Risks of Extra Strength Tylenol

Acetaminophen is used to reduce fever and treat pain and is the active ingredient in Tylenol, including Extra Strength Tylenol. Acetaminophen is one of the most commonly used drugs in the United States, reports the Food and Drug Administration (FDA), and liver damage and liver failure is a common and serious health problem concerning Tylenol use. Extra Strength Tylenol products, from arthritis relievers to children's cold tablets, pose risks other than liver damage, from allergic reactions to kidney injury.

Extra Strength Tylenol Recall

• Wood pallets used to store Tylenol contained contaminants.

  The Johnson & Johnson company McNeil-PPC Inc. recalled a number of Extra Strength Tylenol products in 2010 because they were contaminated with tribromoanisole (TBA). This chemical is present in the wood pallets used to store and transport the products and packaging materials. TBA gives off a moldy, musty odor and has been linked to gastrointestinal effects such as cramps, diarrhea, stomach pain, nausea and vomiting, reports CNN Money. The company says that risk of serious adverse effects is unlikely.

  You can visit the McNeil website or the FDA website to see the full list of recalled Extra Strength Tylenol products, or you can call 1-888-INFO-FDA (1-888-463-6332).

Liver Effects

• Acetaminophen has a narrow safety margin.

  Acetaminophen was the leading cause of liver failure in the United States from 1998 to 2003, reports the FDA, and the most common cause of the 1,600 yearly cases of acute liver failure in 2007. Four hundred fifty eight deaths, 26,000 hospitalizations and 56,000 emergency room visits were caused by acetaminophen overdose from 1990 to 1998.

  The acetaminophen in Tylenol has a very narrow safety margin, according to the FDA. In some cases, just taking a small amount more than the recommended dosage can pose risks, but scientists can't agree on what the threshold dose for toxic risk is. In some cases, liver injury has occurred with as little as 2.5 g of acetaminophen per day, so Extra Strength Tylenol products might increase liver damage risk dramatically.

  Alcohol use raises the risk of liver damage when Tylenol and other acetaminophen products are used, and fasting or being unable to eat while ill can increase the risk of liver injury, according to Drugs.com.

Allergies and Hypersensitivities

• Some Extra Strength Tylenol products, especially those formulated for children, contain aspartame. This sweetener is dangerous to children with phenylketonuria. Anaphylactic shock can occur if a person is allergic to acetaminophen. In rare cases, Extra Strength Tylenol can cause thrombocytopenia, a blood-clotting disorder, if patients are sensitive to a metabolite of acetaminophen. Skin rashes and other allergic skin reactions can occur with acetaminophen use, reports Drugs.com, and eosinophilic pneumonia can occur when the body's immune system overreacts to acetaminophen.

Other Physiological Effects

• Extra Strength Tylenol medicines can cause stomach pain and block bile flow, reports Drugs.com, and chronic use or overdose can cause kidney problems or acute renal failure. Acetaminophen might increase the risk of kidney cancer. Acetaminophen might cause blood pressure levels to drop dangerously, and an overdose of Tylenol can cause methemoglobinemia, a condition that prevents the blood from delivering enough oxygen to the body.

Interactions With Other Medications, Tests and Medical Conditions

• Tylenol can skew blood glucose tests.

  Extra Strength Tylenol can increase the risk of side effects of certain medications. You should not take Tylenol and these medications together for more than a few days, according to Drugs.com: acenocoumarol, aspirin and other salicylates, carbamazepine, diclofenac, etodolac, fenopren, floctafenine, flurbiprofen, ibuprofen, indomethacin, isoniazid, ketoprofen, ketorolac, meclofenamate, mefenamic acid, nabumetone, naproxen, phenylbutazone, phenytoin, piroxicam, sulindac, tenoxicam, tiaprofenic acid, tolmetin, warfarin and zidovudine.

  You shouldn't use acetaminophen if you have kidney or liver disease or phenylketonuria.

  Extra Strength Tylenol and other acetaminophen products can interfere with medical tests results such as blood glucose levels. Acetaminophen and caffeine combined can interfere with tests of blood flow.

Symptoms

• Liver damage symptoms are often confused with the flu.

  Symptoms of acetaminophen overdose might not appear until four days after Tylenol is taken, and treatment to prevent liver damage must be taken within 24 hours of the overdose, reports Drugs.com.

  Overdose symptoms include diarrhea, loss of appetite, nausea or vomiting, stomach pain or swelling and sweating.

  Symptoms of liver injury occur over several days and might be attributed to the flu. Besides yellowing eyes and skin, symptoms of liver damage include black or bloody stool, bloody or cloudy urine, fever, increased urination, pain in the lower back or side, skin rashes, sores on the lips or mouth, unusual bleeding or bruising and unusual tiredness or weakness.