Precautions if you take acetaminophen

Paracetamol (otherwise known as acetaminophen) is one of the common most pain relievers in the world, and its use is becoming more common in Brazil. But most people are unaware that paracetamol is also potentially a dangerous medication. Take too much, or with alcohol, and it can cause permanent, even fatal, liver damage.

Paracetamol (brand names Tylenol, Acetofen, Anatyl, Cetafrin, Dorfen, and others) is considered a safe pain and fever reliever when taken in the appropriate doses.

Unlike aspirin or non-steroidal anti-inflammatory agents (NSAIDs), paracetamol does not reduce inflammation. So, for example, paracetamol might be less effective for the inflammatory pain of arthritis. One advantage though of paracetamol over aspirin or the NSAIDs is that paracetamol does not irritate the stomach lining, and it does not thin the blood.

The Food and Drug Administration in the USA (the equivalent of Anvisa in Brazil) has over the past few years taken measures to limit the dosage size of paracetamol tablets, and the maximal daily recommended dose. This is because paracetamol overdose, either intentional or (usually) accidental, has become the biggest single cause of liver failure requiring liver transplant in the United States.

The big problem with paracetamol is when it is combined with alcohol—or when there is alcohol in your system—then it is much easier to overdose and suffer serious liver damage. It is best NOT to take paracetamol if you have alcohol in your body, consume 3 or more drinks of alcohol daily, or have pre-existing liver damage.

For otherwise healthy people (without liver problems or alcohol) the United States FDA recommends a maximal dose of 3000 mg per day. So that means that if you take the 750 mg tablet, you cannot take more than 4 per day, or one every six hours.

Best though if you want to take paracetamol is to find the 500 mg sized pills, and see if you can get relief with one-half or one tablet of 500mg every four to six hours. Again, even if you are healthy and don’t have alcohol in your system, the maximum dose acceptable is 3000 mg per day for an adult.

Be aware also that some pharmaceutical companies sell paracetamol in tablets or liquid form combined with other medications, so read carefully the label or package insert on any pain medicine you take.

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