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Acetaminophen and Liver Failure: Paracetamol and Tylenol Side Effects

Updated on October 14, 2017
Think cough medicines and become familiar with all the concerns about acetaminophen and paracetamol.
Think cough medicines and become familiar with all the concerns about acetaminophen and paracetamol. | Source

Liver Failure and Death Due to Acetaminophen Overdose

A friend’s elderly mother had been ill with age-related issues for some time, but she was not dealing with anything unexpected for her stage of life.

That is why it came as a real shock to learn of her death. Since none of her known illnesses took her life the blow to her family and friends was even more difficult to bear.

She took acetaminophen for her painful aches and it built up in her system resulting in an overdose. Pain relief was her killer. She deteriorated surprisingly quickly and died unexpectedly once the problem was detected.

How do Side Effects Occur?

This over the counter (OTC) drug is a fast acting poison when its levels become concentrated in a person's system. If doses are repeated too quickly or when there is a slow build up of it in the body liver damage and liver failure can occur.

Reports say that the side effects of acetaminophen are now the most common reason people suffer critical liver failure in America. Combining that OTC with certain other prescription medications or herbal supplements increases the risks associated with using the pain relief product.

How can it be that so many people overdose and even die from liver failure because they use the pain reliever acetaminophen (also known as paracetamol) in an effort to relieve their pain symptoms?

Questioning OTC Pain Relievers

Know the Risks Related to Acetaminophen and Paracetamol!
Know the Risks Related to Acetaminophen and Paracetamol! | Source

Who is at Risk Of Acetaminophen Related Liver Failure and Death?

♦ Like my friend’s mother, the elderly are at risk of toxicity with this painkiller. There could be several factors at work, but how much medication is in their system and how those medicines build up due to their age increases the chance of an unexpected overdose.

♦ Liver transplant patients can be at risk and guidelines should be considered carefully.

♦ Patients with HIV, alcoholics, eating disorders, or who take alcohol containing medications such as cough syrup can have complications when taking acetaminophen or paracetamol containing products.

♦ People who take other medications, prescription or OTC, without checking on the safety of using them with acetaminophen can endanger their health.

♦ Teens and even children who decide to treat themselves for pain symptoms without telling their parents or another adult so they can get supervised advice on how to take acetaminophen are at risk.

♦ Children can have significant risks due to their age related needs, latent illness, improper nourishment, and more. Parents should be familiar with the alerts before giving these OTC products to their kids.

Why are More People at Risk of Acetaminophen Related Liver Failure than Most Realize?

♦ Evidenced-based studies show that the number of acetaminophen related liver failures is on the rise. Consistent reports indicate that taking this pain killer with narcotics, alcohol, depression medications, St. John’s Wort and a number of other medications could lead to toxicity.

♦ Not knowing that a multiple ingredient OTC product may label acetaminophen as APAP can lead patients to unknowingly take more than their intended dose. Not realizing that they have taken a harmful dose, they may take even more acetaminophen if they don’t feel better soon, or if they feel worse in a few hours.

♦ Failure to know that acetaminophen can have side effects is a weighty error. Recognizing the symptoms of acetaminophen related liver failure can take a patient several days. Failure to recognize that too much acetaminophen has been ingested leads to a critical delay in testing and treatment.

♦ Avoiding liver injury or even death when there is an overdose requires getting tested and treated within 24 hours, and some reports indicate that certain cases need that testing and treatment within 16 hours.

Anyone at any age may be surprised by the side effects that acetaminophen or paracetamol can have on their own or a loved one's liver.
Anyone at any age may be surprised by the side effects that acetaminophen or paracetamol can have on their own or a loved one's liver. | Source

What Causes Acetaminophen Poisoning?

♦ A primary cause of liver failure due to acetaminophen poisoning is a simple failure to read and follow the package directions for using any brand of this pain killer. No one is above this rule; everyone who breaks it is in danger of a dangerous and/or lethal overdose.

♦ Combining an acetaminophen tablet or capsule with another OTC drug that combines doses of acetaminophen with other symptomatic drugs is another primary cause of serious overdose.

♦ Reports indicate that it is possible for consistent use of fairly small doses to cause acute damage to the liver. Paramedics learn to recognize and deal with the symptoms because side effects are so common.

Is Acetaminophen a Safe Pain Killer?

There are always risks when taking medicines, but many doctors consider acetaminophen a safe pain blocking drug if used according to directions. A better way to look at the directions for taking this pain blocker might be to look at them as warnings.

Take the warnings seriously:

• Take acetaminophen drugs according to directions. Be aware that dosing instructions can change and read new packages.

