Tylenol (Acetaminophen) – Oral, Rectal

Warning:

Taking too much Tylenol can cause damage to the liver. The damage may be severe enough to require a liver transplant or cause death. It is possible to take too much Tylenol if you do not carefully follow the directions on the label, or if you take more than one medication that contains acetaminophen (the active ingredient in Tylenol).

You should only take one product at a time that contains the ingredient acetaminophen. Check the labels of all your prescription and over-the-counter (OTC) medications or ask a pharmacist if you are unsure if your medications contain acetaminophen. Tylenol is sometimes abbreviated as APAP or another abbreviation.

Take Tylenol exactly as directed on the label. Do not take more Tylenol or take it more often than the directions state. Ask your healthcare provider or pharmacist if you need help with dosage. Call your healthcare provider if you are still in pain or have a fever after taking Tylenol as directed. The maximum dosage of Tylenol is 4,000 milligrams per day but may be less if you have certain medical conditions, so check with your healthcare provider.

Before taking Tylenol, tell your healthcare provider if you have liver disease or a history of liver disease. You should not take Tylenol if you drink three or more alcoholic beverages per day. Ask your healthcare provider about safe alcohol use while you take Tylenol. If you think you have taken too much Tylenol, call your healthcare provider or Poison Control right away.

What Is Tylenol?

Tylenol (acetaminophen) is an over-the-counter (OTC) drug that can help relieve pain and reduce fever. Tylenol is classified as an analgesic, which is a pain reliever. It is also classified as an antipyretic, which means it can reduce fevers.

Tylenol works on the hypothalamus (the region of the brain where body temperature is regulated) to reduce fever. It also works on the central nervous system to help with pain.

Although Tylenol is available as a single-ingredient product, the ingredient in Tylenol, acetaminophen, can be found in many medications, both OTC (such as cough and cold and flu medications) and prescription (such as in combination with opioid pain medications). This article will focus on the single-ingredient product acetaminophen.

Tylenol is available in various oral formulations, such as tablets, capsules, liquid suspension, liquid gels, chewable tablets, and dissolve packs. Acetaminophen is also available as a rectal suppository called FeverAll, which is placed inside the rectum. FeverAll is available in adult and children's formulations under either brand or generic versions.

Drug Facts

Generic Name: Acetaminophen

Brand Name(s): Tylenol, FeverAll

Drug Availability: Over the counter (also available in some prescription products as a combination drug)

Administration Route: Oral, rectal

Therapeutic Classification: Analgesic (pain reliever) and antipyretic (fever reducer)

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Acetaminophen

Dosage Form(s): Oral tablet, capsule, liquid gel, dissolve pack, chewable tablets, suspension, rectal suppository

What Is Tylenol Used For?

The Food and Drug Administration (FDA) approved Tylenol to temporarily relieve pain and reduce fever. Some of the common uses for Tylenol include:

Although it may help with pain, acetaminophen is not an anti-inflammatory drug. It will not reduce swelling or inflammation, unlike nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil and Motrin (ibuprofen) or Aleve and Naprosyn (naproxen).

How to Take Tylenol

Take your acetaminophen product as directed on the label. Do not take more than recommended.

If you are giving acetaminophen to a child, be sure to use the correct product for the child's age and weight. Consult with your child's healthcare provider if you have questions about appropriate use and/or dosage. Adults can usually take Tylenol four to six times throughout the day. However, it is important to not take more than directed on the package label due to the potential risk of liver damage.

The following are tips for using various acetaminophen formulations:

  • Tylenol suspension: Shake well before using. Measure the medication with a medication measuring oral syringe or dosing cup, not a kitchen measuring device. If the product comes with a measuring device, use the measuring device that comes with the product.
  • Tylenol dissolving tablets: Chew the tablet or let it dissolve on the tongue.
  • Tylenol chewable tablets: Chew the tablet thoroughly before you swallow.
  • Tylenol extended-release tablet: Swallow the tablet whole. Do not chew, crush, or split the tablet.
  • FeverAll rectal suppository: Follow the directions on the product packaging. Ask your healthcare provider for dosing for a child if unsure. Unwrap the suppository before inserting it rectally (in the rectum). The suppository is for rectal use only and should not be taken by mouth or swallowed.

Do not take acetaminophen for more than three days for fever or 10 days for pain. Do not use it for more than five days in children. Check with your healthcare provider if symptoms worsen or do not improve. Contact your child's healthcare provider if they develop a sore throat.

Storage

Store acetaminophen at room temperature, away from direct heat, moisture, and light. Keep the medication out of reach and out of sight of children and pets.

How Long Does Tylenol Take to Work?

