Acetaminophen

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Acetaminophen

Definition

Acetaminophen is a medicine used to relieve pain and reduce fever.

Purpose

Acetaminophen is used to relieve many kinds of minor aches and pains—headaches, muscle aches, backaches, toothaches, menstrual cramps, arthritis, and the aches and pains that often accompany colds.

Description

This drug is available without a prescription. Acetaminophen is sold under various brand names, including Tylenol, Panadol, Aspirin Free Anacin, and Bayer Select Maximum Strength Headache Pain Relief Formula. Many multi-symptom cold, flu, and sinus medicines also contain acetaminophen. The ingredients listing on the container should state if acetaminophen is included in the product.

Studies have shown that acetaminophen relieves pain and reduces fever about as well as aspirin. But differences between these two common drugs exist. Acetaminophen is less likely than aspirin to irritate the stomach. However, unlike aspirin, acetaminophen does not reduce the redness, stiffness, or swelling that accompany arthritis.

Recommended dosage

The usual dosage for adults and children age 12 and over is 325-650 mg every four to six hours as needed. No more than 4 grams (4000 mg) should be taken in 24 hours. Because the drug can potentially harm the liver, people who drink alcohol in large quantities should take considerably less acetaminophen and possibly should avoid the drug completely.

For children ages 6-11 years, the usual dose is 150-300 mg, three to four times a day. A physician should recommend doses for children under age 6 years.

Precautions

In 2004, the U.S. Food and Drug Administration (FDA) launched an advertising campaign aimed at educating consumers about proper use of acetaminophen and other over-the-counter pain killers. Often, acetaminophen is hidden in many cold and flu products and people unexpectedly overdose on the medicine. Some cases have led to liver transplantation or death. More than the recommended dosage of acetaminophen should not be taken unless told to do so by a physician or dentist.

Patients should not use acetaminophen for more than 10 days to relieve pain (five days for children) or for more than three days to reduce fever, unless directed to do so by a physician. If symptoms do not go away—or if they get worse—a physician should be contacted. Anyone who drinks three or more alcoholic beverages a day should check with a physician before using this drug and should never take more than the recommended dosage. A risk of liver damage exists from combining large amounts of alcohol and acetaminophen. People who already have kidney or liver disease or liver infections should also consult with a physician before using the drug. So should women who are pregnant or breastfeeding.

Many drugs can interact with one another. A physician or pharmacist should be consulted before combining acetaminophen with any other medicine. Two different acetaminophen-containing products should not be used at the same time.

Acetaminophen interferes with the results of some medical tests. Avoiding the drug for a few days before the tests may be necessary.

Side effects

Acetaminophen causes few side effects. The most common one is lightheadedness. Some people may experience trembling and pain in the side or the lower back. Allergic reactions occur in some people, but are rare. Anyone who develops symptoms such as a rash, swelling, or difficulty breathing after taking acetaminophen should stop taking the drug and get immediate medical attention. Other rare side effects include yellow skin or eyes, unusual bleeding or bruising, weakness, fatigue, bloody or black stools, bloody or cloudy urine, and a sudden decrease in the amount of urine.

Overdoses of acetaminophen may cause nausea, vomiting, sweating, and exhaustion. Very large overdoses can cause liver damage. In case of an overdose, immediate medical attention should be sought. In 2004, researchers announced that an injection to counteract the liver injury caused by acetaminophen overdose has been approved by the FDA.

KEY TERMS

Arthritis— Inflammation of the joints. The condition causes pain and swelling.

Fatigue— Physical or mental weariness.

Inflammation— A response to irritation, infection, or injury, resulting in pain, redness, and swelling.

Interactions

Acetaminophen may interact with a variety of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. Among the drugs that may interact with acetaminophen are alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs) such as Motrin, oral contraceptives, the antiseizure drug phenytoin (Dilantin), the blood-thinning drug warfarin (Coumadin), the cholesterol-lowering drug cholestyramine (Questran), the antibiotic Isoniazid, and zidovudine (Retrovir, AZT). A physician or pharmacist should be consulted before combining acetaminophen with any other prescription or nonprescription (over-the-counter) medicine.

Resources

PERIODICALS

"Antidote Cleared for Acetiminophen Overdose." Drug Topics February 23, 2004: 12.

Mechcatie, Elizabeth. "FDA Launches Campaign About OTC Drug Risks: NSAIDs, Acetaminophen." Family Practice News March 15, 2004: 81

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