Tylenol is an effective, frequently used, over-the counter pain reliever. Acetaminophen is the generic name of Tylenol and an active ingredient found in many over-the-counter products and prescription medications.
Acetaminophen is used to relieve
mild to moderate pain from headaches, muscle aches, menstrual periods, colds
and sore throats, toothaches, backaches, and to reduce fever. Acetaminophen may
also be used to relieve the pain of osteoarthritis (arthritis caused by the
breakdown of the lining of the joints). Acetaminophen is in a class of
medications called analgesics (pain relievers) and antipyretics (fever
reducers). It works by changing the way the body senses pain and by cooling the
body.
Tylenol is the brand name for
acetaminophen produced by McNeil Consumer Healthcare, a subsidiary of Johnson
& Johnson. Like other well-know
products, such as Kleenex for tissues, Clorox for bleach, or Advil for
ibuprofen, Tylenol is the commonly used name for acetaminophen. Acetaminophen is often used in combination
with other active ingredients, called "combination medicines," to
treat symptoms of colds and influenza (flu), allergy and insomnia. Many
prescription drugs contain acetaminophen and other active ingredients to help
relieve pain. For example, the
often-prescribed, pain reliever Vicodin by Abbott Laboratories combines
acetaminophen with the narcotic hydrocodone.
The Safe Use of Acetaminophen
Acetaminophen-containing products
are safe and effective when used according to their label instructions. The
recommended maximum daily dose is 4,000 milligrams. Taking more than this amount, particularly
for several or more days, can lead to liver damage. In the United States, acetaminophen
overdose is the primary cause of acute liver failure. It is extremely important
to check the amount of acetaminophen in any medication being taken by reading
the list of “active ingredients “ and determining the total amount being
consumed. For example, Tylenol Regular
Strength contains 325-milligram tablets, so the maximum daily dose is 12
tablets. Tylenol Extra Strength contains
500-milligram tablets, so the maximum dose is 8 tablets
.
.
Be extremely careful when taking
more than one product that contains acetaminophen. Acetaminophen overdose can happen when
multiple products such as cold medications and pain relievers are taken
together and exceed over 4000 milligrams of acetaminophen per day. This often happens without the person even
realizing that they are taking multiple doses of acetaminophen. Read the labels of all the prescription and
nonprescription medications you are taking to see if they contain
acetaminophen. Be aware that abbreviations such as APAP, AC, Acetaminophn,
Acetaminoph, Acetaminop, Acetamin, or Acetam. may be written on the label in
place of the word acetaminophen. Ask your doctor or pharmacist if you don't
know if a medication that you are taking contains acetaminophen.
Treatment of Dental Pain
The combination of ibuprofen
[Advil] and acetaminophen [Tylenol] is extremely effective for treating dental pain. The two medications work
differently. Ibuprofen is a good
anti-inflammatory drug when used in high doses and acetaminophen is a good pain
reliever. I recommend a Tylenol-Advil
regime to patients with dental pain:
Tylenol Regular Strength [325
milligrams of acetaminophen] – Take 2 tablets every 4 hours [6 times a day] not
to exceed 12 tablets or 4000 milligrams.
Advil [200 milligrams of ibuprofen]
– Take 2 tablets every 4 hours [6 times a day] not to exceed 12 tablets or 2400
milligrams.
Several years ago, I began
prescribing this regime to my patients. Most patients have been impressed with
the effectiveness of this combination of ibuprofen and acetaminophen. This drug
combination makes a significant difference in patient comfort levels. As a
result of this effectiveness, I have been able to prescribe fewer narcotics in
my practice and hear reports of less discomfort. I learned about this drug
combination in one of the many continuing education seminars that my staff and
I attend as an office team.
When a dental infection is
involved, adding an antibiotic to this regime noticeably helps reduce dental
pain and swelling. If pain is not
controlled by these medications, then a narcotic medication such as Vicodin can
be taken. I tell patients to use the
Advil-Tylenol regime, but if they need to take a Vicodin, then do not take a
Tylenol since acetaminophen is found in Vicodin. However, they should keep taking the
ibuprofen when taking Vicodin. Actually
acetaminophen and ibuprofen work better for direct pain relief at the problem
site, such as a tooth ache, than narcotic medications. Narcotics work on the brain and replace the
pain sensation with euphoria, so the patient doesn't care that they have
pain. “I have a tooth ache, it hurts,
but ha, ha, ha; I feel great!”
Overdosing on Acetaminophen
Taking more than 4,000 milligrams
of acetaminophen for several days, can lead to liver damage. Common signs and symptoms of possible liver
damage include abnormally yellow skin and eyes (jaundice), dark urine,
light-colored stools, nausea, vomiting and loss of appetite. Because these
signs and symptoms are similar to those of flu, they are often unnoticed for
several days and believed to part of the initial illness. Serious cases of
liver disease can lead to mental confusion, coma and death.
As with
most medications, children should be dosed at a lower level of acetaminophen
than adults. To avoid errors, the measuring tool packaged with the medicine
should be used and a record kept of the treatment times and the doses give to
the child. Make sure to share this
information with caregivers so they will know how much acetaminophen your child
has taken.
Alcohol affects livers as well as
acetaminophen. Acetaminophen-containing
products should not be used if three or more alcoholic drinks are consumed in a
day. The medication should also not be
used in cases of alcohol abuse, active liver disease or past liver damage. Acetaminophen should also not be taken in
individuals with advanced kidney disease, or in individuals that are
malnourished or are fasting.
Acetaminophen increases the risk of
bleeding in persons taking warfarin [a common brand name is Coumadin by
Bristol-Meyers Squibb]. Acetaminophen
should be avoided if you are taking warfarin.
If you have any of these
conditions, tell your dentist or physician. You can determine if an over-the-counter
medicine contains acetaminophen by checking the product’s drug facts label
under the heading "active ingredients." If you don’t know the active
ingredients of your prescription medicines, ask your dentist or physician. You
should follow all directions on the drug facts label, and/or prescription
label. Acetaminophen is a great
medication for pain if used wisely.