Oral Tylenol will start working anywhere from 20 to 45 minutes after taking it, with some forms such as the dissolving packs possibly working even faster. The suppository form may take longer to work and depends on factors such as your rectal pH (how acidic or basic it is) and if anything is in the rectum.

What Are the Side Effects of Tylenol?

This is not a complete list of side effects and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 800-FDA-1088.

As with all medications, Tylenol can cause side effects. Tell your healthcare provider about any side effects you experience while taking this medication.

Common Side Effects

The most common side effects of Tylenol are:

  • Nausea
  • Rash
  • Headache

Severe Side Effects

Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:

  • Hypersensitivity reaction or anaphylaxis: Symptoms can include rash, hives, swelling around the lips, tongue, and face, and difficulty breathing.
  • Severe skin reaction: People who experience red skin, blisters, and/or rash should stop using Tylenol and get emergency medical help.
  • Liver toxicity: Taking more than the maximum daily dose, taking Tylenol with other drugs that contain the same ingredient (acetaminophen), or drinking three or more alcoholic beverages per day while using Tylenol can cause severe liver damage. Do not use Tylenol with other drugs that contain acetaminophen because too much may be taken accidentally. Ask your healthcare provider or pharmacist if you need help understanding the ingredients. If you already have liver problems, ask your healthcare provider before using acetaminophen.
  • Kidney problems: People who have kidney problems should ask their healthcare provider before using Tylenol.
  • Anemia (low red blood cell counts): Symptoms may include tiredness, weakness, and cold hands and feet.
  • Low platelet levels (platelets help blood clot normally, so having low platelets makes a person more likely to bruise and bleed): Symptoms may include tiredness, bruising, and bleeding.

Long-Term Side Effects

While many people tolerate Tylenol well, long-term or delayed side effects are possible. Some long-term side effects can be mild, such as:

  • Anxiety
  • Appetite loss
  • Muscle cramps
  • Purpura (a purplish rash due to small blood vessels leaking under the skin)

Moderate long-term side effects can include:

  • Constipation
  • Liver problems; jaundice (yellowing of the skin and whites of the eyes)
  • Low levels of magnesium, potassium, and phosphate in the blood
  • Low levels of red and white blood cells
  • Low platelet levels, which can cause bleeding
  • Medication overuse headache (also known as rebound headaches): These are headaches that can occur from the regular use of certain pain medications. If you are using Tylenol or a medication that contains acetaminophen, discuss with your healthcare provider how to prevent medication overuse headaches.
  • Skin rashes
  • Swelling of the extremities

Severe long-term side effects may include: 

  • Hearing loss
  • Heart problems, such as heart failure
  • Kidney problems, such as kidney failure
  • Liver problems, such as liver failure
  • Low levels of red and white blood cells
  • Lung problems that can cause cough and shortness of breath
  • Rhabdomyolysis (muscle breakdown that can cause kidney damage)
  • Stevens-Johnson syndrome (a severe skin reaction characterized by red or purple rash, itching or peeling skin, fever, sore throat, and burning eyes) or other skin reactions

Report Side Effects

Tylenol may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Tylenol Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For pain or fever:
    • For oral and rectal dosage forms (capsules, granules, powders, solution, suppositories, suspension, or tablets):
      • Adults and teenagers—650 to 1000 milligrams (mg) every 4 to 6 hours as needed. Dose is based on form and strength. Carefully follow the label instructions for the maximum dose per day.
      • Children—Dose is based on weight or age. Carefully follow the label instructions for the maximum dose per day.
        • Children 11 to 12 years of age: 320 to 480 mg every 4 to 6 hours as needed.
        • Children 9 to 11 years of age: 320 to 400 mg every 4 to 6 hours as needed.
        • Children 6 to 9 years of age: 320 mg every 4 to 6 hours as needed.
        • Children 4 to 6 years of age: 240 mg every 4 to 6 hours as needed.
        • Children 2 to 4 years of age: 160 mg every 4 to 6 hours as needed.
        • Children under 2 years of age: Use and dose must be determined by your doctor.

Modifications

You may need to use caution when taking Tylenol if you are 65 years or older, especially if you have other medical conditions.

When giving Tylenol to a child, use the measuring device that comes with the product. Do not use a kitchen spoon. Check with the child's healthcare provider if you need guidance on product selection and dosing.

People with liver or kidney problems should ask their healthcare provider before using Tylenol, as a lower dose may be required.

Also, consult with a healthcare provider before using Tylenol if you drink alcohol. The risk of liver problems is increased in people who drink alcohol.

Although Tylenol is often a preferred drug to use when needed during pregnancy or breastfeeding, consult your healthcare provider before taking any medication while pregnant, trying to become pregnant, or while breastfeeding. This is especially important because acetaminophen is found in many combination products in which the other ingredients in the product are not safe to use while pregnant or breastfeeding.

