Acetaminophen Easy on Stomach.
Wimpy on Relieving Arthritis Symptoms

Acetaminophen (known as paracetamol outside the United States) is a popular worldwide analgesic and fever reducer with tens of millions of consumers. As non-prescription Tylenol it is recommended for mild to moderate pain and fevers. As prescription acetaminophen-hydrocodone (combined), it is prescribed for moderate to severe pain. In either case it does not significantly relieve the arthritis symptoms of joint inflammation, swelling and stiffness.

Because it is remarkably safe when used as directed, and is generally well tolerated in the stomach, the drug is a preferred choice for temporary pain relief for many health issues, including arthritis. Acetaminophen is an alternative to non-steroidal anti-inflammatory drugs (NSAIDs), which have common side effects of abdominal pain and bleeding, nausea, heartburn and dizziness.

Acetaminophen works mostly on the central nervous system and is not an anti-inflammatory. It does not reduce the inflammatory swelling or stiffness caused by an injury or rheumatoid arthritis.

What is acetaminophen?

Acetaminophen is a non-narcotic analgesic (pain reliever) and antipyretics (fever reducer) that decreases the formation of prostaglandins, therefore relieving pain. It is found in over 100 over-the-counter medications for the relief of mild pain.

It’s best known by the brand name, Tylenol, the number one non-prescription choice of painkiller in the U.S. Click here for a list of acetaminophen brand names.

In addition to pain relief, acetaminophen is a common remedy for symptoms such as fever, colds and coughs.

For moderate to moderate-severe pain relief, acetaminophen is included in generic combination prescription medications, such as hydrocodone and acetaminophen (see details later in this report) but is more recognizable by the brand name Vicodin. Click here for a list of combination acetaminophen products combination brand names.

The combination of hydocodone/acetaminophen (HYCD/APAP) as a generic painkiller, manufactured by Mallinckrodt Pharmaceuticals and Watson Pharmaceuticals was the 2nd and 3rd most prescribed drug in America in 2007.

What is the maximum recommended daily amount of acetaminophen?

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

If you’re a woman, recent research in August, 2005 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 study involved 5,123 women participating in the Nurse’s Health Study at Harvard Medical School and Brigham and Women's Hospital in Boston. Results were published in the American Heart Association journal Hypertension.

A Jan. 14, 2014 post on Medline Plus cites the FDA is recommending health care professionals discontinue prescribing and dispensing prescription combination drug products that contain more than 325 milligrams (mg) of acetaminophen per tablet, capsule or other dosage. Consumers are precautioned against taking two or more products that contain acetaminophen at the same time.

Prescription dosages of acetaminophen might be restricted for patients taking anticoagulants (blood thinners) and certain medications for seizures, pain, fever, coughs and colds. Always tell your doctor what medications you are taking, whether over-the-counter, prescription, vitamins or even herbal supplements.

Acetaminophen side effects

Acetaminophen is generally considered a safe pain reliever option, when taken as directed for ten days or less. It’s also not as likely to cause stomach damage, like aspirinand ibuprofen, but large doses may cause irreversible liver damage and death. In fact acetaminophen toxicity is the most common cause of drug-induced liver failure in the U.S.

Most people experience little or no side effects with this medication. However, tell your doctor immediately if any of these highly unlikely but very serious side effects occur:

  • bleeding
  • easy bruising
  • persistent sore throat
  • other signs of infection

If you do not have liver problems, the adult maximum dose of acetaminophen is 4 grams per day (4000 milligrams). If you take more than the maximum daily amount, it may cause serious (possible fatal) liver disease. Tell your doctor immediately if you have any of the following symptoms of liver damage:

  • severe nausea
  • yellowing eyes or skin
  • dark urine
  • stomach pain
  • extreme fatigue.

A very serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction may include:

  • rash
  • itching
  • swelling
  • severe dizziness
  • trouble breathing.

If you notice other effects not listed above, contact your doctor or pharmacist. Click here for a list of acetaminophen side effects published by the drugs.com.

Death from acetaminophen toxicity is its greatest risk

The major acetaminophen side effect is that it is capable of irreversibly destroying the liver at about 2.5 times the daily dose, and in some cases smaller doses, for some people or when taken with alcohol or when fasting.

Acetaminophen overdose was implicated in 254 deaths in the first quarter of 2010, accounting for 26.1% of 972 overdose deaths, more than any other drug group, according to the Institute of Safe Medication Practices (ISMP) November 4, 2010 QuarterWatch

Report. It concluded that there was an alarming rise in reports of serious adverse drug events (ADEs) associated with acetaminophen, in addition to fatalities.

According to Quarter Watch, the Food and Drug Administration (FDA) database received 1,066 reports of ADEs in first quarter of 2010, of which an astounding 46% [492] were associated with acetaminophen, and 20% [209] met FDA's definition of a "serious health outcome".

To avoid acetaminophen side effects, choose natural supplements instead

If you could achieve the arthritis relief you need safely, without total reliance on drugs, wouldn’t it be worth a try? Arthritis-Relief-Naturally explores clinically-proven, natural alternatives for pain relief of arthritis that safely reduce harmful side effects of drugs.

