Analgesic and antipyretic (non-NSAID)Available without a prescription

Tylenolacetaminophen

Also sold as: Paracetamol, Panadol, Tylenol Arthritis, Atasol

The go-to option for pain and fever when NSAIDs are not suitable — safe within its limits, but the daily maximum is easy to exceed by accident.

Quick answer

What it is: A non-NSAID pain reliever and fever reducer that works mainly in the brain rather than at the site of injury.
What it's used for: Headache, fever, general aches, dental and post-procedure pain, and cold and flu symptoms.
Worth knowing: Check every other product you are taking. Cold and flu remedies, night-time formulas and prescription combination painkillers frequently contain acetaminophen, and the totals add up.
Main safety point: It does not reduce inflammation, and the risk is the liver — staying under the daily maximum from all sources at once is what matters.

Not sure which option is right for you? Pill4Me pharmacists in Chilliwack can help.

Call 604-705-3644 Book a doctor

Drug class

Analgesic and antipyretic (non-NSAID)

Use in Canada

One of the most widely used medicines in Canada — sold over the counter and found in hundreds of combination products

What is Tylenol?

Acetaminophen is used to relieve mild to moderate pain and to reduce fever. It is commonly used for headaches, muscle aches, back pain, toothache, period pain, pain after minor procedures, and the aches and fever that come with colds and flu. Because it does not irritate the stomach lining or affect blood clotting, it is often the preferred choice for people who cannot take anti-inflammatories.

How Tylenol works

Acetaminophen is thought to act mainly within the central nervous system, reducing the production of prostaglandins involved in signalling pain and in setting body temperature. Unlike ibuprofen or naproxen it has very little anti-inflammatory effect at the tissue level, which is why it helps a headache or fever well but does less for a swollen, inflamed joint.

Forms and strengths

Regular strength 325 mg and extra strength 500 mg tablets, caplets and gelcaps. Extended-release 650 mg (Tylenol Arthritis, taken every 8 hours). Liquid suspensions for children, usually 160 mg/5 mL. Suppositories. Also present in a large number of combination cold, flu, sinus, night-time and prescription pain products.

How Tylenol is taken

For adults, the widely used maximum is 4,000 mg in 24 hours from all sources combined, and many clinicians advise staying at or below 3,000 mg per day for regular use or if there is any concern about the liver. Doses for children are calculated by body weight, not age alone, so follow the package chart or ask a pharmacist. Extended-release tablets must be swallowed whole. If you need acetaminophen most days for more than about a week, the underlying problem should be assessed rather than simply managed.

This is general information, not a dose for you. Dosing depends on the reason you are taking it, your kidney and liver function, your age, and everything else you take — follow the directions on your own label, and ask us if they differ from what you read here.

If you miss a dose

Acetaminophen is taken as needed, so there is no missed dose to make up. Take the next dose when it is due, keeping at least 4 hours between doses (8 hours for the extended-release 650 mg tablets) and staying under the daily maximum.

Side effects

Common — usually manageable

At normal doses, most people have no side effects at all
Occasional nausea
Rash in people who are sensitive to it

Get medical help for these

Liver injury from taking more than the daily maximum — this can happen without any early symptoms, so an overdose is treated urgently even if the person feels fine
Severe skin reactions (blistering, peeling, widespread rash) — rare, but stop the medication and seek care immediately
Signs of an allergic reaction: swelling of the face or throat, difficulty breathing — call 911
Yellowing of the skin or eyes, dark urine, or persistent right-sided abdominal pain — seek medical assessment

Important warnings

Suspected overdose is a medical emergency even when the person seems well. In BC, call the Drug and Poison Information Centre at 604-682-5050 (or 1-800-567-8911 toll-free) right away — there is an effective antidote, and it works best when given early.

Add up acetaminophen from every source. Cold and flu products, sinus medicines, night-time formulas and prescription combination painkillers commonly contain it, and doubling up is the most common cause of accidental overdose.

Regular alcohol use lowers the amount of acetaminophen the liver can safely handle. If you drink most days, discuss a safe limit with your pharmacist.

For children, dose by weight rather than age, and use the measuring device supplied with the product rather than a kitchen spoon.

Who should take extra care

Liver disease: The daily limit is lower, and for some people acetaminophen is not appropriate at all — this should be set by your physician or pharmacist.
Regular alcohol use: Drinking most days reduces how much acetaminophen the liver can process safely.
Children: Dose by weight using the supplied syringe or cup, and check that no other product being given contains acetaminophen.
Pregnancy: Acetaminophen is generally considered the first-choice pain reliever in pregnancy, used at the lowest effective dose for the shortest time — discuss ongoing use with your prescriber.
People taking warfarin: Regular daily use can push the INR up; occasional use usually does not.
Low body weight or frailty: Older or smaller adults may need a lower daily maximum than the standard figure.

