Acetaminophen (Tylenol): The Dangers of This Unsuspecting Drug

It’s Accessible, But Is It Safe?

Acetaminophen is used to treat various symptoms, including fever and pain management. You can find variations of this drug at any pharmacy or drugstore, and it’s offered as a staple consumable at gas stations and even in hotel lobbies. Airlines and theme parks keep this drug on hand and will typically provide it at no cost for patrons in need. This drug is considered the most common drug ingredient in America. But its use is much more widespread than that. Not only is acetaminophen the active ingredient in hundreds of different over-the-counter medicines like cold and flu medications, but it’s also used in prescription opioids like hydrocodone and Percocet. If this drug is so widespread and readily available with virtually no purchase limitations, what makes it dangerous?

Before we answer this, we should first note that acetaminophen has some benefits. For starters, it does not pose the same risk of intestinal lining damage as its anti-inflammatory counterparts, including ibuprofen and aspirin. These drugs can damage the kidneys over time, which is not a shared concern with acetaminophen. However, the largest risk associated with acetaminophen is liver damage. When this drug is taken beyond the recommended limit or when someone overdoses or abuses the drug for a long period of time, it can lead to catastrophic liver failure.

The reason for this is that the drug’s byproduct is toxic to the liver. Several hundred cases every year result in death from acetaminophen and thousands of illnesses. The general rule for this drug is to use it only within the dosage guidelines on the label of the bottle and only for short periods. Overdoses (exceeding the daily amount) and long-term use are the two highest contributing factors to liver toxicity and other health complications.

How Acetaminophen Interacts with Other Drugs

Unfortunately, this is not the whole story. While plenty of risks are associated with using acetaminophen beyond its intended use, this is not typically where the danger lies. Instead, acetaminophen becomes especially dangerous when it is used alongside other medications or drugs. One example includes mixing acetaminophen with alcohol. Like pain relievers, alcohol can heavily tax the liver as it works to break down the substance. Readers are probably aware of the connection between alcohol abuse and liver damage, but most people do not think about the role acetaminophen plays in the process. 

With alcohol use disorder (AUD) being one of the most pervasive drug abuse problems in the United States, the added stress on the liver to break down alcohol and acetaminophen can push the organ beyond its limits, resulting in a deadly situation. Beyond liver damage, these can include chronic upset stomach, internal bleeding, stomach ulcers, and rapid heartbeat. 

Additionally, acetaminophen is dangerous when it is mixed with other drugs, such as opioids. While not all opioids contain acetaminophen, many of them do. If someone is prescribed an opioid to manage pain and finds themselves in severe pain before they are within the window for their next dose, they may be tempted to offset their pain with an over-the-counter (OTC) medication. If people do not know their prescription opioid already contains acetaminophen, they might unintentionally take Tylenol or a similar acetaminophen-containing drug from their home supply, resulting in an overdose. Labels will show whether acetaminophen is part of the opioid dosage, but this requires users to take the initiative to research the drugs they are mixing. 

What This Means 

Acetaminophen is not as dangerous as illicit drugs, especially when used within the recommended guidelines. However, this does not mean it should be used long-term or that there is no risk associated with it. One final consideration has to do with using the drug to curb withdrawal symptoms that people might feel during drug detox. Drug detox is considered safe when it is done alongside a dedicated team of professionals. This is because they know which drugs to prescribe to combat withdrawal symptoms. 

However, attempting to self-detox can result in overdosing on acetaminophen or having an unintentional drug interaction. It is always a safe option to do this in a professional manner. If you think you have overdosed on acetaminophen, it is important to seek professional medical help immediately.