that has been poisoned by the acetaminophen may have nausea, experience vomiting, and may have pain in the upper right area of the abdominal cavity. Most have high blood pressure and irregularities in their heart beats.
  • Phase IIIThis phase may occur up to 96 hours after taking acetaminophen. This is considered to be a highly critical period. Nausea, vomiting, and abdominal pain will be present. The area near and over the liver may become extremely tender. Symptoms of damage and/or failure of the liver is likely to occur. These include low blood sugar levels, jaundice of the skin, and loss of cognitive functioning. In many instances, other organs within the body may start to fail.
  • Phase IVThis is the final phase of acetaminophen poisoning. If a patient makes it to this stage, they will likely be hospitalized for anywhere from as little as 4 days to as many as 21 days. This is a recovery period where all of the initial and previously experienced symptoms successfully resolve. 

Additional Signs of Liver Damage Due to Acetaminophen Toxicity

In addition to the symptoms outlined previously in the phases of poisoning and liver failure, there are many other signs that may indicate liver damage as a result of long-term use or overdose of acetaminophen. These include, but are not limited, to the following:

  • The urine may appear darker than usual.
  • The feces may become pale-colored.
  • Bruising may occur more easily.
  • Abnormal bleeding may develop.
  • Poor appetite
  • Unintentional weight loss
  • Fatigue
  • Lack of energy
  • Red-colored palms
  • Fluid accumulation in the legs and/or the abdominal cavity
  • Confusion
  • Problems thinking clearly
  • Heightened sensitivity to medications
  • Enlarged veins
  • The development of kidney failure
  • Gallstones
  • Intense itching
  • Diarrhea
  • Stomach cramps

Reducing the Risks Associated with Acetaminophen Usage

As mentioned previously, if acetaminophen is used at correct dosages, it poses very few risks. In fact, the benefits far exceed the risks when taken appropriately. The issue really comes in when one takes acetaminophen on a long-term basis and/or exceeds the dosage recommendations outlined on medications that contain the drug. According to the National Institutes of Health, there are several steps that consumers may take in order to avoid serious health consequences associated with ingesting acetaminophen. These include the following:

  1. Medications that contain acetaminophen should be taken exactly as outlined on the label on the packaging or in the paperwork that comes with the prescription.
  2. You should never take more than one product at a time that contains the drug acetaminophen.
  3. You should never exceed 4 grams or 4,000 milligrams a day when taking acetaminophen.
  4. If you have suffered from any type of previous liver issue, you should consult your doctor and obtain approval prior to taking anything with the drug acetaminophen.
  5. You should never take any acetaminophen product without discussing it with your doctor. This is especially true if you suffer from health conditions, take prescription medications, or are pregnant. 

Alternatives to Acetaminophen Usage

Now that you know the dangers linked to acetaminophen, it is quite likely that you are interested in alternatives. Again, it is essential that you understand that those that take acetaminophen as recommended are at low risk for developing complications. It is the act of long-term usage, usage during pregnancy, and accidental or intentional overdose that poses the most risk for health-related complications. The drug is used to treat pain by blocking pain signals within the central nervous system and to treat fever. As alternatives, you may take, do, and/or use the following:

  1. To reduce inflammation and pain within the body, you may use the spice or supplement turmeric. This substance decreases the pain response within the body and works to eliminate inflammation.
  2. You may take one teaspoon a day of ginger. In studies, this helped reduce pain associated with the menstrual cycle, headaches, and arthritis for up to 25 percent.
  3. If you are suffering from dental issues that are causing pain, you may dab the affected area with a cotton ball that has been dipped into clove oil.
  4. If you have an injury that is resulting in pain, you may use a topical treatment that includes Capsaicin. This aids in reducing the amount of substance P in your body which is a chemical that informs your brain that you are experiencing pain.
  5. If you experience pain from headaches, muscle issues, or your period, you may drink warm water to soothe the pain. Everything in your body is dependent upon proper hydration. By drinking approximately 8-12 glasses of water a day, you are ensuring that you are properly hydrated and the warmth of the warm water will soothe the pain that you are experiencing.
  6. Speaking of water, you may freeze it and apply it to the skin through the means of an ice pack in order to reduce pain and inflammation.
  7. If you find that you have a fever, you may soak in a bathtub that has lukewarm water. This will aid in reducing your temperature.
  8. There are several essential oils on the market that could potentially aid in reducing pain and inflammation in the body. These may be used during massage therapy sessions, in an oil diffuser, or—if designed for topical use—on the skin or in a relaxing tub of warm water. Keep in mind, though, that the Federal Drug Administration has not approved any essential oil on the market today for the treatment of any medical condition or symptom; however, many believe that these have the potential to help those that suffer health-related complications.
  9. Exercise is a great pain-relieving agent. If you find yourself reaching for the acetaminophen, it may be best to skip it and simply stretch it out. You may engage in several exercises on your own, join a local gym, or even set up physical therapy sessions. Self-care and self-management of pain through exercise is a wonderful means of taking control over your body and experiencing long-term relief of discomfort, without the use of medications.
  10. If your pain is severe, you may need to consider alternative treatments that may help you to relax your muscles, tissues, and your mind. Excellent examples include listening to music, engaging in coloring therapy, hydrotherapy, meditation, and various other relaxation techniques.

This is only a small list of alternatives to taking acetaminophen; however, they are all considered to be extremely beneficial in combating pain or relaxing the body to overcome discomfort. Remember, before taking acetaminophen or engaging in any type of alternative treatment for pain and/or fever, you should consult a healthcare provider. 

It is important that your health history, family history, prescription medications, and general health is taken into professional consideration prior to starting any new regimen—regardless if it is natural or synthetic. The dangers of acetaminophen are real. Remember to share this with your friends, family members, and other loved ones. By passing on this information today, you are likely providing someone with many more tomorrows! 

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