Tylenol is a popular brand of drugs frequently recommended to treat the symptoms of pain and fever. It is also marketed for its relative safety compared to non-steroidal analgesics, such as Advil. The main active ingredient in over-the-counter Tylenol products is acetaminophen, which is offered at either 325 mg or 500 mg per dose. “Tylenol 3” is a prescribed drug and contains acetaminophen and 30 mg of codeine, which is classified as a narcotic and a controlled substance. Both acetaminophen and codeine cause side effects in users, some of which are considered severe.
Liver Damage / Failure
The U.S. Acute Liver Failure Study Group found that acetaminophen poisoning is implicated in nearly 50 percent of all acute liver failure in the U.S. Further, they claim that acetaminophen overdose is the leading cause for calls to Poison Control Centers and accounts for more than 56,000 emergency room visits, 2,600 hospitalizations and an estimated 458 deaths each year.
According to RxList.com, 4,000 mg of acetaminophen per day is the maximum recommended dose for adults and children over 12 years. Although, Drugs.com notes that several cases of hepatotoxicity from acetaminophen usage has been reported despite “safe” dosages and lack of risk factors for toxicity. The main risk factors for liver toxicity, regardless of acetaminophen dosage, are alcohol use, other drug usage, liver disease and fasting.
Kidney Damage
A study published in The New England Journal of Medicine, claimed that “heavier acetaminophen use” was associated with an increased risk of end-stage kidney disease in a dose-dependent fashion. Specifically, the investigators concluded that approximately 8 to 10 percent of the overall incidence of end-stage kidney disease was attributable to acetaminophen use. Drug.com notes that kidney side effects from acetaminophen use are considered rare, but acute renal failure, acute tubular necrosis and interstitial nephritis have been observed. Adverse kidney effects are most often observed with overdose and chronic abuse of multiple analgesics.
Drug Interactions
Acetaminophen may interact with a variety of other drugs, which can increase the risk of known side effects or create unexpected ones. The most common drugs that interact with acetaminophen are alcohol, ibuprofen, oral contraceptives, the anti-seizure drug phenytoin, the blood-thinning drug warfarin and the cholesterol-lowering drug cholestyramine.
Allergic Reactions
Both acetaminophen and codeine can cause allergic-type reactions, according to Drugs.com. Allergic reactions can include facial and throat swelling, difficulty breathing, skin rash, hives, stomach upset and circulatory collapse. Tylenol 3 also contains sodium metabisulfite, which is known to cause severe reactions in a small percentage of asthmatics.
Drug Addiction
Because codeine is an alkaloid-based narcotic drug which metabolizes to morphine, there is potential for physical and/or psychological dependency leading to addiction. A sign of dependency is tolerance to codeine, whereas an increasingly higher daily dose is required for pain relief. Chronic constipation is another symptom created with codeine dependency.
Ultra-Rapid Metabolizers Reaction
According to RxList.com, some people have genetics that convert codeine more rapidly to morphine, which can cause severe drowsiness, confusion and feelings of euphoria for those who consume Tylenol 3. The genotype is found in approximately 16 to 28 percent of North African, Arabian and Ethiopian peoples.
Central Nervous System Effects
Narcotics like codeine can also disrupt the central nervous system. According to Drugs.com, side effects of central nervous system depression are drowsiness, dizziness, headache, mood changes, confusion, hallucinations, seizures, low blood pressure, slow heartbeat, constricted pupils and even problems with urination.
References
- "Hepatology"; Acetaminophen and the U.S. Acute Liver Failure Study Group: lowering the risks of hepatic failure; W.M. Lee; July 2004
- RxList.com: Tylenol Side Effects
- Drugs.com: Tylenol Side Effects
- "The New England Journal of Medicine"; Risk of Kidney Failure Associated with the Use of Acetaminophen, Aspirin, and Nonsteroidal Antiinflammatory Drugs; Thomas V. Perneger et al; December 1994.
- Drugs.com: Tylenol w/ Codeine
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