Acetaminophen Side Effects Include
Acute Liver Toxicity and Death

Acetaminophen side effects include acute liver toxicity from overdoses that caused 254 deaths in the first quarter of 2010, according to the Institute of Safe Medication Practices (ISMP). Acetaminophen is one of the most widely used drugs in the world with well-characterized safety profiles and tens of millions of consumers.

The report of adverse drug events (ADE) was contained in the November 4, 2010 QuarterWatch, a publication by the non-profit research group that identifies new drug risks and medication errors. It concluded that there was an alarming rise in reports of serious ADEs associated with acetaminophen side effects, including fatalities.

Deaths from acute liver toxicity caused by acetaminophen overdose accounted for 26.1% of 972 deaths, more than any other drug group, according to the ISMP.

Acetaminophen and prescription acetaminophen-hydrocodone in combination were ranked as the 5th and 6th most frequent suspect drugs in reported patient deaths in 2009, with 362 and 273 deaths, respectively, according to QuarterWatch June 17, 2010.

Acetaminophen side effects

Over-the-counter (OTC) acetaminophen (e.g., Tylenol), has been used to treat mild to moderate pain and fever for more than 50 years. Prescription acetaminophen-hydrocodone (e.g., Vicodin and generic preparations) is a narcotic combination drug prescribed for moderate to severe pain. When taken as directed, both types of acetaminophen drugs are safe and usually have no side effects.

However, acetaminophen side effects can result in severe or fatal liver damage with even a modest overdose.

Some rare side effects that might indicate an allergic reaction to the drug include:

  • Rash
  • Itching/swelling (especially of the face, tongue, throat)
  • Severe dizziness
  • Breathing difficulties

Some of the more severe acetaminophen side effects includes:

  • Acute liver toxicity
  • Allergic reactions including swelling, difficulty breathing, closing of throat, and more
  • Abdominal pain
  • Nausea
  • Unusual bleeding or bruising
  • Death

With current treatment, more than 90% of patients with acetaminophen effects of toxicity recover completely. Of those who develop acute liver failure, 70% survive and recover fully with supportive care within about 3 months. Acetaminophen poisoning is treated with the drug N-acetylcysteine (NAC), however, early treatment is important to full recovery. NAC does not reverse liver cell damage that has already occurred.

Many cases of overdose are caused by patients inadvertently taking more than the recommended dose (i.e., 4 grams a day) of a particular product, or by taking more than one product containing acetaminophen (e.g., an OTC product and an Rx drug containing acetaminophen). Acetaminophen, sometimes abbreviated as APAP from its pharmacological name acetyl-para-aminophenol, is unrecognizable as acetaminophen to the average consumer reading an ingredient label.

Acetaminophen is also frequently identified as a suspect drug in intentional fatal overdoses.

The acetaminophen-hydrocodone narcotic combination has special hazards if patients develop a tolerance to the narcotic and increase their daily intake, leading to a potentially fatal acetaminophen overdose.

What is hydocodone and acetaminophen?

Hydrocodone is in a group of drugs called narcotic pain-relievers, and is a cough suppressant, similar to codeine. Hydrocodone blocks the receptors on nerve cells in the brain that give rise to the sensation of pain. Acetaminophen is a non-narcotic pain reliever and fever reducer. Acetaminophen works by elevating the threshold to pain, that is, in order for pain to be felt, greater stimulation of the nerves responsible for the sensation of pain is necessary. It reduces fever through its action on the temperature-regulating center of the brain.

Frequently, hydrocodone and acetaminophen are combined in a single prescription drug to achieve moderate to severe pain relief for arthritis and other conditions.

As a narcotic, hydrocodone relieves pain by binding to opioid receptors in the brain and spinal cord. Acetaminophen is a less potent pain reliever that increases the effects of hydrocodone. While this combination drug is often prescribed as a generic, it is also recognized by brand names Vicodin, Lorcet, Lortab, Maxidone, Norco, Stagesic, Xodol, Zydone and others.

Acetaminophen and hydocodone side effects

Hydrocodone may be habit-forming and should be used only by the person it was prescribed for.

Less serious acetaminophen side effects and hydrocodone issues when combined in a drug include:

  • feeling anxious, dizzy, or drowsy
  • mild nausea, vomiting, upset stomach, constipation
  • headache
  • mood changes
  • blurred vision
  • ringing in the ears
  • dry mouth

Serious side effects (call your doctor at once) include:

  • shallow breathing, slow heartbeat
  • confusion, fear, unusual thoughts or behavior
  • feeling light-headed, fainting
  • seizure (convulsions)
  • problems with urination
  • severe nausea, stomach pain, loss of appetite, itching
  • dark urine, clay-colored stools, yellowing of the skin or eyes (jaundice)

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect or allergic reaction.

