# Why didn't Tylenol cause liver damage in the 70's and 80's? **URL:** \ **Category:** Factual Questions\ **Created:** [June 5, 2010, 9:20am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035 "2010-06-05T09:20:45Z")\ **Posts on this page:** 15\ **Page:** 2
**Author:** ![sqweels](https://avatars.discourse-cdn.com/v4/letter/s/f19dbf/32.png) [@sqweels](https://boards.straightdope.com/u/sqweels)\ **Post date:** [June 7, 2010, 6:44pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/21 "2010-06-07T18:44:18Z")
> [@Nametag](#): > > Worse, 2 grams can damage or kill a person who has been drinking, or one with existing liver problems. And by “has been drinking,” I don’t mean recently – the most dangerous time for drinkers to take Tylenol begins when the liver starts metabolizing the alcohol, and doesn’t end until the liver enzymes subside, days later. The maximum hazard is reached after all alcohol has been metabolized, when liver enzymes are at their peak, but there’s no alcohol left to compete for them – i.e., right around the time you take a couple pills for your hangover. I’m a drinker, so I never take Tylenol. But what about ibuprofin, i.e. Advil? ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [June 7, 2010, 9:21pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/22 "2010-06-07T21:21:45Z")
> [@sqweels](#): > > I’m a drinker, so I never take Tylenol. But what about ibuprofin, i.e. Advil? Ibuprofen is not metabolized by the liver. The only problem with Alcohol and Ibuprofen has to do with an increased risk of stomach ulcers or GI bleeds when you combine the two. I’m a pretty heavy drinker at times too (Pharmacy school will do that to you), and my pain reliever of choice is Ibuprofen. As long as you don’t take the Ibuprofen with a shot of rum, there shouldn’t be any problems. It is defiantly fine to treat a hangover, while Acetaminophen is not. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [June 7, 2010, 11:31pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/23 "2010-06-07T23:31:51Z")
**Leo Bloom** said: > [@](#): > > Interesting in the extreme. I knew a suicide attemmptee who took “a $16 bottle” IIRC of Ty. She was in her 6th month in the psych ward plus I don’t know how long in medical. One of my childhood friends tried to commit suicide by oding on tylenol. He said it made him puke, then was rushed to the hospital and had his stomach pumped. He said he was told there was something in Tylenol to make you puke if you OD. Turns out that was probably a misunderstanding, it was likely the liver failure causing puking. I have to assume he got lucky. ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [June 7, 2010, 11:50pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/24 "2010-06-07T23:50:04Z")
> [@Qadgop\_the\_Mercotan](#): > > But then they started adding acetominophen to damn near everything. So we started seeing chronic pain patients who are not just taking the max 4 grams a day of it, but also taking vicodin 5/500 (5 mg hydrocodone plus 500 mg acetaminophen) 2 tabs every 4 hours, for a possible daily total of 10 grams of acetaminophen. Then add the shotgun cold medicines they’re taking, with acetaminophen added to the cough suppressant and decongestant and antihistamine in it, and the total is even higher. > > the next thing you know, Mr. Liver is saying “so long, and thanks for all the hepatotoxins”. I wonder, also, if part of the problem is that the brand name has become so strongly associated with the drug in America. People taking _Tylenol_ may not realize that the very same stuff is in their cold medicine (or whatever), even if they check the label and see it contains _acetominophen_. Even if they are taking a generic acetominophen (or _Motrin_, or some other brand), they may still be in the habit of calling it, and thinking of it as _Tylenol_, and thus fail to make the connection. To further spread confusion, the same drug, in its generic form, is known in the U.K. as _paracetomol_. When I came to America, it took me a while to figure out that acetominophen was the same stuff. ---