Missed Dose

Because Tylenol is intended to be taken as needed, if you miss a dose, take it when you remember. If it is almost time for the next dose, skip the missed dose and resume your regular dosing schedule. Do not take an extra dose to try to make up for a missed dose.

Overdose: What Happens If I Take Too Much Tylenol?

Do not take more Tylenol than directed on the package label. In general, adults should not take more than 4,000 milligrams (mg) in one day and children should not take more than five doses in one day.

Taking too much Tylenol can cause symptoms such as:

  • Nausea or vomiting
  • Appetite loss
  • Sweating
  • Bleeding
  • Bruising
  • Upper stomach pain
  • Yellowing of the skin or whites of the eyes (jaundice)

A Tylenol overdose may also cause flu-like symptoms and extreme tiredness.

What Happens If I Overdose on Tylenol?

If you think you or someone else may have overdosed on Tylenol, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Tylenol, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check the progress of you or your child while you are using this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to take it.

If your symptoms or fever do not improve within a few days or if they become worse, check with your doctor.

Many combination medicines contain acetaminophen, including products with brand names such as Alka-Seltzer Plus®, Comtrex®, Drixoral®, Excedrin Migraine®, Midol®, Sinutab®, Sudafed®, Theraflu®, and Vanquish®. Adding these medicines to the medicine you already take may cause you to get more than a safe amount of acetaminophen. Talk to your doctor before taking more than one medicine that contains acetaminophen.

Check with your doctor right away if you or your child have pain or tenderness in the upper stomach; pale stools; dark urine; loss of appetite; nausea; unusual tiredness or weakness; or yellow eyes or skin. These could be symptoms of a serious liver problem.

If you will be taking more than an occasional 1 or 2 doses of acetaminophen, do not drink alcoholic beverages. To do so may increase the chance of liver damage, especially if you drink large amounts of alcohol on a regular basis, if you take more acetaminophen than is recommended on the label, or if you take it regularly for a long time.

Acetaminophen may interfere with the results of some medical tests. Before you have any medical tests, tell the person in charge if you have taken acetaminophen within the past 3 or 4 days. You may also call the laboratory ahead of time to find out whether acetaminophen will cause a problem.

Acetaminophen may cause false results with some blood glucose tests. If you are diabetic and notice a change in your test results, or if you have any questions, check with your doctor.

If you think you have taken too much acetaminophen, get emergency help at once, even if there are no signs of poisoning. Treatment to prevent liver damage must be started as soon as possible.

What Are Reasons I Shouldn't Take Tylenol?

Tylenol is not appropriate for everyone. You should not take this medication if you are allergic to acetaminophen or any of the inactive ingredients in Tylenol.

Tylenol may be used with caution in some people only if the healthcare provider determines it is safe. This includes:

  • People with liver or kidney problems
  • People with hypovolemia (low fluids in the body)
  • People who are malnourished
  • People who regularly drink a certain amount of alcohol
  • People with phenylketonuria, or PKU (do not use acetaminophen products that contain aspartame, such as certain chewable products)

What Other Medications May Interact With Tylenol?

Tell your healthcare provider about all of the medicines you take, including prescription and OTC medicines, and vitamins or supplements. 

Tylenol should not be used in combination with topical lidocaine or topical prilocaine (numbing agents) in infants less than 12 months old. In adults and children older than 12 months, if the combination must be used together, the lowest doses and shortest treatment time should be used.

The following medications can increase the risk of toxicity when taken with Tylenol:

  • Mysoline (primidone)
  • Rifadin (rifampin)
  • Barbiturates such as phenobarbital or pentobarbital

If taking any of the above medications, talk to your healthcare provider before using Tylenol. You may need to avoid the medication or use a lower dose.

Other interactions can occur with:

  • A blood thinner called Jantoven (warfarin): This interaction can increase the risk of bleeding, which may be life-threatening.
  • Other medications containing acetaminophen: Combining acetaminophen from more than one medication can increase the risk of overdose and toxicity.
  • NSAIDs such as aspirin, Celebrex (celecoxib), Mobic (meloxicam), or Advil and Motrin, especially with long-term treatment: Taking these with Tylenol can increase the risk of kidney problems.

Other drug interactions may occur with Tylenol. Consult your healthcare provider for a complete list of drug interactions.

What Medications Are Similar?

Tylenol is used for fever or mild-to-moderate pain relief. It contains acetaminophen, known as an antipyretic (fever reducer) and an analgesic (pain reliever). There are no other drugs that are exactly like Tylenol.

NSAIDs are a class of drugs often confused with Tylenol. Like Tylenol, NSAIDs can help with fever and pain relief. However, NSAIDs can also reduce inflammation, unlike Tylenol. OTC and prescription forms of NSAIDs are available in various formulations, including oral and topical. NSAIDs have a higher risk of stomach-related side effects and can cause serious side effects such as stomach ulcers and heart problems like stroke or heart attack.