Note: Hydrocodone is an opioid, the use of which has doubled over the past 20 years. Best known for treating chronic pain from cancer, opioids have become common therapy to treat chronically severe osteoarthritis pain and to control pain of periodic flares of autoimmune diseases (e.g., rheumatoid arthritis). Despite its benefits, there are no randomized, controlled studies looking at the benefit/risk of long-term use of opioids in patients with chronic non-cancer conditions. As a result the risk of addiction or tolerance to these medications in these patients is not known.

What is the maximum recommended daily amount of acetaminophen?

The maximum allowable daily dose of acetaminophen is 4,000 mg (4 grams) daily. Labels warn you should not take this much for more than 10 days unless under direct medical supervision.

If you’re a woman, recent research has shown that continual routine use of as little as 500 mg of this pain reliever daily may elevate the risk of developing high blood pressure for some women.

The Nurses' Health Study has been following thousands of women for decades. Those who relied on acetaminophen nearly doubled their likelihood of developing higher blood pressure within a three-year period (American Journal of Hypertension, August, 2005). Regular use of ibuprofen and naproxen also raised the risk of hypertension.

In the study, continual use was defined as 22 times a month or more. The study showed that taking non-aspirin NSAIDs were 86% more likely to have high blood pressure than those who did not take NSAIDs. Those taking acetaminophen were twice as likely to be hypertensive. Aspirin did not increase the risk. The investigators conducted two prospective cohort studies, one involving 1,903 women and the other 3,220 women. Ages ranged from 34 to 77.

Study: Acetaminophen side effects increases risk of high blood pressure in older men

Men who take acetaminophen, aspirin or other types of non-steroidal anti-inflammatory drugs, known as NSAIDs, six to seven days a week have an increased risk of developing hypertension, according to a four-year study in the Feb. 26, 2007 Archives of Internal Medicine. The study was conducted by a group led by John Forman, MD, of the Brigham and Women’s Hospital in Boston, Massachusetts.

The study determined the high risk percent of developing high blood pressure than nonusers as follows:

  • Acetaminophen = 36%
  • NSAID = 38%
  • Aspirin = 26%

Similar results were observed when the number of pills taken per week was analyzed rather than frequency of use in days per week.

"Acetaminophen, ibuprofen and aspirin are the three most frequently used drugs in the United States," say the authors in the report. "Given their common consumption and the high prevalence of hypertension (in the United States), our results may have substantial public health implications, and suggest that these agents be used with greater caution."

The 16,031 men in the study had an average age of 64.7 years and did not have a history of high blood pressure at baseline. The results were, for the most part, consistent with the results of 2 previous large cohort studies, the Nurses' Health Study and the Physicians' Health Study, both of which demonstrated an increased risk of hypertension with these analgesic drug classes.

38% of American adults use complementary alternative medicine (CAM)

According to the National Institute of Health’s National Center for Complementary and Alternative Medicine (NCCAM), many Americans use complementary alternative medicine (CAM) in pursuit of health and well being--possibly to avoid acetaminophen side effects.

A government fact sheet on CAM reports that the 2007 National Health Interview Survey (NHIS) showed approximately 38 percent of American adults use CAM.

In a newer study April 7, 2011, Many Older People Use Both Prescription Drugs and Dietary Supplements by the NCCAM analyzing 3,070 people aged 75 and older, the following keys were found:

  • Nearly 75% of the participants took at least one prescription drug and one dietary supplement.
  • Approximately 33% used three or more prescription drugs and three or more supplements.
  • 10% combined five or more prescription drugs with five or more dietary supplements.
  • Individuals using prescribed NSAIDs, thyroid drugs, and estrogens were more likely to use dietary supplements.
  • Individuals who used prescription drugs for high blood pressure and diabetes were less likely to use dietary supplements.

The researchers concluded that there are a substantial number of older adults who take multiple prescription drugs as well as multiple dietary supplements.

Therefore, they recommend that patients discuss dietary supplement use with their health care providers. In addition, the researchers emphasized the need for further investigations to better define the clinical importance of interactions between drugs and supplements.

