I've heard people say that Tylenol is safe but many of us think that its safe maybe because its easily available but, what are the risks associated with Tylenol (acetaminophen/paracetamol)?
The main risk of Tylenol (aka acetaminophen/paracetamol) is liver damage, as this article from the FDA advises:
This drug is generally considered safe when used according to the directions on its labeling. But taking more than the recommended amount can cause liver damage, ranging from abnormalities in liver function blood tests, to acute liver failure, and even death.
Liver damage may take awhile to develop:
You may not notice the signs and symptoms of liver damage right away because they take time to appear. Or, you may mistake early symptoms of liver damage (for example, loss of appetite, nausea, and vomiting) for something else, like the flu. Liver damage can develop into liver failure or death over several days.
RxList recommends the maximum dosage as 3250 mg (3.250 grams) per day, which is pretty much in line with everything else I've read.
As I said in comments, nearly all drugs have some sort of side effects. That said, acetaminophen appears to be safe when taken as directed. While taking acetaminophen, you need to pay close attention to any other medications you may be taking that may include acetaminophen, such as cough and cold remedies. You also need to be careful that you're not taxing your liver with other things like alcohol.
Edit: In response to comments:
The aforementioned link to RxList also advises that up to 4 grams per day may be taken under the care of a healthcare professional, who will, presumably, monitor your hepatic function. Do not take this dose unless you are under the care of said professional! This statement in no way endorses this dosage.
As the other answer stated, the main risk is liver damage caused by overdose.
The reason why acetaminophen (including Tylenol) is so dangerous is that unlike alcohol whose effects you can notice in real time (if you drink another glass of alcohol you will notice that you are getting more drunk, and can therefore stop before you get alcohol-induced liver damage) with acetaminophen you don't notice the effects until it is already too late. By the time you notice effects from Tylenol overdose, you will certainly die without a liver transplant.
So education of the effects is important. Therefore, acetaminophen (including Tylenol) is considered unsafe for the following people:
- Adults who may harm themselves accidentally (intellectually-impaired, fragile-minded, etc, and adults who are not aware of the overdose risk)
- Adults at risk of intentional self-harm (prisoners, mental health patients, etc)
Tylenol is considered unsafe for that subset of the population described above. In those cases, there are 2 common recommendations:
- Give them NSAID (ibuprofen, aspirin etc) instead
And for intellectually-able adults who just don't know about the overdose risk, the recommendation is to educate them.
Tylenol is considered safe for intellectually-able adults who have been educated about the risks of acetaminophen overdose and who are not at risk of self-harm.