Acetaminophen

Acetaminophen (term used in the United States, Canada, and Japan), APAP, or paracetamol (term used elsewhere) is a widely used OTC pain reliever and fever reducer.  A mild analgesic commonly used for the relief of headaches and other minor aches and pains, it is also a major ingredient in numerous cold and flu remedies.  While it is used to treat inflammatory pain, it is not classified as an NSAID because its anti-inflammatory action is quite weak.  Tylenol (OTC name) is acetaminophen and because it does not reduce inflammation it is not very helpful for people with arthritis or aching joints to use. 

It is imperative that acetaminophen be taken in recommended doses.  It is generally safe for use at these recommended doses, but even small overdoses can have serious health consequences.  It may be more toxic in overdose than other OTC painkillers, but may be less toxic when used chronically at recommended doses.  Acetaminophen is metabolized by the liver and side effects are multiplied if consumed with alcoholic drinks or when fasting. 

Overdoses can cause potentially fatal liver damage.  Severe kidney damage is also a possibility.  Symptoms of overdose begin several hours after ingestion and include nausea, vomiting, and pain as acute liver failure starts.  If an overdose is suspected  taking activated charcoal given within one hour of acetaminophen ingestion may treat the overdose.  Acetylcysteine should be given the acetaminophen levels are high.  Treatment within 10 hours of ingestion reduces the risk to the liver.