Are you a candidate for natural supplements to avoid acetaminophen side effects?,

As you can see in this report, acetaminophen side effects from overuse are potentially deadly serious.

If your answer is yes to any of the following questions, you may be a candidate to choose natural supplements instead:

  • Do you have pain that requires non-prescription or prescription medication as many as five days a week?

  • Do you wonder about the potential damage painkilling drugs have on your liver or other organs?

  • Are you discouraged with your present arthritis treatment program?

  • Are you disappointed with the overall results of your present treatment program, or feel that you have to increase the recommended dosage to get results?

  • If you could achieve the arthritis relief you need safely, without total reliance on drugs, wouldn’t it be worth a try?

One featured natural pain relief product has patent pending formulation

It’s possible to free yourself completely (or cut back substantially) from pain relief drugs by switching to the best safe alternatives. Do you fear acetaminophen side effects, or NSAID stomach issues?

The natural arthritis relief products featured on this site are based on science--concrete scientific evidence accumulated from hundreds of clinical studies--and not merely personal opinion.

Arthritis-Relief-Naturally explores clinically-proven, natural alternatives for pain relief of arthritis that safely reduce harmful side effects of drugs.

As an example, one featured natural pain relief complex is a proven, excellent substitute for acetaminophen or NSAIDs. It is effective against the 5 Lox and Cox 2 pain pathways--both of the major pathways—and is the only natural supplement of its kind on the market.

Its formulation and synergy is so unique that there's a patent pending on it. It’s manufactured by the number one natural nutrition company in the U.S.

It’s one of three arthritis products featured at the conclusion of this report.

A personal testimony—we no longer use pain relief drugs of any kind!

From other pages on this website, you may be aware that my husband and I both have osteoarthritis for many years.

We have both taken non-prescription acetaminophen and different NSAIDs, with disappointing results in reducing pain and relieving symptoms of joint swelling and stiffness. I am chemically sensitive, so I experienced acetaminophen side effects of nausea and stomach upset, and cannot tolerate the more pronounced gastrointestinal side effects of NSAIDs at all!

In 2003 the natural products company we were using for nutritional dietary supplements introduced a pain relief program, consisting of three complementary natural products containing no artificial flavors, sweeteners, colors, aspirin or preservatives.

My husband has knee osteoarthritis, and I have neck arthritis. We have had excellent results (our testimony) with pain relief, increased range of motion and elimination of swelling/stiffness.

We no longer use pain relief drugs of any kind, our arthritis symptoms are completely under control, and my husband is back to playing tennis as many as four times a week.

Three featured natural products for arthritis—they’re safe and they work!

If you are considering the use of natural products because of acetaminophen side effects or reactions to other drugs, we strongly recommend three supplements based on our personal use.

They are safe. They work. We continue to use them daily. If we don’t, our arthritis symptoms return full force. There’s no cure for arthritis.

For a fuller overview of the supplements and the herbal ingredients used in each, click on three natural pain products.

Each arthritis product has a specific purpose:

The goal of these unique arthritis products, when taken together, is to provide rapid pain relief, support sustained relief and promote joint renewal. However, each product can be ordered and effectively taken separately and you won’t have to worry about acetaminophen side effects.

Here’s a view on the same page to all three natural pain products. Here’s another info link to the pain trio.


Acetaminophen Side Effects Disclaimer: Health statements on this acetaminophen side effects page have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.








Acetaminophen for Arthritis. Eliminate all possibility of acetaminophen side effects. Are you taking acetaminophen for arthritis or non prescription NSAIDs with ineffective results? Worried about your health from taking too much for too long? Read this report for answers. Click here for more details.

Arthritis Products 3 safe natural products scientifically designed to fight pain and reduce dependency on pharmaceutical medicines. Each unique for rapid relief and joint health. Click here for details

Find Best Company. 30 questions concerning standards of excellence help find the best dietary supplement company. One company stands out with 90 published studies in prestigious medical journals, the gold standard for natural health products. Click here for more information

Natural Arthritis Pain Relief. Millions choosing herbal supplements when acetaminophen side effects are of concern or haven’t provided acceptable results. How to find the best pain relief….Click here for more

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Osteoarthritis Relief. Osteoarthritis is the most common type of arthritis. It affects joints of the knees, hips, fingers, lower spine and neck. Click here for more on osteoarthritis

Rheumatoid Arthritis Relief. Many of the natural or herbal supplements for osteoarthritis are also recommended for rheumatoid arthritis. Click here for RA natural treatment options


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