- A Visual Guide to Migraine Headaches Slideshow
- Headache and Migraine Triggers Slideshow
- Take the Migraines Quiz
- What is acetaminophen? How does it work (mechanism of action)?
- What are the uses for acetaminophen?
- What are the side effects of acetaminophen?
- What is the dosage for acetaminophen for children and adults?
- What drugs interact with acetaminophen?
- Is acetaminophen safe to take if I'm pregnant or breastfeeding?
- What brand names are available for acetaminophen?
- What else should I know about acetaminophen?
What is acetaminophen? How does it work (mechanism of action)?
Acetaminophen belongs to a class of drugs called analgesics (pain relievers) and antipyretics (fever reducers). The exact mechanism of action of acetaminophen is not known. It may reduce the production of prostaglandins in the brain. Prostaglandins are chemicals that cause inflammation and swelling. Acetaminophen relieves pain by elevating the pain threshold, that is, by requiring a greater amount of pain to develop before a person feels it. It reduces fever through its action on the heat-regulating center of the brain. Specifically, it tells the center to lower the body's temperature when the temperature is elevated.
The FDA approved acetaminophen in 1951.
What are the uses for acetaminophen?
Acetaminophen is used for the relief of fever as well as aches and pains associated with many conditions. Acetaminophen relieves pain in mild arthritis but has no effect on the underlying inflammation, redness, and swelling of the joint. If the pain is not due to inflammation, acetaminophen is as effective as aspirin.
Acetaminophen is as effective as the non-steroidal anti-inflammatory drug ibuprofen (Motrin) in relieving the pain of osteoarthritis of the knee. Unless directed by a physician, acetaminophen should not be used for longer than 10 days.
What are the side effects of acetaminophen?
When used appropriately, side effects with acetaminophen are not common.
Other important side effects include:
- Hypersensitivity reactions
- Serious skin reactions
- Kidney damage
- Reduced number of platelets in the blood (thrombocytopenia)
Chronic alcohol use may also increase the risk of stomach bleeding. The most serious side effect is liver damage due to large doses, chronic use or concomitant use with alcohol or other drugs that also damage the liver.
Other serious side effects that have been reported include bleeding in the intestines and stomach, angioedema, Stevens-Johnson syndrome, and kidney damage. A reduction in the number of white blood cells has also been reported.
What is the dosage for acetaminophen for children and adults?
- The dose for adults is 325 to 650 mg every 4 hours or 500 mg every 8 hours when using immediate release formulations.
- The dose for extended release caplet is 1300 mg every 8 hours.
- The maximum daily dose is 4 grams.
- The oral dose for a child is based on the child's age and weight. If less than 12 years of age, the dosing is 10-15 mg/kg every 6-8 hours not to exceed 2.6 g/day (5 doses). If older than 12 years of age the dose is 40-60 mg/kg/day every 6 hours not to exceed 3.75 g/day (5 doses).
What drugs interact with acetaminophen?
Acetaminophen is metabolized (eliminated by conversion to other chemicals) by the liver. Therefore drugs that increase the action of liver enzymes that metabolize acetaminophen, [for example, carbamazepine (Tegretol), isoniazid, rifampin (Rifamate, Rifadin, and Rimactane),] reduce the levels of acetaminophen and may decrease the effectiveness action of acetaminophen.
Doses of acetaminophen greater than the recommended doses are toxic to the liver and may result in severe liver damage. The potential for acetaminophen to harm the liver is increased when it is combined with alcohol or drugs that also harm the liver.
Cholestyramine (Questran) reduces the effect of acetaminophen by decreasing its absorption into the body from the intestine. Therefore, acetaminophen should be administered 3 to 4 hours after cholestyramine or one hour before cholestyramine .
Acetaminophen doses greater than 2275 mg per day may increase the blood thinning effect of warfarin (Coumadin, Jantoven) by an unknown mechanism. Therefore, prolonged administration or large doses of acetaminophen should be avoided during warfarin therapy.
Quick GuideMigraine or Headache? Migraine Symptoms, Triggers, Treatment
Is acetaminophen safe to take if I'm pregnant or breastfeeding?
