Tylenol is an over-the-counter analgesic and antipyretic; that is, a pain reducer and fever reducer. Tylenol is the North American trade name for the active ingredient acetaminophen. The use of Tylenol is contraindicated in individuals with certain diseases due to its biochemical profile, action and side effects.
Hypersensitivity
Tylenol is contraindicated in individuals with acetaminophen hypersensitivity. Acetaminophen hypersensitivity is not common, but the allergic reactions can be severe. Allergic reactions include drug-induced bronchospasm and anaphylaxis.
Liver Disease
The liver metabolizes acetaminophen so that it can be eliminated from the body. After being metabolized in the liver cells, the byproducts, referred to as metabolites, are transported to the blood stream to be excreted by the kidneys. These metabolites are toxic and may cause liver damage, also known as hepatotoxicity. A 2003 article in the journal "Drug Metabolism and Disposition" implies that individuals with pre-existing liver disease are at risk for acetaminophen-induced hepatotoxicity because their livers are not working efficiently enough to break down and transport the toxic metabolites. Additionally, ingestion of alcohol decreases the liver's capacity to fully metabolize acetaminophen. The result is the rapid accumulation of toxic metabolites and associated danger of liver damage. Individuals who drink more than two to three alcoholic beverages per day should take only half the recommended dosage of Tylenol or avoid the medication altogether.
Kidney Disease
The kidneys are the major filtering and waste elimination organs of the body. In addition to filtering waste products created from normal biochemical processes, they filter and eliminate many drugs and drug metabolites. Therefore, those with pre-existing renal disease should use Tylenol with extreme caution. The National Kidney Foundation states that doctors do generally recommend acetaminophen over aspirin to those with kidney disease, but adds that this recommendation is due mainly to the bleeding complications that may arise from the use of aspirin. The foundation goes on to say that if a patient with kidney disease feels the need to use Tylenol more often than "once in a while," he should speak with his doctor, who will then either supervise the treatment or recommend another.
G6PD Deficiency
G6PD is an enzyme that stabilizes red blood cells. Individuals with G6PD deficiency are susceptible to severe red blood cell damage after exposure to certain foods or medications. The damage and destruction of red blood cells is called hemolysis. The signs of hemolysis include sudden fever, yellowing of the skin, dark colored urine, fatigue, heavy breathing and a fast pulse. Use of Tylenol may cause hemolysis in individuals with G6PD deficiency.
References
- "Annals of Allergy, Asthma and Immunology"; Paracetamol (Acetaminophen) Hypersensitivity; B. J. de Paramo, S. Q. Gancedo, M. Cuevas, I. P. Camo, J. A. Martin, E. L. Cosmes; December 2000
- "Drug Metabolism and Disposition"; Acetaminophen-Induced Hepatotoxicity; L. P. James, P. R. Mayeux, J. A. Hinson; December 2003
- "Journal of Medical Toxicology"; Acetaminophen-Induced Nephrotoxicity: Pathophysiology, Clinical Manifestations, and Management; M. Mazer, J. Perrone; March 2008
- NorthShore University HealthSystem: Anxious About Acetaminophen and Alcohol?
- National Kidney Foundation: Safer Use of Pain Medicines
