Acetaminophen (uh-see-tuh-min-uh-fuhn) is the main ingredient in Tylenol. It is a pain reliever and a fever reducer that is also great for headaches, minor pains, and aches. Acetaminophen belongs to a class of painkillers known as non-opioid analgesics, which means they do not relieve pain by acting directly on the central nervous system. Although scientist know how all of this class of painkillers works, they are still unsure about Acetaminophen. They believe it has something to do with inhibiting an enzyme, possibly the enzyme COX or cyclooxygenase which is a catalyst for the conversion of fatty acid to the prostaglandins. The prostaglandins produce pain and inflammation, which by inhibiting this would cause a pain relief effect and anti inflammation. Acetaminophen is that it is not an anti-inflammatory like the other non-opioid analgesics, which causes much debate about how this product works. Acetaminophen has also been known to cause liver damage and allergic reactions, so those with a poor liver, kidneys and/or allergies to this substance should not take it. This painkiller can also cause ulcers, sores, bloody urine, pain in the lower back, fever, tiredness, unusual bleeding and bruising, and pinpoint red spots on skin. Acetaminophen could interact with other drugs such as acetylsalicylic acid, alcohol, blood thinners like warfarin, carbamazepine, cholestryramine, isoniazid, phenobarbital, phenytoin, and rifampin. Makers of Tylenol are extremely Nervous over the acetaminophen controversy. It comes in many different forms for medicinal purposes such as; Liquid suspension, chewable tablets, coated caplets, gelcaps, geltabs, and suppositories. Common dosages are 325, 500 and 650 mg.

Acetaminophen is an ingredient in over 600 different medicines, including many of the pain relievers used to treat chronic pain conditions. It is also found in fever reducers and sleep aids, as well as cough, cold, and allergy medicines.
Acetaminophen comes as a tablet, chewable tablet, capsule, suspension or solution (liquid), drops (concentrated liquid; removed from U.S. market), extended-release (long-acting) tablet, and orally disintegrating tablet (tablet that dissolves quickly in the mouth), to take by mouth, with or without food. Acetaminophen also comes as a suppository to use rectally. Acetaminophen is available without a prescription, but your doctor may prescribe acetaminophen to treat certain conditions. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand.
Acetaminophen may also be used in combination with aspirin and caffeine to relieve the pain associated with migraine headache.
Acetaminophen may cause side effects.
Some side effects can be serious. If you experience any of the following symptoms, stop taking acetaminophen and call your doctor immediately:
  • rash
  • hives
  • itching
  • swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
  • hoarseness
  • difficulty breathing or swallowing
    • low fever with nausea, stomach pain, and loss of appetite;
    • dark urine, clay-colored stools; or
    • jaundice (yellowing of the skin or eyes).
  • 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. 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.
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. It is as effective as thenon-steroidal antiinflammatory drug ibuprofen (Motrin) in relieving the pain of osteoarthritis of the knee. Unless directed by physician, acetaminophen should not be used for longer than 10 days.
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. Chronic alcohol use may also increase the risk of stomach bleeding.
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Tuesday the Center for Drug Evaluation and Research held a joint meeting with the Drug Safety and Risk Management Advisory Committee, the FDA’s Nonprescription Drugs Advisory Committee and the Anesthetic and Life Support Drugs Advisory Committee to discuss the risks of taking acetaminophen.
Studies have concluded that thousands of Americans have suffered acute liver failure resulting from taking acetaminophen which is the main ingredient in the brand name Tylenol. They have also indicated that the drug has caused hundreds of deaths due to overdosing on the pain killer.
Although it was found that the drug is safe when strictly taken at recommended doses, acetaminophen can be dangerous when taken at too high of levels. Because it is commonly a hidden ingredient in pain relievers, cold medicines and fever reducers the conference was convened to discuss, among other things, the need for the public to be more aware of the risks.
Alcohol only increases the risk of liver damage and the committees are also calling for manufactures of drugs containing acetaminophen to display more comprehensive warning labels on their packaging. The panel is also considering making it mandatory for medical professionals to prescribe lower dosages and making the maximum daily dosage levels for over-the-counter acetaminophen to 3,250 milligrams rather than the limit of 4,000 milligrams prescribed per day.
Trail lawyers, in particular products liability attorneys, are keeping a close watch on the outcome of the meeting. They are not anticipating acetaminophen to face an onslaught of products liability cases; however, they are paying closer attention to what experts are saying about the drugs hazards as a result of the controversy.
The makers of Tylenol are also waiting anxiously for the outcome of this meeting to more accurately gauge the concern acetaminophen is causing. Nonetheless, it is currently considered safe at the proper dosages and will still be available to the public over the counter.
ABC News Medical Contributor Dr. Marie Savard said on “Good Morning America” earlier this week, “It’s important to say that they’re not considering taking acetaminophen off the shelves.” He went on to say, “When taken in the proper dosage, this is a safe drug that’s been used for more than a half century. The problem is that people often take more than the maximum dosage and that can cause serious liver damage and sometimes even death.”