What brand names are available for acetaminophen?
Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain Reliever, Little Fevers Infant Fever/Pain Reliever, PediaCare Single Dose Acetaminophen Fever Reducer/Pain Reliever, Infants Feverall, Acephen, Neopap, and others.
What else should I know about acetaminophen?
What preparations of acetaminophen are available?
- Solution/suspension/syrup: 160 mg/5 ml
- Liquid: 500 mg/ml
- Chewable tablets: 80, 160 mg
- Tablet (disintegrating) 80, 160 mg
- Caplets: 325, 500, 650 mg
- Caplet (extended release): 650 mg
- Gelcaps: 500 mg
- Geltabs: 500 mg
- Suppository: 80, 120, 325, 650 mg
How should I keep acetaminophen stored?
Tablets and solutions should be stored at room temperature 15 C to 30 C (59 F to 86 F). Suppositories should be refrigerated between 2 C and 27 C (35 F and 80 F).
A prescription is not necessary for OTC acetaminophen, however, medicines that contain acetaminophen and another painkillers such as hydrocodone (Norco, Vicodin) or codeine (Tylenol #4) require a prescription.
Migraines and Headaches Resources
Acetaminophen is a drug that reduces fever and relieves pain. It is available alone, or in combination with hundreds of other drugs available both over-the-counter (without a prescription) or that that may require a prescription from your doctor, for example, acetaminophen and hydrocodone (Vicodin, Norco) or acetaminophen and oxycodone (Percocet).
Acetaminophen treats a variety of diseases or other medical problems that cause pain or fever. Examples of conditions acetaminophen treats include, headache, minor arthritis pain, back pain, tooth pain, menstrual cramps, PMS, osteoarthritis, common cold, tension headache, chronic pain, hip pain, shoulder and neck pain, sore throat, sinus infection, teething, TMJ, bites and stings, and sprains and strains.
Acetaminophen generally has no side effects when taken as prescribed. When
side effects are experienced, the most common are headache, rash, and nausea.
In 2014, the FDA recommended that doctors and other health care professionals only prescribe acetaminophen in doses of 325 mg or less. This warning highlights the potential for allergic reactions, for example, face, mouth, and throat swelling, difficulty breathing, itching, or rash. This action also will help reduce the risk of severe liver injury and serious allergic reactions associated with this drug. Other possible serious side effects adverse effects include anemia, kidney damage, thrombocytopenia (a reduced number of platelets in the blood), and liver problems.
Other patient information. Do not take more than one product that contains acetaminophen at the same time. Do not take more than one acetaminophen-containing drug than directed. Do not drink alcohol while taking medicine that contains acetaminophen due to severe liver damage.
REFERENCE: FDA Prescribing Information.
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Treatment & Diagnosis
- Joint Pain
- Menstrual Cramps
- Neck Pain (Cervicalgia)
- Elbow Pain
- Knee Pain
- Shoulder Pain
- Sore Throat (Pharyngitis)
- Doctor: Checklist to Take To Your Doctor's Appointment
- Chronic Pain
- Buttock Pain
- Foot Pain
- Swollen Ankles and/or Swollen Feet
- Heel Pain
- Jaw Pain
- Arm Pain
- Sore Tongue
- Painful Gums
- Ankle Pain
- Hip Pain
- Unsteady Gait
- Joint Stiffness
- Swollen Joints
- Wrist Pain
- Toe Pain
- Rectal Pain
- Finger Pain
- Hand Pain
- Joint Cracking (Joint Popping)
- Stiff Neck
- Common Cold
- Infectious Mononucleosis (Mono)
- Kidney Stone
- West Nile Virus
- Chronic Sore Throat
- Peripheral Neuropathy
- Measles (Rubeola)
- Hand, Foot, and Mouth Disease
- Enterovirus (Non-Polio Enterovirus Infection)
- Joint Redness
- Joint Deformity
- Upper Respiratory Infection
- Groin Pain
- Zika Virus Infection
- Tightness in Chest
- Cold & Flu FAQs
- Headaches FAQs
- Back Pain FAQs
- Pain FAQs
- Chickenpox FAQs
- Strep Streptococcal Throat Infection FAQs
- Tylenol Toxicity
- Pain Management Over-The-Counter
- Prescriptions: Complying with the Doctor's Orders
- Drug Interactions: Know Ingredients, Consult Your Physician
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Pain (Acute and Chronic)
- Drugs: Buying Prescription Drugs Online Safely
- Drugs: The Most Common Medication Errors
- Medication Disposal
- Dangers of Mixing Medications
- Swine Flu: One New York City Pediatrician's View
- Propofol (Diprivan) Safety
- Swine Flu Symptoms, Diagnosis, and Vaccination
- What to Do in a Drug Recall
- Kidney Infections During Pregnancy
- Living With Rheumatoid Arthritis
- Home Remedies for Shingles
- Can Children Get Erythema Nodosum?