**Author:** ![Hirka\_T\_Bawa](https://avatars.discourse-cdn.com/v4/letter/h/db5fbb/32.png) [@Hirka\_T\_Bawa](https://boards.straightdope.com/u/Hirka_T_Bawa)\ **Post date:** [June 8, 2010, 1:19am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/25 "2010-06-08T01:19:11Z")
> [@Irishman](#): > > **Leo Bloom** One of my childhood friends tried to commit suicide by oding on tylenol. He said it made him puke, then was rushed to the hospital and had his stomach pumped. He said he was told there was something in Tylenol to make you puke if you OD. Turns out that was probably a misunderstanding, it was likely the liver failure causing puking. I have to assume he got lucky. There is actually an antidote to acetaminophen overdose, most likely when he was brought to the hospital, they administered it to save him from liver toxicity. > [@njtt](#): > > Even if they are taking a generic acetominophen (or _Motrin_, or some other brand), Motrin isn’t a brand of acetaminophen, it is a brand of Ibuprofen. ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [June 8, 2010, 5:17am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/26 "2010-06-08T05:17:40Z")
> [@Hirka\_T\_Bawa](#): > > Motrin isn’t a brand of acetaminophen, it is a brand of Ibuprofen. :smack: ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [June 8, 2010, 5:23am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/27 "2010-06-08T05:23:00Z")
So is it okay to take Tylenol or not? We keep a bottle in our place. Use it for various old-age aches and pains, not just headaches. 😕 ---
**Author:** ![Superhal](https://avatars.discourse-cdn.com/v4/letter/s/b4bc9f/32.png) [@Superhal](https://boards.straightdope.com/u/Superhal)\ **Post date:** [June 8, 2010, 6:12am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/28 "2010-06-08T06:12:04Z")
> [@Siam\_Sam](#): > > So is it okay to take Tylenol or not? We keep a bottle in our place. Use it for various old-age aches and pains, not just headaches. 😕 Imho, what I learned from this thread: it’s all about the dosage. ---
**Author:** ![Irishman](https://avatars.discourse-cdn.com/v4/letter/i/b487fb/32.png) [@Irishman](https://boards.straightdope.com/u/Irishman)\ **Post date:** [June 8, 2010, 4:23pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/29 "2010-06-08T16:23:08Z")
**Siam Sam** said: > [@](#): > > So is it okay to take Tylenol or not? Follow the dosage limits on the bottle and you should be fine. _This is not medical advice._ 😉 ---
**Author:** ![Siam\_Sam](https://avatars.discourse-cdn.com/v4/letter/s/d78d45/32.png) [@Siam\_Sam](https://boards.straightdope.com/u/Siam_Sam)\ **Post date:** [June 9, 2010, 1:51am UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/30 "2010-06-09T01:51:28Z")
Not that Tylenol is my worst fear. Back in the 1980s, I used a powerful bug spray in my house up North, something I heard was banned in the US because it maybe caused cancer later on. But it kept the giant flying cockroaches away! I’m still waiting for that to kick in. ---
**Author:** ![Annie-Xmas](https://avatars.discourse-cdn.com/v4/letter/a/ecc23a/32.png) [@Annie-Xmas](https://boards.straightdope.com/u/Annie-Xmas)\ **Post date:** [June 9, 2010, 1:45pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/31 "2010-06-09T13:45:11Z")
and yet House popped Vicodan like candy. ---
**Author:** ![Speak\_to\_me\_Maddie](https://avatars.discourse-cdn.com/v4/letter/s/58956e/32.png) [@Speak\_to\_me\_Maddie](https://boards.straightdope.com/u/Speak_to_me_Maddie)\ **Post date:** [June 9, 2010, 2:01pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/32 "2010-06-09T14:01:27Z")
> [@Annie-Xmas](#): > > and yet House popped Vicodan like candy. And in one episode he tells Wilson how every morning he wakes up and checks the whites of his eyes for jaundice. He seemingly knew he was destroying his liver. When I hear news reports about celebs, etc. who are taking 20+ Vicodins a day I wonder how it is they are able to survive. I mean that’s 10 grams a day of acetaminophen, right? Isn’t that the real reason Vicodin contains acetamionpohen? As an abuse deterrant? I’m not sure how I feel about that, ethically. ---
**Author:** ![Mister\_Rik](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mister_rik/32/491_2.png) [@Mister\_Rik](https://boards.straightdope.com/u/Mister_Rik)\ **Post date:** [June 9, 2010, 6:40pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/33 "2010-06-09T18:40:52Z")
> [@Hirka\_T\_Bawa](#): > > Ibuprofen is not metabolized by the liver. The only problem with Alcohol and Ibuprofen has to do with an increased risk of stomach ulcers or GI bleeds when you combine the two. I’m a pretty heavy drinker at times too (Pharmacy school will do that to you), and my pain reliever of choice is Ibuprofen. As long as you don’t take the Ibuprofen with a shot of rum, there shouldn’t be any problems. > > It is defiantly fine to treat a hangover, while