Acetaminophen, most commonly known as Tylenol, is an over-the-counter (OTC) medication that is taken for pain and fever.  Acetaminophen is packaged by itself to treat pain and fever, but it is also included in 600 other OTC and prescription medications, like cold medications, sleep preparations, and pain medications.    It is viewed as a safe medication, but is it really as safe as we think?  This article is intended to educate you on the effects of acetaminophen in the body so that you can choose whether to give or not to give!

Acetaminophen is metabolized (broken down) in the liver using a compound called glutathione.  Glutathione is an antioxidant that is important for detoxifying the body.  When acetaminophen is taken, it can deplete the amount of glutathione in the body, thus reducing the body’s natural detoxification and immune response.  The more glutathione our body has the healthier it is and the better it heals itself.

Acetaminophen in high doses can cause liver toxicity, which can result in death.  Many people, especially children, accidentally overdose, because they are not aware that acetaminophen is in multiple medications.  You may be giving your child a cold & cough preparation and Tylenol for fever, thus resulting in accidental overdose.  Because you think it is safe, you may give just a little extra dose, or give it a little earlier than every 4 hours.  Some people use acetaminophen to purposely overdose in suicide attempts, including teenagers.

Some studies show that administration of acetaminophen (and ibuprofen) prior to some vaccines led to a reduced antibody response.     Administering acetaminophen to a non-febrile child does not appear to reduce the risk of febrile seizures.   Some studies find a correlation between acetaminophen use in the development of asthma and autism.  While, these studies are not conclusive and further study is needed, using caution with acetaminophen during pregnancy and infancy is warranted.

Recommendations:

  • Let your child have a fever. Fever is very effective at killing viruses and bacteria, reduces the duration of illness, and helps your immune system develop longer immunity.  Your child’s symptoms of illness are more important than the degree on the thermometer.  Read more here for the Case for Letting Fever Run its Course.  Call your pediatric healthcare provider for any fever in an infant 3 months or younger.
  • Do not give acetaminophen or ibuprofen prior to vaccines or to “prevent fever”.
  • If using rectal version, spread doses further apart (6-8 hours) as it is absorbed and peaks at different rates than oral.
  • Use appropriate dose when you choose to use acetaminophen.
  • When you choose to give your child cough and cold medications, give those without acetaminophen – ideally avoid combination medications altogether.
  • Consider ibuprofen for pain and fever for children over 6 months who are not dehydrated (ie significant vomiting/diarrhea).
  • As your child approaches an age where he/she may administer their own medications have discussions about balancing the safety and risk of medications AND the importance of following recommended dosage for medications.
  • Choose the use of acetaminophen judiciously.

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