- Is Reye Syndrome Less Common than It Used to Be?
- Why Is It Called Reye's Syndrome?
- Osteoarthritis of the Hands
- Home Remedies, Treatment, and Prevention of Sprains and Strains
- When to Call the Doctor for Fever, Nausea, Diarrhea, Colds, and Coughs
- Bug Bite Treatment
- Pain Relievers and High Blood Pressure
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- Percocet (oxycodone and acetaminophen, Roxicet, Tylox, Oxycet)
- hydrocodone/acetaminophen (Vicodin, Norco)
- propoxyphene and acetaminophen, Darvocet A500; Darvocet-N, Wygesic
- OTC Pain Relievers and Fever Reducers
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- tramadol and acetaminophen, Ultracet
- expectorant/decongestant/narcotic antitussive/acetaminophen-oral
- pentazocine/acetaminophen - oral, Talacen
- isometheptene, acetaminophen, dichloralphenazone - oral, Amidrine, Isocom, Midchlor, Mi
- butalbital/acetaminophen - oral, Phrenilin
- decongestant/narcotic antitussive/acetaminoph/antihistamine - oral
- acetaminophen/phenyltoloxamine-oral, Dologesic, Flextra-650, Novagesic, Rhinoflex, Staflex
- butalbital/acetaminophen/caffeine (Esgic, Fioricet)
- salicylamide/acetaminophen/phenyltoloxamine - oral, Anabar, Dolorex, Lobac
- butalbital/acetaminophen/caffeine (Alagesic LQ, Capacet, Dolgic Plus, Esgic, Fioricet, and Others)
- dimethyl fumarate (Tecfidera)
- Oxycodone vs. Vicodin (hydrocodone/acetaminophen) for Pain
- Acetaminophen vs. Ibuprofen for Pain (Differences in Side Effects and Dosage)
Prevention & Wellness
- Pfizer Recalls a Type of Children's Advil
- As U.S. Kids Take More Meds, Dangerous Drug Mixes Could Rise
- Non-Opioids Often Underused After Back Surgery
- Fighting a Cold or Flu? Beware of Overdosing on Tylenol
- Acetaminophen in Pregnancy Tied to Language Delays -- in One Sex
- Many Migraine Sufferers Given Unecessary Opioids, Study Finds
- Medication Mistakes Have Doubled in U.S. Since 2000: Study
- When Is an Opioid Safe to Take?
- Marathon Running May Cause Short-Term Kidney Injury
- Fewer U.S. Kids Overdosing on Opioids
- Spring-Clean Your Medicine Cabinet to Safeguard Your Kids
- Kids' OD Risk Rises When Opioids Left Out at Home
- Try Drug-Free Options First for Low Back Pain, New Guidelines Say
- Common Painkillers Don't Ease Back Pain, Study Finds
- Kids Born to Opioid-Addicted Moms Seem to Fare Poorly in School
- Many Misuse OTC Sleep Aids: Survey
- Everyday Pain Relievers May Be Linked to Hearing Loss in Some Women
- Drug Use by U.S. Teens Drops to All-Time Low
- Self-Harm a Cause of Death During Pregnancy and for New Moms
- Number of Americans With Severe Joint Pain Keeps Rising
- Countless Opioid Pills Unused by Dental-Surgery Patients
- Nanoparticles Ease Aching Joints in Mice
- Codeine Not Safe for Kids, Pediatricians Warn
- Health Tip: Preparing for Baby's First Teeth
- Non-addictive Painkiller Shows Promise in Animal Trials
- Kids With Mild Asthma Can Take Acetaminophen: Study
- Acetaminophen and Pregnancy: Bad Mix?