As you can see in this report, acetaminophen has potential serious side effects from overuse. Do you have pain that requires non-prescription or prescription medication as many as five days a week?

If so, you may wonder about the potential damage this drug has on your liver, or other organs. Are you discouraged looking for an arthritis program you can trust for performance and safety? 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.

It’s possible to free yourself completely (or cut back substantially) from pain relief drugs by switching to safe, natural alternatives. One natural pain relief product is manufactured by the number one natural nutrition company in the U.S. It is an excellent substitute for acetaminophen or NSAIDs and is one of three arthritis products featured at the conclusion of this article.,

Daily alcohol use and acetaminophen increases risk for liver damage

Acetaminophen preparations are for short-term use for temporary relief and are remarkably safe when taken as directed. However, alcohol use of three drinks or more per day is cause for special warnings.

Daily use of alcohol, especially when combined with acetaminophen, may increase your risk for liver damage.

Tylenol side effects: the package label for adult Tylenol acetaminophen products contains an alcohol warning that states, "If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take acetaminophen or other pain relievers/fever reducers. Acetaminophen may cause liver damage."

The label also instructs adults not to take Tylenol for pain for more than 10 days or for fever for more than 3 days unless directed by a doctor. As with all over-the-counter analgesics, this warning is necessary so that patients and parents will seek appropriate medical evaluation of their condition if it persists beyond these time periods.

Acetaminophen is listed by the American Association of Poison Control Centers as one of the most common drugs taken in overdose quantities either intentionally or accidentally

Acetaminophen as a pain reliever for osteoarthritis

Acetaminophen was well tolerated in clinical studies evaluating its use in adult patients with osteoarthritis of the knee at recommended doses of 4000 mg per day for up to 4 weeks, published in the journals Current Therapeudic Research, 1983 and New England Journal of Medicine in 1991. Another study published in the journal in 1993 evaluated the use of acetaminophen in doses up to 2600 mg/d for up to 2 years.

Acetaminophen is often used instead of non-steroidal anti-inflammatory drugs (NSAID) aspirin, ibuprofen, naproxen or celecoxib (Cox-2). All are equally effective in relieving pain; however, acetaminophen does not reduce swelling and inflammation from arthritis like NSAIDs.

What is hydocodone and acetaminophen?

There are no prescription drugs that contain acetaminophen alone, but it is found. in combination with many other drugs, hydrocodone in particular (widely prescribed for moderate to severe pain). Hydrocodone is in a group of drugs called narcotic (opioid) 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 in Vicodin and Lortab. 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 prescribed frequently as a generic, it is also recognized by brand names Vicodin, Lorcet, Lortab, Maxidone, Norco, Stagesic, Xodol, Zydone and others..

Hydocodone and acetaminophen side effects

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

Less serious side effects for hydrocodone and acetaminophen as a combined 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 to become common therapy to treat arthritis pain and they can be quite useful to control pain of periodic flares. Despite their benefits, there is a potential downside as there are no randomized, controlled studies looking at the benefit/risk of long-term use of opioids in patients with chronic arthritis conditions. As a result the risk of addiction or tolerance to these medications in these patients is not known.

Other drugs may contain acetaminophen, be careful not to overdose

Because acetaminophen is contained in a variety of non-prescription medications, one must be careful not to overdose by taking more than the recommended maximum dosage. Overdosing causing liver damage (possibly irreversible) or death may occur without warning. Also, literature warnings say not to take it if you consume daily more than three alcoholic drinks, because the combination can poison your liver.

In addition, be careful to realize that you may be taking another medication that contains acetaminophen without your knowledge. You should be aware of its content in other over-the-counter or prescription products, to avoid taking more than the recommended amount per day. It’s always best to tell your medical practitioner exactly what medications you are taking whether prescription or non prescription.

Study: Acetaminophen nearly doubles high blood pressure risk in 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 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.

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

The use of natural products is the most common type of CAM (mind body medicine, and manipulative and body based practices comprise the remainder). Natural products include over-the-counter dietary supplements, vitamins, minerals, herbal medicines and other. (Some uses of dietary supplements—e.g., taking a multivitamin to meet minimum daily nutritional requirements or taking calcium to promote bone health—are not thought of as CAM.)

According to the National Institute of Health, Interest in and use of CAM natural products have grown considerably in the past few decades. The 2007 NHIS found that 17.7 percent of American adults had used a non-vitamin/non-mineral natural product.

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

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.

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. We no longer use pain relief drugs of any kind and my husband is back to playing tennis up to four times a week.

If you are considering the use of natural products as a substitute for acetaminophen or other drugs, we strongly recommend these three featured supplements based on our personal use. They are safe. They work. We continue to use them daily.

Each arthritis product has a specific purpose: one is a dietary herbal supplement for pain relief; a second is an herbal supplement for joint health; and the third is an arthritis joint pain relief cream.

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.

As a starting point, here’s an introduction to three natural pain products for clinically-proven alternatives without using acetaminophen or similar painkilling drugs.

And here’s the 100% satisfaction guarantee. Please read it all the way through. You won’t find anything like it anywhere else. It’s the best in the business.


Disclaimer: Health statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any disease.








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