Who should not take it

Known allergy to acetaminophen
Severe active liver disease — needs physician direction before any use
Do not use with any other product containing acetaminophen without adding up the total daily dose

Drug interactions

Warfarin — regular use of higher-dose acetaminophen can raise the INR, so INR is checked more often if you start taking it daily. Alcohol increases the risk of liver injury. Medications that induce liver enzymes, such as carbamazepine, phenytoin and rifampin, can increase the production of the toxic breakdown product. The most important interaction of all is with other acetaminophen-containing products. Acetaminophen does not interact with blood pressure medications, lithium or methotrexate the way NSAIDs do, which is one of the reasons it is often preferred.

Commonly asked about alongside Tylenol: Advil, Aleve, Voltaren, Aspirin.

This is not a complete list. If you take several medications, or buy anything over the counter, a pharmacist medication review is the reliable way to catch interactions that matter.

Coverage in British Columbia

Over-the-counter acetaminophen bought off the shelf is not usually a PharmaCare benefit. Coverage may depend on indication, PharmaCare plan and Special Authority requirements — some products are covered for residents of long-term care under Plan B, or when prescribed in specific circumstances. Ask Pill4Me Pharmacy to check your coverage, or call 604-705-3644 and we will look it up for you.

Coverage may depend on indication, PharmaCare plan and Special Authority requirements. Ask Pill4Me Pharmacy to check your coverage, or see BC PharmaCare.

Frequently asked questions

Can I take Tylenol and Advil at the same time?

Yes — acetaminophen and ibuprofen work by different mechanisms, so they can be taken together or alternated, and this combination is often more effective than either alone for dental pain or injury. What matters is that each is kept within its own daily maximum, and that ibuprofen is suitable for you in the first place (stomach, kidney, heart and blood thinner considerations all apply). If you are planning to do this for more than a couple of days, run it past a pharmacist first.

How much acetaminophen is too much in one day?

For most healthy adults the accepted maximum is 4,000 mg in 24 hours from all sources, and many clinicians suggest keeping to 3,000 mg or less for regular use. That is easier to exceed than people expect: two extra-strength tablets are already 1,000 mg, and a night-time cold remedy can add another 650 mg. If you have liver disease, drink alcohol regularly, or are frail or underweight, your safe limit is lower — ask us what it should be for you.

Does acetaminophen reduce inflammation?

Not meaningfully. It relieves pain and lowers fever, but it does not have the anti-inflammatory action that ibuprofen, naproxen and diclofenac have. For a swollen ankle, an inflamed joint, or period cramps, an anti-inflammatory often works better — provided it is safe for you. For a headache or fever, acetaminophen is usually the simpler and gentler choice.

Is acetaminophen safe during pregnancy?

Acetaminophen is generally regarded as the pain reliever of choice during pregnancy, and anti-inflammatories such as ibuprofen and naproxen are usually avoided, particularly later in pregnancy. Current advice is to use the lowest effective dose for the shortest period needed. If you find you need pain relief regularly while pregnant, that is worth discussing with your prescriber or midwife rather than managing on your own.

What should I do if I think I have taken too much?

Treat it as urgent, even if you feel completely well — acetaminophen overdose often causes no symptoms in the first day, while liver damage is already underway. In British Columbia, call the Drug and Poison Information Centre at 604-682-5050 or 1-800-567-8911 immediately, or go to the nearest emergency department. There is an antidote and it is highly effective when started early.

Is Tylenol covered by BC PharmaCare?

Acetaminophen bought over the counter is generally not covered. Coverage may depend on indication, PharmaCare plan and Special Authority requirements, and some situations — such as residents in long-term care — are handled differently. Ask Pill4Me Pharmacy to check your coverage, or call 604-705-3644 and we will confirm it for your plan.

Related medications

Advil (ibuprofen)Aleve (naproxen sodium)Voltaren (diclofenac)Aspirin (acetylsalicylic acid (ASA))

Compare your options

Compare acetaminophen, ibuprofen, naproxen and Voltaren

Not sure which option is right for you?

You don't need an appointment to ask. Our pharmacists can check this against your other medications and your health history, in the store or over the phone — there's no charge for the conversation.

Call 604-705-3644 Minor ailments service Transfer my prescription

Pill4Me Pharmacy is at 5625 Promontory Rd Unit 101, Chilliwack, BC. We deliver free to Chilliwack, Sardis, Promontory, Vedder and Yarrow, and you can reach a pharmacist directly at 604-705-3644.