- Acetaminophen During Pregnancy May Up Risk of ADHD in Kids
- Fentanyl-Laced 'Norco' Is Lethal, Report Warns
- New Guidelines Issued for Cancer Patients' Post-Treatment Pain
- Opioid Abusers Missing Out on Addiction-Fighting Drug
- Tai Chi: Rx for Arthritic Knees
- Health Tip: Watch Medication Use During Pregnancy
- More People Surviving Sudden Liver Failure
- Nearly All U.S. Doctors 'Overprescribe' Addictive Narcotic Painkillers: Survey
- Infant Ear Infections Becoming Less Common
- Acetaminophen Won't Help Arthritis Pain, Study Finds
- Health Tip: Managing a Fever at Home
- Prenatal Acetaminophen Use Tied to Higher Asthma Risk in Kids: Study
- Many Chronic Pain Sufferers May Overuse Nonprescription Painkillers
- No Antibiotics for Common Respiratory Infections: Experts
- Acetaminophen Tops List of Accidental Infant Poisonings
- Did Painkiller Crackdown Cause Heroin Epidemic?
- Try Home Remedies for Child's Cough or Cold
- Hawaii Facing Rise in Dengue Fever Cases
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- Prescription Naproxen as Good as Narcotic Painkillers for Low Back Pain: Study
- Kids' ER Visits for Medicine Overdoses Dropping: Report
- Searing Heat, High Humidity a Threat to Your Health
- Prescription Meds: Too Common in Pregnancy?
- Antidepressant, Painkiller Combo May Raise Risk of Brain Bleed
- Many Migraine Sufferers Given Narcotic Painkillers, Barbiturates
- Do Certain Medicines Raise Murder Risk?
- Many Americans Under 50 Living With Cold Sore Virus
- Teens With History of Self-Poisoning Face Greater Suicide Risk
- Could Taking Acetaminophen Dull Your Happiness?
- Ear Infections Common, But Often Missed, in Infants
- Study Casts Doubt on Acetaminophen for Low Back Pain, Arthritis
- Health Tip: Don't Mix Meds and Alcohol
- Does Long-Term Acetaminophen Use Raise Health Risks?
- Morphine After Tonsillectomy Tied to Breathing Problems in Study
- Study Rates Migraine Medications
- Tips for Steering Clear of Flu
- Knee Arthritis Drugs Beat Placebos, but Study Finds No Clear Winner
- No Link Between Acetaminophen in Pregnancy, Asthma in Kids: Study
- Some Painkillers Tied to Bleeding Risk in Those With Abnormal Heartbeat
- Placebo Treatment May Quiet Kids' Cough
- Circumcision Past Newborn Stage Poses Risk for Boys, Study Finds
- Doctors' Group Issues Painkiller Guidelines
- Kids Prescribed Antibiotics Twice as Often as Needed, Study Finds
- Acetaminophen May Not Help Against Back Pain, Study Contends
- Tips for Beating BBQ Burns
- Chikungunya Virus: Questions and Answers
- Use Prescription Painkillers Safely
- Taking Blood Thinners With Certain Painkillers May Raise Bleeding Risk
- More ERs Treating Headaches With Narcotics, Study Finds
- Use of Tylenol in Pregnancy Tied to Higher ADHD Risk in Child
- Daily Aspirin May Guard Against Ovarian Cancer
- Hand Washing, Zinc May Ward Off Colds: Review
- Health Tip: Coping With Strep Throat
- FDA Warns Against Prescription Drugs With High Levels of Acetaminophen
- Health Tip: Don't Take Too Much Acetaminophen
- Health Tip: Keep a First Aid Kit in the Car
- Acetaminophen and Alcohol a Bad Mix, Study Suggests
- Tylenol and Alcohol a Bad Mix, Study Suggests
- FDA OKs New Hydrocodone Painkiller
- After Tonsillectomy, Over-the-Counter Painkillers Suffice, Study Says
- Weight-Loss Surgery May Add to Painkiller Dependence, Study Says
- Opioids Not Winning the Battle Against Pain, Study Suggests
- Health Highlights: Aug. 30, 2013
- Most Medications OK During Breast-Feeding, Report Says
- FDA Warns of Rare Skin Reactions to Acetaminophen
- Docs Order Too Many Narcotics, Pricey Scans for Back Pain: Study
- Tylenol-Induced Liver Failure Presents Own Set of Problems: Study
- Most Pregnant Women Treated for Migraines Able to Deliver Vaginally
- Daily Aspirin Linked to Lower Risk for Deadly Skin Cancer in Women
- Codeine Risky for Kids After Certain Surgeries, FDA Says
- Medical Marijuana: Voodoo or Legitimate Therapeutic Choice?
