by Carla White

Created on: January 24, 2010

Risks of Acetaminophen as an Alternative to NSAIDS for Arthritis

Given the common side effects of nonsteroidal anti-inflammatory drugs (NSAIDS) and the potential damage their regular, long term use can cause, it is wise to seek other ways to reduce pain and disability caused by arthritis. However, of equal concern is the common recommendation - including by the medical world - of acetaminophen (Tylenol) as an alternative to NSAIDS.  Acetaminophen is frequently the first alternative recommended for people wanting to avoid or minimize NSAID use. It is the most commonly used over-the-counter (OTC) pain reliever in the U.S., and indeed is marketed for its "safety" compared to NSAIDS.

The U.S. Acute Liver Failure Study Group reports that acetaminophen is the number one cause of acute liver failure (ALF) in the U.S. Liver failure kills. Even people following instructions for dosage on pill bottles can ingest toxic amounts of acetaminophen. People who drink alcohol regularly (think of how many people this applies to), who are taking other drugs that can affect the liver, who have hepatitis or already impaired liver function, who are malnourished or have anorexia nervosa, or who have AIDS are warned not to take acetaminophen with out talking to their doctor first. In addition, acetaminophen can cause false blood sugar readings, obviously a potentially severe problem for anyone with diabetes.

Two details complicate the matter of how much is too much acetaminophen. First, the combination of acetaminophen with other medications can aggravate dangerous or unwanted side effects. The Mayo Clinic provides a daunting list of medications acetaminophen should not be combined with, including Aspirin and Ibuprofen. Second, a vast number of common OTC and prescription medications contain acetaminophen as an ingredient, which can result in the user unwittingly getting too much acetaminophen. FamilyDoctor.org provides a long list of acetaminophen-containing medications people should be aware of, including (but not limited to) numerous common cold/flu and allergy remedies such as the Alka-Seltzers, Robitussin, Dristan, TheraFlu, Vicks medicines, and pain relievers such as Midol.

Any medication will have side effects and should be taken with caution and with full information provided. Arthritis is the greatest cause of disability and limitation in daily and work activities in the U.S., according to the Centers for Disease Control. Managing it is critical to one's health and daily

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