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Acetaminophen

TYLENOL

What it isTRPV1 agonist and central COX inhibitor with little anti-inflammatory activity; pain and fever.

Why this oneUnlike NSAIDs, it does not inhibit platelets or meaningfully inflame the stomach, making it useful with anticoagulation.

What limits itOverdose causes hepatic failure; combination products invite accidental stacking. Use lower ceilings in liver disease or heavy alcohol use.

FDA-approved for

FDA label

FDA dosingPopulationStartTargetMax
Pain / fever (OTC analgesic-antipyretic)Adults and children ≥12 yr2 caplets q6h PRN2 caplets q6h PRN6 caplets/24 h
Pain / fever (OTC analgesic-antipyretic)Children <12 yrAsk a doctorAsk a doctorUndefined

Renal Undefined

Hepatic Undefined

Doses spaced q6h; maximum 6 caplets per 24 hours.

Instructions

Pregnancy Undefined

Lactation Undefined

NO BOXED WARNINGS

Principal riskHepatotoxicity in overdose, and from stacked combination products

Cost, est. cash$10–$500/month

Generic entry1986

Classes and tags

Clinical profile

Therapeutic safety burden1 / 4
Overdose danger4 / 4
Weight-gain liability0 / 4
Sedation liability2 / 4
QT / Torsades0 / 4
Direct muscarinic antagonism0 / 4
Embryofetal risk1 / 4

Legacy pregnancy categoryB

Defining liabilityUsually well tolerated therapeutically; overdose may cause delayed fulminant hepatic failure.

Active metabolites

Mechanism of action: Acetaminophen ballicule

Acetaminophen ballicule: receptor binding, kinetics and half-life diagram

Open Acetaminophen in the interactive console ↗

Memory aids: mascots and interaction avatars

Acetaminophen PARACETAMOL / APAP / TYLENOL mascot mnemonic cartoon
“I see the mini fin, a Pair a’ aces, A papule, Tile ‘n’ all”
“I see the mini fin” = acetaminophen
“Pair a’ aces” = paracetamol
“A papule” = APAP
“Tile n’ all” = Tylenol
Acetaminophen CYP2E1 substrate avatar
CYP2E1 substrate

Open Acetaminophen in the interactive console ↗