Acetaminophen or paracetamol, commonly sold in the U.S. under the brand name Tylenol®, is one of the most common OTC medications, particularly for children. It is often recommended by pediatricians for a myriad of conditions ranging from teething to earaches and even minor bumps or bruises. Its use is so common that few of us ever stop to wonder why we use it so frequently and whether it carries any risks that we should consider. While there are actually multiple known risks documented in the scientific literature, two of the most serious include liver damage and the potential to contribute to asthma.

Liver Failure

The single greatest risk with routine use of acetaminophen is damage to the liver. As recently as a decade ago, this was believed to be only related to misuse or overuse, but modern studies demonstrate that even appropriate use of the drug can negatively impact liver function (Watkins,, 2006). In fact, acetaminophen overuse leads to 56,000 emergency room visits and roughly 458 deaths each year in the United States (Lee, 2004). It has been found to be a leading cause of liver failure in children requiring transplant, and is the single most common cause of acute liver failure in both the U.S. and the U.K. each year (Kulkarni, 2015; Chun,, 2009). 

Does Tylenol Cause Asthma? 

Acetaminophen is particularly risky early in life. Several epidemiological studies have found that infants and children who take acetaminophen during childhood are far more likely to develop asthma afterwards. One particularly noteworthy study evaluated over 320,000 children in across 50 countries and found that, not only is acetaminophen use strongly associated with asthma, but that there is a relationship between the total exposure of acetaminophen and the severity of the child’s symptoms (Beasley, 2011).

Is the evidence currently sufficient to say without a doubt that acetaminophen use causes asthma? Not yet, but what does exist indicates that it is likely to increase the overall risk for asthma. Given that asthma incidence rates are rapidly increasing in both the U.S. and the U.K., avoidance of any substance with strong potential to increase risks is always a good move. 

What to do? 

What does all of this mean for our health? For the health of our children? In practical application, even routine, occasional uses where the dosing instructions are followed precisely can potentially increase the risk of asthma, liver damage, or other health outcomes. So before reaching for that familiar bottle, a good first question to ask is: Are there any alternatives that would be safer? Given that acetaminophen is usually used to treat symptoms such as pain and fever, there are several effective and gentle natural alternatives. 

Options for Pain Relief

Capsicum, ginger, peppermint oil, and cinnamon oil are all powerful topical analgesics in the natural toolkit. For inflammatory conditions, turmeric is unsurpassed at reducing painful inflammation and in some countries it is used routinely in place of acetaminophen.

How to cite this article: Franklin Institute of Wellness. (2018). Is Tylenol/ Acetaminophen / Paracetamol Safe?. Retrieved from on June 20, 2019.