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What Are the Contraindications for Acetaminophen?

By B. Leslie Baird
Updated Mar 03, 2024
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Acetaminophen does have contrainidications, or situations in which it is not recommended for use. These contraindications for acetaminophen include an existing allergy to the drug, liver disease, regular alcohol consumption, and possible interactions with certain other medications. Acetaminophen is excreted in breast milk and nursing mothers should discuss usage with a physician. One of the brand names for acetaminophen is Tylenol®.

Either a brand name or generic acetaminophen product can be used for common mild aches or muscle pain, fever reduction, and headache relief. While acetaminophen is not a non-steroidal anti-inflammatory drug (NSAID,) it does work in similar ways. The difference is that acetaminophen, by itself, does not reduce swelling or inflammation.

Allergic reactions are one the contraindications for acetaminophen use. Serious reactions are fairly rare, but symptoms can include itching, rashes, dizziness, difficulty in breathing, or swelling. This swelling is most common in the throat, tongue, or facial area. Other allergic reactions are also possible. If unusual changes are noticed, a physician should be consulted.

The potential for liver damage is another contraindication for acetaminophen use. Excessive use, or large doses of the product, can be harmful. Patients who are already experiencing any illness of the liver should consult a physician before an acetaminophen product is taken. Use of multiple products containing this pain reliever is discouraged. Due to the potential for liver damage, patients that consume alcohol on a daily basis should also avoid acetaminophen use.

Lesser contraindications for acetaminophen include its use with isoniazid, rifampin, and carbamazepine. These medications change how acetaminophen is metabolized in the liver and reduce its effectiveness. Patients, not feeling relief, may end up taking excesses doses of the pain reliever. Cholestyramine also reduces the pain-relieving effect and should be taken three hours before or one hour after an acetaminophen dose.

Relative contraindications are situations in which a drug may be acceptable, because the benefits of using the product outweigh the risks of use. Using acetaminophen with rifampin can be in the category of a relative contraindication. Absolute contraindications are situations in which adverse reactions can be life-threatening. For example, a patient with pre-existing severe liver damage should consider acetaminophen use an absolute contraindication.

Labels on prescription and over-the-counter medications should indicate potential side effects of product use. These labels must be read carefully and dosage instructions should be followed. Patients are advised to consult a physician, or even a pharmacist, if they have concerns or questions regarding contraindications for acetaminophen, or any non-prescription medication. In the event of an adverse reaction, a patient should discontinue product use and seek medical attention.

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Discussion Comments

By Slitherine — On Mar 23, 2014

If you are on any sort of prescription medication, it's a good idea to get to know your pharmacist well.

It is so difficult to keep track of the potential side effects of a lot of drugs, as well as what over-the-counter medications, like acetaminophen, aspirin and NSAIDs, can be taken.

For example, diabetics and people with high blood pressure have to be very careful about possible side effects.

Many heart and blood pressure patients are on daily low dose aspirins or other blood thinners that could make the use of any other product containing aspirin dangerous.

And, diabetics often have problems with their kidneys. Taking frequent doses of acetaminophen can sometimes be harmful to the kidneys as well as the liver.

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