- Doubling Up on Cold, Flu Remedies May Harm Liver
- Common Painkillers Tied to Kidney Risks for Children: Study
- Painkillers Before Exercise May Be Bad for the Gut
- Health Tip: Make Sure Kids Get Enough Water
- Health Tip: Treating Bronchitis
- Health Tip: Managing Chronic Fatigue Syndrome Pain
- Health Tip: Don't Combine Medication and Alcohol
- 'Where Is My Excedrin?'
- 'Excellent' Survival Seen for Liver Transplant From Live Donor
- When Prescription Drugs Go OTC, Ads Talk Less of Harms: Study
- Common Painkillers May Be Risky After Heart Attack
- Health Tip: Caring for an Ingrown Toenail
- Steroids Won't Ease Most Sinusitis Attacks, Study Finds
- The Health Benefits, and Risks, of Alcohol
- 'Abuse-Resistant' Oxycontin May Be Driving Addicts to Heroin
- Tylenol Overdose Can Be Deadly for a Child
- Scientists Spot More Migraine Genes
- Many Americans Taking Too Much Acetaminophen
- Patients May Receive Too Much Acetaminophen in Hospital
- Health Tip: Caring for a Sunburn
- Health Highlights: April 19, 2012
- Taking Multivitamins Won't Prevent Canker Sores, Study Says
- Antibiotics Do Not Reduce Symptoms of Sinus Infection
- Epidural Plus Fever in Mom May Raise Risks for Baby
- IV Acetaminophen Linked to More Child Overdoses
- Bufferin, Excedrin, NoDoz, Gas-X Recalled
- Spinal Manipulation, Home Exercise May Ease Neck Pain
- Infant Acetaminophen Dosage Change May Cause Confusion
- Infants May Sleep Better When Vaccinated in Afternoon
- Too Much Acetaminophen Over Time May Damage Liver
- Maggots May Help Heal Hard-to-Treat Wounds
- NSAIDs May Raise Miscarriage Risk: Study
- Supplement May Ease Pain of Hand Osteoarthritis
- New Dosing Labels for Extra Strength Tylenol
- New Tylenol Recall Due to Musty Odor
- Health Tip: Ease Neck Pain
- FDA Panel: Correct Acetaminophen Dose Depends on Kids' Weight
- The 10 Most Prescribed Drugs
- Acetaminophen in Pregnancy: Link to Baby's Asthma?
- Johnson & Johnson Recalls Even More Tylenol
- Tylenol Products Recalled
- FDA Warns of Acetaminophen in Prescription Pain Drugs
- Rolaids Recalled
- Acetaminophen: Teen Asthma Trigger?
- Tylenol Recall Grows Again
- FDA: Manufacturing Problems Led to Tylenol Recall
- Recall of Kids' Tylenol, Motrin, Zyrtec, Benadryl
- Pain Relievers May Reduce Cancer Risk
- 10 Ways to Manage Low Back Pain at Home
- Living with Chronic Pain
- 12 Tips for Family Emergencies
- On the Teen Scene: When Mono Takes You Out of the Action
- Sleep Better When You're Sick
- Drug Name Confusion: Preventing Medication Errors
- Tylenol: Children's TYLENOL® Meltaways and SoftChews Recalled
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