• Adults administering acetaminophen to young children should be aware that children should not take the product designed for infants because in reality infant doses are more concentrated.

• If you have chronic health problems that require the use of other medication do not take acetaminophen until you have researched whether taking it with those other medications is safe.

• If you take acetaminophen do not take other OTC medications until you are absolutely certain that they do not also contain acetaminophen.

• If you realize that you have taken more than the recommended dose of acetaminophen seek medical attention immediately as delay could result in liver damage and/or failure.

Is Acetaminophen Overdose Really the Primary Cause of Death from Liver Failure?

Do you know anyone whose health has been compromised by liver failure due to using too much acetaminophen?

See results

Is the FDA Looking at Liver Damage, Liver Failure, Death, and Acetaminophen?

Yes, and the problem is being evaluated:

The failure of consumers to read and follow directions on acetaminophen product packaging could result in legal action requiring a doctor’s office visit and a prescription so that patients would be certain to have the education needed in order to take the pain killer safely and effectively.

American consumers could soon see the availability of this product greatly reduced as in other countries, as well as the dosages lowered. Fewer or no multiple ingredient products containing acetaminophen may be available in the future and a switch to other products such as NSAIDs may be on the horizon.

The solutions have their own set of complex problems, but hands down, the best solution is for patients to educate themselves about acetaminophen (called paracetamol in other countries) and consider its use carefully if a pain reliever is needed.

A Serious Look at the Dangers of Acetaminophen/Paracetamol

Natural Pain Control

Dealing with pain naturally is a great choice for many people, but it is important to know that there are guidelines to be aware of when choosing these products or using them from your own garden.

Supplements for Pain Relief offers good insight into this approach and other writers provide overviews on using natural analgesics. Reading about personal experience on managing pain naturally can be a real benefit.

Do your own research, though, and know the reccomendations for the specific choices you make. For instance, arnica works well for bruising but should never be used on an open wound. Do you know why?

Alert on OTC Pain Meds

More on Health

Taking care of our health can keep us from needing more medicines and can even reduce the amount we currently use.

• Studies are beginning to show concerns about long-term altered cognitive function when children take paracetamol (acetaminophen).

Cholesterol and flax seed--what could happen if you use ground flax seed like a medicine?

Smart food and healthy dieting.

• Do you possibly suffer from an undetected cow milk allergy?

• Diseases from food (aka food poisoning) can wreak havoc on your health.

Beware of Acetaminophen Side Effects: Tylenol & Paracetamol

♦ Were You Aware that Acetaminophen can Cause Liver Failure?

Submit a Comment
  • RTalloni profile imageAUTHOR


    5 years ago from the short journey

    David Carl:

    Thank you for letting me know that this information was helpful to you. We do need to be careful about the OTC products that are available for treating pain symptoms. What we don't know really can kill us.

  • David Carl profile image

    David Carl 

    5 years ago from New York


    Thank you. This Hub was very informative and helpful. I took two Tylenol this morning for back pain. I haven't done that in years. It was just what was in the medicine cabinet. i definitely will be more careful from now on.

  • RTalloni profile imageAUTHOR


    5 years ago from the short journey


    Thank you for stopping in to check out this information. We should be fully informed when using these products and I hope that this post will continue to be helpful to people who deal with pain via OTC pain medications.

  • DDE profile image

    Devika Primić 

    5 years ago from Dubrovnik, Croatia

    Acetaminophen and Liver Failure: Paracetamol and Tylenol Side Effects is an informative and is a helpful health hub. Always needed and you approached this title with thorough research.

  • RTalloni profile imageAUTHOR


    5 years ago from the short journey


    These pain relief products do have a measure of safety for many people, but it is important to know the side effects and stay alert to their causes when using them.

    Making decisions about using them from an informed perspective is essential. One important aspect of their use that we should be familiar with is staggered overdose:

    The CDC reports that about 150 Americans are known to die each year from accidental overdose. That figure does not include the number of damaged/injured livers (sometimes permanent) resulting in an estimated 78,000 trips to the ER for Americans each year.

    This report

    highlights more information. There are several reasons that the question of "how much is too much" has a complicated answer.

    Additionally, here is a post to help balance out the issues for everyone, including writers.

    Thanks much for checking this out and letting me hear from you. Stay safe!

  • DabbleYou profile image


    5 years ago

    I didn't know that paracetamol have side effects. One of our local commercials say that it's a relatively safe pain killer, safer than most other products.

    Thanks for an informative hub. :)

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    Tams R:

    There are way too many stories about the side effects of acetaminophen. While there may be times when there is no choice, it may be that very often, perhaps most often, there is a different, safer choice for pain relief.

