The FDA convened an expert panel recently to make recommendations about acetaminophen, the active ingredient in Tylenol and hundreds of other OTC products. These range from house brand non-aspirin pain relievers to cough and cold remedies, nighttime sleep aids, arthritis drugs and allergy medications. The problem is liver toxicity.
Most people think of acetaminophen as the safest pain reliever on the market. The maker of Tylenol is encouraging that perception with new ads touting Tylenol as “the safest brand of pain reliever you can choose.” Nevertheless, at doses within the recommended range, some people may experience liver toxicity. This is especially a problem for people who drink alcohol or may not be eating because they are sick. When you come down with the flu appetite can disappear along with the fever. Taking high doses of acetaminophen at such a time could pose risks few are aware of.
That is why the FDA panel recommended lowering the maximum daily dose by almost a third, from 4000 mg per day to 2600 mg. There was also a recommendation to reduce the strength of any given pill to 325 mg so that inadvertent overdoses will be less likely. This would mean that Extra Strength Tylenol (500 mg per pill) and Tylenol Arthritis Pain (650 mg per caplet) will have to be reformulated or converted to prescription status.
Acetaminophen is a useful pain reliever, especially for those with sensitive stomachs. Despite this, it should never be taken for granted. Regular use of any pain reliever, including ibuprofen (Advil, Motrin IB), naproxen (Aleve) or aspirin, requires caution.
