There are many over-the-counter medications like acetaminophen, the active ingredient in Tylenol, that consumers assume are safe. However, this could not be further from the truth. In fact, if taken too often or misused, acetaminophen can cause some alarming short and long-term effects.

Acetaminophen was first patented in 1951 as an aspirin alternative but it did not gain attention until 1955 when Tylenol marketed the drug as a safe pain reliever and fever reducer for children.

Dangers of Acetaminophen

Many studies have been conducted to measure the statistics of the emergency room, hospital visits, and deaths related to both accidental and intentional overdoses of acetaminophen. Approximately 450 deaths occur annually due to overdoses related to acetaminophen effects, primarily being an acute liver failure. Around 82,000 emergency room and hospital visits occur because of overdoses from the drug. In fact, the top reason for calls to Poison Control Centers in the US is acetaminophen overdose.

Even for those who just think they are using it as needed may find themselves suffering consequences because it can be extremely toxic when taken at recommended doses for extended periods of time. While the FDA has suggested that health professionals not dispense prescriptions exceeding 325 mg. per dose, there has been little else done to warn consumers about the serious implications of taking acetaminophen.

Drug Interactions:

According to (, a total of 172 drugs interact with acetaminophen. Of these drugs, there are 14 major interaction, 65 moderate, and 93 minor interactions. The major drugs interactions include but are not limited to alcohol, lidocaine, epinephrine, prilocaine, and sodium nitrate. Other more common drugs that should not be taken in conjunction with acetaminophen are aspirin, naltrexone, phenobarbital, and warfarin.

Short-Term Side Effects of Acetaminophen:

There are no common side effects and although serious side effects are rare, they can cause severe consequences. Among the more serious reported side effects are skin reactions, allergic reaction, and overdose.

Skin Reactions

Although rare, there are three main skin reactions that are linked to acetaminophen. According to a Mercola article, Acetaminophen—More Dangerous Than You Ever Suspected, between 1969 and 2012, there were 107 serious cases of skin reactions linked to acetaminophen. Of these cases, 7 died and 67 required hospitalization. The three main skin reactions linked to acetaminophen are Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TENS), and Acute Generalized Exanthematous Pustulosis (AGEP). SJS and TENS both begin with flu-like symptoms and develop into blisters. TENS is fatal in many cases and SJS can be fatal. AGEP is characterized by the development and pustules and fever and usually clears up within a couple of weeks of not taking acetaminophen.

Allergic Reactions

The symptoms of an allergic reaction to acetaminophen include difficulty breathing and swallowing, along with swelling of the throat, tongue, lips, face, eyes, hands, ankles, and feet.


Whether accidental or intentional, overdose on acetaminophen is a significant issue and requires medical attention. The initial signs of an overdose include nausea, vomiting, stomach pain, loss of appetite, weakness, confusion, and sweating. Later symptoms that can indicate liver and/or kidney problems resulting from overuse or overdose include upper abdominal pain, jaundice, and dark urine.

Long-Term Damage from Acetaminophen Effects:

Liver Damage and Failure

Liver damage or injury can result from overdose or prolonged use combined with alcohol use. Overdose on acetaminophen is the main cause of acute liver failure in both the United States and the United Kingdom.

While intentional overdose is the most commonly reported, accidental overdose can occur from either taking other medications with acetaminophen, children ingesting accidentally out of curiosity, or if a caregiver gives a larger dose to children or infants by mistake.

Long-Term Kidney Damage and Failure

According to a study from 2001 New England Journal of Medicine, acetaminophen is also associated with kidney damage and end-stage kidney disease.


Acetaminophen can serve a valuable purpose for short-term pain relief and fever reduction, but the mere fact that it is available without a prescription does not mean you should ignore all precautions or dosing instructions. To avoid short-term or long-term acetaminophen effects, always take the drug only as needed and not for long-term use unless directed to do so by your physician.