    So glad you shared your story about the danger of combining acetaminophen with antihistamines. Thanks much for adding to this discussion.

  • Tams R profile image

    Tams R 

    7 years ago from Missouri

    I had thought Tylenol was safe always. When my daughter suffered a seizure at 18 months old things changed for me. She ran a high fever for a few days and the doctor gave her an antihistamine along with Tylenol. After the seizure which was considered an atypical febrile seizure the doctors told me several people have issues with Tylenol especially in combination with certain antihistamines. I haven't given her Tylenol since! Great informative hub!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    Thanks so much mary615. There's nothing like the voice of experience to help us understand a problem. So appreciate your visit and comments!

  • mary615 profile image

    Mary Hyatt 

    7 years ago from Florida

    You did a great service by researching and publishing this Hub. When I worked in medicine, we used to see first hand patients who had liver damage from acetaminophen. Thanks for sharing. I voted it UP, etc.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    An overdose is a horror story and the fact that there are so many ways to get one with acetaminophen makes this an important topic. So glad you came by with your input to help keep the warnings highlighted. Thanks for your votes, as well.

  • BkCreative profile image


    7 years ago from Brooklyn, New York City

    This is so horrific because it is oh so true. A major cause of liver failure as you mentioned is the fact that so many other drugs also contain acetaminophen - so when you also take a Tylenol (which I'm pretty sure is still on the recall list again - this time supposedly due to contamination at the factory) - you have just multiplied your risk of liver failure.

    By the way, when I was in England 10 years ago I preferred paracetamol to Tylenol so I always wanted to purchase several packs to bring back to the US (and it was so much cheaper) - but I was in a Tesco's and they told me there were now limits. I could buy 2 small packs (of 10 I think it was) but not 4 so my cousin bought the other 2 for me. Of course in the US you can buy all you want.

    Thanks for a very timely article and a very serious reminder. Our dependence on synthetic drugs continue to do us deathly harm.

    Rated up and more. Thanks again.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Following the proper dosing is imperative, but your approach to taking less than the recommended dose to see if that much will do the job is a smart move. I've experienced the same in having half the dose do the job, probably because I will put up with pain while trying to find a different solution than pain blockers. Part of that comes from wanting to solve the problem rather than relieve the symptoms, part of it comes from knowledge of the damage pain killers can do.

    Thanks much for adding helpful comments to this discussion!

  • ktrapp profile image

    Kristin Trapp 

    7 years ago from Illinois

    I had no idea that infant doses were more concentrated. It's so important to follow proper dosing. Even if I get to the point where I need to take something I tend to only take 1/2 the amount if 2 pills is the dose and still get the benefits.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Acetaminophen is actually prescribed by doctors even though it is also an OTC drug. I hadn't thought to mention that. The higher concentration of infant doses seems to be news to many people. It is produced that way to reduce the amount of fluid an infant has to swallow. The danger comes when parents think they should give a child sized dose of the infant product to an older toddler. Thank you so much for helpful comments and for your vote!

  • anglnwu profile image


    7 years ago

    Acetaminophen is so commonly prescribed that it's good to know there could be dangerous side-effects. Didn't know that infant doses are actually more concentrated .Thanks for the useful information and rated up.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Thanks much. I thought I knew enough about the danger of liver failure due to acetaminophen until I did some research after my friend's mother died. The products containing acetaminophen can be used wisely, but that requires knowledge and paying attention to the facts. Misuse by consumers and inattention by doctors may be primary factors that change the availability of acetaminophen for the American public.

    So appreciate your visit and input to help keep the issues with acetaminophen highlighted!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    Just Ask Susan:

    Although I knew that acetaminophen (also known as paracetamol) products could present some danger, I did not know the details until I did some research on the topic. Do encourage your mother in law to read up on the concerns. Thanks bunches for stopping by and sharing the info.

  • cherylone profile image

    Cheryl Simonds 

    7 years ago from Connecticut

    Lot's of information in this one. I am glad you shared, I was totally ignorant of how dangerous acetometophin could be especially to the very young or the very old. It used to be that tylenol was the go-to for pain, guess that will be changing in the future.

  • Just Ask Susan profile image

    Susan Zutautas 

    7 years ago from Ontario, Canada

    My mother in law is always taking Tylenol. I better send her a link to your hub as this is really scary stuff.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    You are welcome. Being certain that we know what all of the ingredient are in any product we use is imperative. Helping each other pay attention by talking and writing about the concerns is important. Thanks so much for helping to highlight this topic's issues by reading the hub and adding your comments to the discussion!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    You mention an important key to using any product safely--only when absolutely necessary.

