Recent Blog Articles

Harvard Health Blog

Cold and flu warning: The dangers of too much acetaminophen

January 27, 2016

About the Author

photo of Susan Farrell, MD

Susan Farrell, MD, Contributing Editor

Dr. Susan Farrell is the Director of the comprehensive clinical skills OSCE examination at Harvard Medical School, and worked as an educator in the Partners Healthcare Office for Graduate Medical Education, before taking her current position … See Full Bio
View all posts by Susan Farrell, MD


As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.

No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.


Maria Jasmine Freeman
February 2, 2016

A drug without side effects, has no effect, we were taught in medical school . Very critical data, Dr Ann Bauer; potential toxicity of acetaminophen is more than appreciated by its users, and it has little effect on the course of influenza or other illnesses, though admittedly it does relieve certain kinds of pains.
Irene Eggers, your description about your pain remaining as long as you are alive , suggests you may be having a neuropathic type of pain which is vanquishing, and responds only perhaps to SSRI drugs- antidepressants; I suggest u dig further into ur pain causes.
Bottom line: Take as little medications as feasible!

February 1, 2016

I would like to commend for putting out some useful, and free medical advice. For years I have been ashamed that this great medical school was selling medical information in the form of Harvard Health Beats… with teaser ads to rival their stock market brethren.

Joan Aiken
February 1, 2016

I have been diagnosed with osteoarthritis and every one I speak to uses Tylenal to treat their arthritis pain –
I do not want to add another liver problem to my life battle with the existing health issues I am dealing with now –
Question: what does one do ?
BTW – my Arthritis Society in Toronto also says ” Tylenal is the only “drug” that
will address the pain – and give me some relief for short periods of time.
Joan A.

February 2, 2016

Tylenol is not even an anti inflammatory. Why is a doctor telling you it is the only drug for osteoarthritis? What about ibuprofen??

Dr. Robert Shaver
February 1, 2016

I was prepared to write a contrary opinion regarding the “opinion” of this writer, but rather I will merely second the comments of Dr. Ann Bauer and recommend that patrons visit the website she cites.

Irene Eggers
February 1, 2016

I have never fount acetaminophen to be effective. I suspect I could take much more than the recommended dose, and I would still have the pain (as long as I remained alive).

Diane Sommers
February 1, 2016

I take 1Advil sinus congestion&pain aday do to allergy. What side effects can be the result of this?I

Gail McLeod
February 1, 2016

In 2007-2008 I was suffering through undiagnosed Hodgkin’s lymphoma for nearly a year. Because of my high fevers of long duration – 20 days out of 30 – I followed the directions of the emergency room doctors who advised me to take medication to bring down the fever. I was taking two tylenol 4 times per day. When I was admitted to hospital with Stage 3B Hodgkins lymphoma, I went through severe jaundice – edema and yellow skin all over. I still don’t know if it was due to the lymphoma or the number of Tylenol I took but doctors still prescribe it. I try not to take more than 3 or 4 in a month. Just thought I would pass this along.

Dr. Ann Bauer
January 27, 2016

Research suggests that the safety margin of acetaminopen is considerably narrower than this article would lead one to believe. It is well known that acetaminophen is the leading cause of acute liver failure in the US. A 2009 FDA report states “in some individuals, taking just a small amount more than the recommended total daily dose of acetaminophen may lead to liver injury. Acetaminophen has a narrow safety margin. This means that there is little difference between the maximum recommended daily dose (4 gms/day) and a potentially harmful dose.”

As you note, the recommended dose has been lowered to 3gms/ day but 2015 research suggests that the safety margin may be even narrower than previously thought. A novel liver on chip technology has found that acetaminophen stops cellular respiration at therapeutic doses, below the threshold of acetaminophen toxicity.

Another important research study, not mentioned, is a recent randomized controlled trial that found no efficacy of acetaminophen for influenza. There was no difference in symptom scores, temperature, time to resolution of illness and health. status.

The recent research on acetaminophen is suggestive of a number of adverse outcomes, as well as, limited efficacy. Particularly noteworthy are four studies which have found increased risk of adverse neurodevelopmental outcomes, ADHD and now autism in offspring, when their pregnant mothers used acetaminophen.

Commenting has been closed for this post.

Free Healthbeat Signup

Get the latest in health news delivered to your inbox!

Harvard Health Publishing Logo

Thanks for visiting. Don't miss your FREE gift.

The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School

Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more.

Harvard Health Publishing Logo

Health Alerts from Harvard Medical School

Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss...from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts.

BONUS! Sign up now and
get a FREE copy of the
Best Diets for Cognitive Fitness

Harvard Health Publishing Logo

Stay on top of latest health news from Harvard Medical School.

Plus, get a FREE copy of the Best Diets for Cognitive Fitness.