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Pain Issues Author: Staff Editor Last Updated: Sep 7, 2017 - 10:06:33 PM

Acetaminophen — Safest Choice for Nonprescription Pain Relief

By Staff Editor
Dec 19, 2013 - 7:02:18 PM

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( - ROCHESTER, Minn. - Acetaminophen, taken as directed, is the safest nonprescription pain reliever choice available, according to the December issue of Mayo Clinic Health Letter.

But too much acetaminophen (Tylenol, others) can cause serious liver damage or even liver failure. The maximum dose for adults in 24 hours is generally 4,000 milligrams (mg), but some manufacturers are voluntarily setting the maximum dose even lower.

Excess acetaminophen interferes with the liver's ability to neutralize toxic substances. It changes the usual breakdown process in the liver, and a small amount of toxic compound is produced. Working normally, the liver detoxifies this toxin with glutathione, a compound stored in the liver. A healthy liver stores an adequate amount of glutathione to do the job - if acetaminophen levels don't exceed the recommended maximum dose on a regular basis.

Managing daily doses requires vigilance and label checking. Acetaminophen is found in more than 600 medications, both prescription and nonprescription. In addition to pain relievers and fever reducers, acetaminophen is used in nonprescription combination products to treat coughs, colds, flu and allergies and in sleep aids. Among combination prescription drugs, acetaminophen often is paired with opioids, such as codeine (Tylenol with Codeine, others), oxycodone (Percocet, Roxicet, others) and hydrocodone (Vicodin, Norco, others).

Many nonprescription products are nonsteroidal anti-inflammatory drugs (NSAIDs). Examples include ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). They provide pain relief and reduce inflammation. But when used at higher doses and for longer periods, NSAIDs pose the risk of stomach ulcers and bleeding or kidney problems. Proper use of acetaminophen isn't associated with these side effects.

Mayo Clinic Health Letter es un boletín de noticias mensual de ocho páginas que contiene información confiable, precisa y práctica sobre lo último en salud y medicina. Para suscribirse, por favor, visite


About Mayo Clinic

Mayo Clinic is the first and largest integrated, not-for-profit group practice in the world. Doctors from every medical specialty work together to care for patients, joined by common systems and a philosophy of "the needs of the patient come first." More than 3,700 physicians, scientists and researchers, and 50,100 allied health staff work at Mayo Clinic, which has campuses in Rochester, Minn; Jacksonville, Fla; and Scottsdale/Phoenix, Ariz.; and community-based providers in more than 70 locations in southern Minnesota., western Wisconsin and northeast Iowa. These locations treat more than half a million people each year. To obtain the latest news releases from Mayo Clinic, go to For information about research and education,


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