Acetaminophen is not. Back when I used to drink a lot, I simply found that ibuprofen got rid of hangover headaches much more quickly/effectively than acetaminophen. (Naproxen didn’t become available OTC until some time after I’d stopped drinking, so I can’t speak to its effectiveness.) No clue why, though. OTOH, I also found it was even more effective if I took the ibuprofen right before I went to bed after I’d been drinking heavily - then I wouldn’t wake up with a headache to begin with. To be fair, I was a beer drinker back then, not a liquor drinker, so there was probably enough water in what I was drinking to keep things dilute enough that I never experienced any stomach/GI issues. ---
**Author:** ![pinkyvee](https://avatars.discourse-cdn.com/v4/letter/p/6de8d8/32.png) [@pinkyvee](https://boards.straightdope.com/u/pinkyvee)\ **Post date:** [June 11, 2010, 3:35pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/34 "2010-06-11T15:35:26Z")
```auto ``` > [@Qadgop\_the\_Mercotan](#): > > Acetaminophen overdoses have been a headache for the medical profession ever since I belonged to it, back in the 70’s, and even before. As has already been noted, a person with a healthy liver shouldn’t take more than 4 grams of it a day, and a person with an impaired liver (such as a chronic drinker or a person with hepatitis) should consume less than 2 grams a day at most. > > But then they started adding acetominophen to damn near everything. So we started seeing chronic pain patients who are not just taking the max 4 grams a day of it, but also taking vicodin 5/500 (5 mg hydrocodone plus 500 mg acetaminophen) 2 tabs every 4 hours, for a possible daily total of 10 grams of acetaminophen. Then add the shotgun cold medicines they’re taking, with acetaminophen added to the cough suppressant and decongestant and antihistamine in it, and the total is even higher. > > the next thing you know, Mr. Liver is saying “so long, and thanks for all the hepatotoxins”. For more than a decade I helped run a migraine clinic. One of the tasks I faced was getting a migraineur to stop using Excedrin. (aspirin + acetaminophen + caffeine). Excedrin works well for migraine in many cases … However … It is a huge problem as a cause of rebound migraine when Excedrin wears off and the headache frequency increases. When that starts, the headache sufferer then requires an increased dose to get the same level of headache relief initially experienced when they reached for their first Excedrin. Also, they would often seek headache advice from a primary care physician, NOT inform their physician that they were taking Excedrin on a daily basis, so their helpful and caring MD might prescribe vicodin or Esgic or fiorcet, all containing acetaminophen as well. I treated a man for rebound headaches who was, at the time, taking 32 (I am serious) Excedrin a day, and this was AFTER he’d already had a LIVER TRANSPLANT. Most of my rebounders were not really addicts in the sense they were getting high. They were trying to become relatively pain free for a few hours at a time. The real pain in the ass was, once we were successful getting the patient off Excedrin, they would often reach for it again a few years down the road, and the rebounding effect would resume right were it was when we had the first encounter. That’s what happened with the 32 a day guy. In many cases, treating Excedrin rebounders was way more challenging than narcotic rebounders. I think advertising had a lot to do with this. The TV advertising for Excedrin makes it sound so benign. Sorry for the mini-rant. I have had a burr up my ass about Excedrin for a long time. I yell at the TV when Excedrin runs their ads. BTW, Excedrin Migraine is exactly the same formula as Excedrin, just pricier for the box instructions. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [June 11, 2010, 6:09pm UTC](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035/35 "2010-06-11T18:09:58Z")
I am always grumpy about the freaking excederin commercial. If the damned shite worked, don’t you think I would be taking it instead of horking down frovatriptan or imitrex? I would be popping that cute little dose of excedrine and doing whatever I needed to do, not laying down in a dark room waiting for my head to either explode and put me out of my misery or to stop hurting badly enough to make me vomit. [Previous page](https://boards.straightdope.com/t/why-didnt-tylenol-cause-liver-damage-in-the-70s-and-80s/542035.md?page=1)