    Thanks very much for your comment to help keep this topic highlighted!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    ethel smith:

    Yes, paracetamol and acetaminophen are the same pain reliever. I meant to mention that in my hub and I thank you for giving me the heads up that I failed to do so--have just added that information.

    Acetaminophen alone can and has caused liver damage and death, but a combination of drugs is a sign of danger.

    Thanks kindly for your helpful input to help highlight the problems associated with this drug.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    Shelly McRae:

    That's an excellent point, one that has perhaps contributed to deaths. Consumer responsibility cannot be ignored in some of the cases.

    So glad for your input--thanks for adding to this discussion!

  • AliciaC profile image

    Linda Crampton 

    7 years ago from British Columbia, Canada

    Thank you for the very important warning, RTalloni. Liver damage from acetaminophen is a scary thought, especially since so many people take the medication as a pain reliever and the name of an OTC product may not not indicate that acetaminophen is present. It's a great shame that your friend's mother died of acetaminophen poisoning when she could have lived longer, despite her health problems.

  • homesteadbound profile image

    Cindy Murdoch 

    7 years ago from Texas

    I do take tylenol for pain but only when I absolutely need to because the pain is preventing me from going to sleep. I have had liver problems before, and I knew this to be a problem. It's good to share so more people know about it.

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    Arlene V. Poma:

    Thanks for helping to highlight the topic with your comments. It is sad to see the careless use of products and prescriptions for the results are often devastating. You are right in pointing out that it is sometimes not until later in life that we see the consequences--a concept that is applicable to all areas of life, actually. Appreciate your input and votes very much!

  • ethel smith profile image

    Ethel Smith 

    7 years ago from Kingston-Upon-Hull

    Is this what is called paracetamol in the UK? I know that OTC can cause liver problems. So often though it is the combination of OTC drugs that can prove lethal, Interesting

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Thanks for stopping by and joining this dialogue!

    You might like to have your mom do some reading on acetaminophen and the elderly for it is important to be aware of the side effects that we don't hear enough about. All medicines need careful consideration before we take them, and certain people are more at risk than others.

    So appreciate that you helped highlight the topic with your input!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Thank you--sobering information is usually well able to speak for itself without our adding scare tactics, but our emotion will sometimes get in the way of letting serious issues do their own work.

    There is a lot of information on the dangers of acetaminophen products, but there seems to be a missing link in the education process--possibly because of the sheer numbers of people and drugs available.

    So glad that you were able to gain some new information because one sharing with another is going to help get the message out. Thanks for helping to highlight this hub's topic by sharing your comments, and for the vote!

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey


    Yes, and good points to keep in mind about acetaminophen products--all products for that matter.

    Thanks much for helping to highlight this topic with your input and for your votes!

  • Shelly McRae profile image

    Shelly McRae 

    7 years ago from Phoenix, Arizona

    Good information to have, RTalloni. Too often, people believe that because something is available over-the-counter, that it is safer than presciption meds and so can be taken without regard to dosage.

  • profile image

    Arlene V. Poma 

    7 years ago

    Very good to get the word out. I can't take Acetaminophen because of my kidneys. People don't seem to understand that in all phases of life, you need to protect your liver and your kidneys. It all makes sense down the road. Voted up and everything else.

  • rebeccamealey profile image

    Rebecca Mealey 

    7 years ago from Northeastern Georgia, USA

    I knew about this and usually take Ibuprofen, but will pop a Tylenol from time to time. My mother takes it quite often for arthritis, so thanks for the reminder.

  • DonnaCosmato profile image

    Donna Cosmato 

    7 years ago from USA

    I like the way you presented this is in an unbiased factual manner rather than using scare tactics. I especially appreciated the information about the infant formula being more concentrated than the child's formula. I would have thought it would be the other way around with the child's formula being the most concentration so that was educational. Voted up.

  • profile image


    7 years ago

    All those years of watching Tylenol commercials that lulled us into believing it was a safe drug, and now look what we're finding out. It's so important not to become overly dependent on these easily available drugs and to follow the directions on the label when we do take them. Thanks for sharing this timely information. Rated up and useful

  • RTalloni profile imageAUTHOR


    7 years ago from the short journey

    angela p:

    It is sobering, and I hope this info helps you do some research that will help you make the best decision for your health. The videos are full of interesting information.

    Thanks kindly for reading and commenting!

  • angela p profile image

    angela p 

    7 years ago from Richmond, Virginia

    This is very scary. I take a lot of tylenol for aches and pains...getting old I guess. This has made me think twice about the amount I take. Very good information.


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