Examples of NSAIDs include:

  • Advil, Motrin (ibuprofen)
  • Aleve (naproxen)
  • Aspirin
  • Celebrex (celecoxib)
  • Mobic (meloxicam)
  • Voltaren (diclofenac)

You will also see combination products with the name "Tylenol" on them at drugstores. These products are often used for flu or cough and cold symptoms and contain multiple ingredients in addition to acetaminophen, such as cough suppressants, antihistamines, and nasal decongestants. Acetaminophen can also be found in other medications such as Excedrin Migraine.

Consult your healthcare provider or pharmacist if you are trying to find a suitable OTC option to treat your cough or cold symptoms. There are many products with similar names and ingredients, so you'll want to ensure you pick the safest medication for you.

Acetaminophen can also be found in many stronger pain medications used for more severe pain, such as Percocet (oxycodone and acetaminophen) or Vicodin (hydrocodone and acetaminophen). These medications are controlled substances because they have the potential for abuse and dependence. They are only used under the close supervision of a healthcare provider.

This is a list of drugs also used for pain. It is not a list of drugs recommended to take with Tylenol. Discuss any questions or concerns with your pharmacist or a healthcare provider.

Frequently Asked Questions

  • What is Tylenol used for?

    Tylenol is an over-the-counter (OTC) medication used to treat pain or fever. It is also part of many combination products, including OTC headache, flu, cough and cold medications, and prescription pain medications.

  • How does Tylenol work?

    Tylenol works on the hypothalamus to reduce fever. The hypothalamus is an area in the brain that regulates body temperature, as well as performing other functions. It also works on the central nervous system (CNS) to help relieve pain.

  • What drugs should not be taken with Tylenol?

    Tylenol interacts with several drugs, which may require a dosage adjustment or avoiding the medication altogether. Before taking Tylenol for the first time, tell your healthcare provider or pharmacist about all of the medications you take. When taking Tylenol, it is important to avoid other medications that contain acetaminophen. Ask your healthcare provider or pharmacist if you need help understanding the ingredients in your medications.

  • How long does it take for Tylenol to work?

    Oral Tylenol starts to work in about 20 to 45 minutes, depending on the dosage form. Some formulations, such as the dissolving packs, may work faster. The suppository form may take longer to work.

  • What are the side effects of Tylenol?

    Tylenol's most common side effects are nausea, headache, and rash. Other side effects are possible, and some may be severe, such as liver or kidney problems.

How Can I Stay Healthy While Taking Tylenol?

Talk to your healthcare provider about other non-pharmaceutical measures you can try with Tylenol to relieve your symptoms. For example, if you are taking Tylenol for arthritis pain, you may also want to try physical therapy.

If you drink alcohol, ask your healthcare provider about alcohol intake while taking Tylenol. Tylenol can harm the liver, and alcohol can increase the risk of liver damage.

When taking Tylenol, follow the directions on the label carefully. If you have certain medical conditions, you may need a lower dose. Ask your healthcare provider if you are unsure.

Children are dosed according to age and weight. To give the correct dosage, this medication should be measured with a medicine measuring device. Check with your child's healthcare provider or pharmacist before using Tylenol if you are unsure of the dose or the appropriate product.

While unlikely, severe skin reactions are possible. Watch out for any skin changes, such as rash, redness, or blistering, and notify your healthcare provider right away if changes occur.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Gabay M, Tanzi M. Medications for chronic pain–nonopioid analgesics. Pract Pain Manag. 2011;11(3).

  2. DailyMed. Label: FeverAll Childrens- acetaminophen suppository.

  3. DailyMed. Label: Tylenol Regular Strength - acetaminophen tablet, film coated.

  4. MedlinePlus. Acetaminophen.

  5. Møller PL, Nørholt SE, Ganry HE, et al. Time to onset of analgesia and analgesic efficacy of effervescent acetaminophen 1000 mg compared to tablet acetaminophen 1000 mg in postoperative dental pain: a single-dose, double-blind, randomized, placebo-controlled study. J Clin Pharmacol. 2000;40(4):370-8. doi:0.1177/00912700022009071

  6. Epocrates. Tylenol.

  7. Prescribers’ Digital Reference. Acetaminophen - drug summary.

  8. U.S. National Library of Medicine. Medline Plus. Acetaminophen.

  9. Ong CK, Lirk P, Tan CH, Seymour RA. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clin Med Res. 2007;5(1):19-34. doi:10.3121/cmr.2007.698

By Karen Berger, PharmD
Karen Berger, PharmD, is a community pharmacist and medical writer/reviewer.