Acetaminophen, popularly known as paracetamol, is a widely used pain reliever and fever medication. It is available over the counter and is often used to treat headaches, muscle aches, toothaches, and other types of pain.
While acetaminophen is considered safe when used as directed, it can be dangerous when taken in large doses or for extended periods.
This blog post will discuss the importance of medication management and the dangers of acetaminophen—mainly when it is metabolized by the liver, excreted through the kidneys, or taken by pregnant or breastfeeding women.
Potential Effects On The Fetus And Breastfed Babies
Acetaminophen was considered safe for pregnant women and more likely to be recommended for fever and pain relief than aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
However, recent studies have raised concerns about its potential effects on fetal brain development.
In 2019, a study funded by the National Institutes of Health and conducted at Johns Hopkins University suggested a link between the fetal risk for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) and exposure to acetaminophen.
It showed that children with higher levels of the drug in the umbilical cord had a higher risk of eventually developing ADHD and ASD. Before they turned nine years old, about 25% of the subjects were diagnosed with ADHD, and 6.6% were diagnosed with ASD. Meanwhile, 4.4% were diagnosed with both conditions.
Over the 20-year duration of the study, it was found that ADHD caused by Tylenol was three times more likely in children with the highest levels of acetaminophen in cord blood than those with the lowest.
This is consistent with a related study in 2021. Again, it showed a correlation between exposure to acetaminophen and the development of symptoms: 22% were likely to develop ADHD, and 19% with ASD.
While acetaminophen is generally considered safe when breastfeeding, the effects on high-risk infants differ from full-term, healthy babies because they cannot metabolize the drug efficiently. In fact, those who are premature, underweight, less than six months old, or born with medical issues are more likely to suffer from acetaminophen’s toxic effects.
Common Complications Of Acetaminophen
Acetaminophen, considered safe when prescribed, can have adverse effects like long-term complications and organ injury. While some undesirable effects are dose and duration-related, the drug should always be used cautiously, especially among those with impaired liver and kidney function.
Common complications of misusing acetaminophen include:
- Liver Damage
Acetaminophen overdose is the leading cause of acute liver failure in the United States. The symptoms include abdominal pain, nausea, vomiting, and jaundice. It can get fatal in severe cases.
When the liver metabolizes acetaminophen, it produces a toxic substance that can damage the organ’s cells. This harmful byproduct, called N-acetyl-p-benzoquinone imine (NAPQI), causes oxidative stress.
Under normal circumstances, the liver can break down this substance into something non-toxic called mercapturic acid. This is then excreted through the urine.
However, when you take too much acetaminophen, the liver can become overwhelmed. It may be unable to process the toxic substance fast enough, causing it to accumulate. This leads to inflammation, cell death, fibrosis (scarring), and hepatic failure.
- Kidney Damage
Acetaminophen can also cause kidney damage when taken in high doses or for extended periods. Long-term use of the drug can lead to chronic kidney disease, which causes symptoms such as fatigue, nausea, and swelling in the legs and ankles.
- Allergic Reactions
Symptoms of an allergic reaction to acetaminophen may include hives, rash, itching, swelling, and difficulty breathing. If you experience these symptoms after taking acetaminophen, seek medical attention immediately.
Interaction With Other Medications
Acetaminophen can interact with other medications, affecting its efficacy, causing side effects, or leading to other health problems.
For example, taking acetaminophen with alcohol can increase the risk of liver damage. The drug can also interact with blood thinners, antidepressants, and other medications.
Stick To Prescriptions
Abuse of acetaminophen is dangerous. Taking more than the prescribed dose can lead to liver, kidney, and other health problems. It also has the risk of causing addiction disorders, making it much harder to provide immediate treatment due to the risk of withdrawal symptoms.
Like any drug in the market, acetaminophen was well-studied for potential adverse effects and drug interactions before it was launched as a safe analgesic, even during pregnancy.
However, recent studies showed a strong connection between the development of ADHD and ASD in children whose mothers took acetaminophen during pregnancy—even in recommended doses. If you’re expecting, you may want to discuss this with your doctor and reconsider your options.
Other dangers of taking acetaminophen, especially in higher dosage or extended use, are liver damage, kidney damage, allergic reactions, and drug interactions.
As always, the best course of action is to work with your doctor to weigh your risk of complications. Following their advice may be the key to continued good health.