Brief History of Acetaminophen

A derivative of coal tar, acetaminophen or paracetamol belongs to a class of drugs called “aniline analgesics”; and is the only drug known as such that’s still in use. It is in fact, the active metabolite of phenacetin, a well-known analgesic and antipyretic in the past; however, unlike phenacetin and its combinations, paracetamol is not known to cause cancer at therapeutic levels. The names paracetamol and acetaminophen are both derived from the chemical name of the compound para-acetylaminophenol. In certain contexts, this compound is simply called APAP, an abbreviation for N-acetyl-para-aminophenol. In this article, acetaminophen and paracetamol are used interchangeably, but since the title bears the name acetaminophen, this name will be used more often here than paracetamol.

In the United States, acetaminophen gained FDA approval in 1951 and was first distributed by Sterling-Winthrop Co. in 1953. The company promoted the drug as preferable to aspirin since children and people with ulcers could take it safely. Tylenol, the most popular acetaminophen brand in the U.S. was launched in 1955 by McNeil Laboratories which began to market acetaminophen under the brand name Tylenol Children’s Elixir, a pain and fever medication for children. Like acetaminophen and paracetamol, the word Tylenol also came from para-acetylaminophenol.

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Taking too much acetaminophen can cause liver damage, sometimes serious enough to require liver transplantation or cause death. You might accidentally take too much acetaminophen if you do not follow the directions on the prescription or package label carefully, or if you take more than one product that contains acetaminophen.This medicine could be found in majority of over the counter medicines.

It is an ingredient in more than 100 commercial products including Abensanil®, Acamol®, Acetagesic®, Alpinyl®, Alvedon®, Anaflon®, Anelix®, Anhiba®, Calpol®, Datril®, Dirox®, Doliprane®, Dymadon®, Enelfa®, Eneril®, Exdol®, Febrilix®, Febrolin®, Fendon®, Finimal®, Hedex®, Homoolan®, Lonarid®, Multin®, Panadol®, Phendon®, Tylenol®, Valdol®, and Valgesic®.

Common Uses and Potential Hazards
In addition to its use as a pain reliever, acetaminophen has a number of industrial uses, including:
  • Stabilizer for hydrogen peroxide solutions, to prevent the peroxide from breaking down too quickly
  • Raw material in the production of other pharmaceutical compounds
  • Raw material in the manufacture of photographic chemicals
  • Raw material in the production of azo dyes, dyes that contain nitrogen atoms at the core of their molecules

Mixing acetaminophen with alcohol can be very dangerous and
can cause “stomach upset, bleeding and ulcers, liver damage … and rapid heartbeat.”

Please read this before you take acetaminophen:

Do not take this medication without a doctor's advice if you have ever had alcoholic liver disease (cirrhosis) or if you drink more than 3 alcoholic beverages per day. You may not be able to take acetaminophen. Avoid drinking alcohol. It may increase your risk of liver damage while taking acetaminophen.

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have liver disease or a history of alcoholism.

Ask a doctor or pharmacist before using any other cold, allergy, pain, or sleep medication. Acetaminophen (sometimes abbreviated as APAP) is contained in many combination medicines. Taking certain products together can cause you to get too much acetaminophen which can lead to a fatal overdose. Check the label to see if a medicine contains acetaminophen or APAP.

  • low fever with nausea, stomach pain, and loss of appetite;
  • dark urine, clay-colored stools; or
  • jaundice (yellowing of the skin or eyes).
    • low fever with nausea, stomach pain, and loss of appetite;
    • dark urine, clay-colored stools; or
    • jaundice (yellowing of the skin or eyes).