Tylenol is a staple medicine for relieving pain and reducing fever, and is considered safe by the Food and Drug Administration when taken as directed. However, the potential risk of the medicine's adverse effects on the liver has been carefully studied and reported by medical experts. Various factors affect Tylenol's potential to harm the liver, and these should be carefully examined in order to prevent any adverse liver effects from the drug.
Acetaminophen
Tylenol's active ingredient is acetaminophen, a chemical found in many other over-the-counter medicines, as well as in a host of prescription drugs. Acetaminophen metabolizes---or becomes active within the body's system---through the liver. At indicated doses, in the absence of pre-existing health conditions, Tylenol does not cause harm as it passes through the organ for most people.
Dose as a Factor
Tylenol is considered safe at recommended doses, which for most people is a maximum of 4,000mg per day, or eight extra-strength Tylenol pills, according to Harvard Health Publications. When someone exceeds the recommended dose---especially for more days than Tylenol's label directs the medicine's use---the liver becomes overwhelmed with acetaminophen, responding by processing the drug through a pathway called the cytochrome P450 enzyme system. When this process starts to work, a toxin called NAPQI, or N-acetyl-p-benzo-quinone imine, is produced and kills healthy liver cells.
Overdose
If a person takes far too much Tylenol, an overdose is likely to result. Overdosing on acetaminophen can cause severe liver damage and even liver failure, which is fatal. Harvard reports that between 1998 and 2003, the percentage of deaths attributed to acetaminophen-induced acute liver failure rose from 28 percent to 51 percent. According to the FDA, a person may not notice the early signs of severe liver damage or acute liver failure until it's too late---mistaking symptoms for those of the flu.
Alcohol and Tylenol
Alcohol greatly increases the risk of adverse effects on the liver when combined with acetaminophen. People who consume more than two alcoholic beverages per day should avoid taking Tylenol regularly, and limit their daily intake of the medicine to 2,500mg---the equivalent of five extra-strength Tylenol pills in a 24 hour period. Especially dangerous to the liver is taking Tylenol to relieve symptoms of severe alcohol hangovers---a time when the liver is already weakened and more prone to acetaminophen's potential adverse effects.
Prevention
The best way to prevent adverse effects to the liver if you plan on taking Tylenol is to use the medicine exactly as directed. If you're in doubt, talk to your doctor about the risks to your liver. If you consume more than two alcoholic beverages a day, the safest method of preventing liver damage from acetaminophen is to try a different pain reliever such as aspirin or ibuprofen, or alternate between Tylenol and these, reports Harvard. Also, children are especially sensitive to acetaminophen, so carefully follow the medicine label instructions on formulations of Tylenol designed for children when giving the medication to a child.
References
- HCV Advocate: The Liver: Acetaminophen and Your Liver
- U.S. Food and Drug Administration: Acetaminophen and Liver Injury: Q & A for Consumers
- Baylor College of Medicine: Normal Acetaminophen Dosage Can Trigger Liver Failure in Alcoholics
- Harvard Health Publications: Acetaminophen Overdose: How to Avoid Acetaminophen-Related Liver Problems
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