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Acetaminophen (Common: Tylenol)

  • Victoria Wermers, RN,MSN,FNP, PMHNP
  • Dec 16, 2024
  • 3 min read

Updated: Sep 30, 2025

Used as a common pain reliever and fever reducer.


Note: Tylenol use during pregnancy has become a controversial issue since Robert F Kennedy, the Secretary of Health and Human Services, claims that it potentially causes autism in children when pregnant women to take it for pain or fever. There have been no formal studies regarding this, and there have been no other alternatives recommended for pain or fever by the Health and Human Services Director. In fact, the American College of Obstetricians and Gynecologists (ACOG) states it’s one of the only safe options for treating pain and fever in pregnancy. Before totally nixing this medication, further studies need to be done.


According to studies cited by MedicalNewsToday, a fever left untreated during various stages of pregnancy has risks of its own.


Left untreated in the first trimester can cause:

  • Neural Tube Defects (NTDs): Studies show that fevers over 102–103°F (39–39.4°C) early in pregnancy may double the risk of NTDs like spina bifida.

  • Congenital Heart Defects & Cleft Lip/Palate: Elevated maternal temperature has been associated with increased risk of these structural anomalies.

  • Autism Spectrum Disorder: Some studies suggest a possible link, but findings are inconclusive and require more research


    According to Medicover Hospitals in Europe and India, a high or prolonged left untreated in pregnant women can cause:

  • Reduced placental function

  • Dehydration & Electrolyte Imbalance: Especially if fever is accompanied by vomiting or diarrhea, which can decrease amniotic fluid and affect fetal oxygenation and maternal stability.

  • Infection-related complications


High or prolonged fever later in pregnancy may contribute to:

  • Preterm labor

  • Fetal distress

  • Low birth weight

  • Preterm Labor: Fever from infections like flu or COVID-19 can trigger contractions and increase the risk of early delivery.

Understand this: There are so many toxins in our environment that can affect fetal development. If you are unsure what to do, discuss this with your healthcare provider.


Background: Acetaminophen (common: Tylenol) is a very common over-the-counter medicine for fever and pain. It was inadvertently discovered in the late 1800s in Europe when a febrile person was given a derivative of coal tar to treat parasitic worms. The parasites did not go away, but the person's fever went down. From that, paracetamol was developed. In the 1950s, the same medicine was marketed for pain and fever in the United States as acetaminophen (Tylenol). The rest is history.

Tylenol kills pain by working the central nervous system - not at the site - to decrease pain. Interestingly, no one has been able to figure out exactly how it works.


Acetaminophen
Acetaminophen

OTHER NAMES: APAP,  Paracetamol (Europe), Tylenol


REPORTED USES

General: Antipyretic (lowers fever), analgesic (decreases pain). It is NOT an anti-inflammatory.

Respiratory: Colds, ear pain and sore throat

Cardiovascular: N/A

GI: Toothache

GU: Menstrual cramps 

Musculoskeletal: Muscle aches, backaches, pain, osteoarthritis

Neurologic: Headaches

Other: Fever reducer

Forms: Liquid, liquid gels, caplets, effervescent, chewable

Notes: This is not an inflammatory but does have fever-reducing and pain-killing properties

Side Effects: Rare side effects, long-term use - liver problems, skin reaction, anemia, renal disease (long-term use), nausea, headache​

Caution/Contraindications: Liver disease or impairment, kidney disease, alcohol overuse, chronic malnutrition, known hypersensitivity

Adult Dosages: As directed

How much you use depends on your condition. Start low (325 mg) if you can and increase the next dose if the initial dose is not effective enough.


  • Regular Strength and Extra Strength Acetaminophen: Comes in 325-500 mg tablets respectively: Usually 1-2 mg every 4-6 hours. The oral Solution comes in a concentration of 160/5 ml oral solution - 2-3 tsp every 4-6 hours.

    Tylenol Arthritis extended release comes in 650 mg dose - Take one every 8 hours.

The total maximum dose 3250-4000 mg in 24 hours.

There is now an over-the-counter medicine that has both acetaminophen (common: Tylenol) in it for pain and fever AND ibuprofen (common: Advil, Motrin) for inflammation. Many times, pain, fever, and inflammation accompany one another. So, with this, you may get the best of all worlds. 

Recommendations: Most generics of acetaminophen are less expensive and are acceptable as substitutes (although, as of this writing, there is not yet a Tylenol Arthritis [650 mg] generic). It is also important to note that Tylenol is often a component of multi-symptom cold and flu OTC medicines. If you take a multi-symptom medicine you may not need any Tylenol or NSAID like ibuprofen. READ LABELS!

DO NOT EXCEED RECOMMENDED DOSES WITHOUT DISCUSSING WITH YOUR HEALTHCARE PROVIDER

 
 

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