Acetaminophen, best known under the brand name "Tylenol".

It is also known by the abbreviation APAP and called paracetamol in Europe.
Tylenol is the second part of the well known hydrocodone formulations (Norco, Lortab, Vicodin...).
The dosage is usually written as hydrocodone 5/325 APAP or hydrocodone/APAP 5/325. That means that the tablet contains 5 mg (milligram = 1/1000th of a gram) of hydrocodone and 325 mg of Tylenol. The ending "cet" usually means that there is some Tylenol in the combination. Examples are percocet (oxycodone + Tylenol), Lorcet (hydrocodone + Tylenol), darvocet (propoxyphene + Tylenol) and ultracet (tramadol + Tylenol). It can be found in many headache and pain medication combinations. Often it will state on the bottle "Non-Aspirin" or "Aspirin-Free" pain reliever.

Tylenol is available on its own in strengths usually from 325 mg (regular strength) to 500 mg Extra Strength (ES) Tylenol and 650 mg (Tylenol Arthritis).

It is one of the oldest and most commonly used pain medications and anti-fever medication. It is generally considered to be one of the safest pain medication. Most of the pain medication for children contain Tylenol.

Generally safe does not mean that there are no potential problems with it. One of the major concerns with Tylenol is acute toxicity. Tylenol is often used for suicide as it is easily available and very cheap. While at low doses for short durations it is indeed very safe, the situation changes in overdoses that can lead to liver failure and death.

Generally up to 4gm of Tylenol (2 ES Tylenol four times a day) is considered safe in patients with normal liver function for short duration (weeks to months). In patients with some liver problems (from active hepatitis, excessive alcohol use to liver cirrhosis) 2gm should not be exceeded for more than a couple of days.

For long-term use I limit the amount of Tylenol to about 3 gm in patients without liver problems and about 2 gm with liver issues.

While the liver concerns (acute toxicity and long-term side effects) with Tylenol have been known for a long time, there is now more information about concerns regarding high blood pressure and kidney problems with Tylenol.

Patients can sometimes take unknowingly excessive doses of Tylenol when they combine prescribed Tylenol (e.g. contained in hydrocodone or propoxyphene preperations) with over the counter (OTC) Tylenol-containing pills.

As with any medication you have to look at the whole balance of benefit versus harm. This not only includes the harm of the medication at hand but also of alternatives to the Tylenol which have their own potential for harm and the harm that can arise from not treating the pain.

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