Is Tylenol bad for your kids?

July 11, 2:01 PMAtlanta Children's Health ExaminerKristen DiPaolo

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AP Photo/ Steven Senne

A recent government warning has many parents asking if they are harming their children by giving them over-the-counter medications like Tylenol.

An FDA advisory panel recently warned that overdoses of acetaminophen (the main ingredient in Tylenol and dozens of other painkilling products) can cause liver damage. 

The drug sends 56,000 people to the emergency room every year, and around 200 people die.

“Liver damage is a significant problem because it’s not a reversible thing,” says Dr. Ruth Brown of Northside Pediatrics in Sandy Springs. 

An FDA advisory panel has recommended lowering the maximum amount of acetaminophen that can come in a single pill.  Extra Strength Tylenol would be over the limit.  There's no word on when the FDA will make a final decision.

Pharmacist Rebecca Drake told the panel that her sister died of liver failure last year, after taking increasing amounts of acetaminophen to control the pain of acid reflux.

Even though Tylenol is a relatively safe drug, parents have to use extreme caution when giving it to their kids.  Measuring incorrectly can be a grave mistake.

Dr. Brown says three to four times the normal dose is an accute overdose, which can be immediately toxic.
 
Liver damage can occur with one single megadose or by repeatedly giving a child too much acetaminophen over an extended period of time.

“Read labels, read labels, read labels!” Dr. Brown advises. 

This is especially important because there are many different types of Tylenol, all with different dosing instructions.

“There's Tylenol for babies, there's chewable Tylenol, there's junior strength Tylenol, so you have to read labels very carefully or you can significantly overdose.”

Brown’s partner, pediatrician Dr. Jonathan Winner says to never exceed giving a child Tylenol five times a day.

The amount of acetaminophen you give to your child depends on weight, not age.  The general rule of thumb is seven milligrams per pound.

He also says don’t be afraid to skip the pain reliever altogether. “Allow the fever or headache to go away on its own.”
  
Dr. Winner says sometimes parents run into trouble because they assume that if one pill is good, two is better.

In pediatrics, Dr. Brown says most acetaminophen overdoses occur from suicide attempts in teens.

“They don't think,” she says.  “When they do this they are impulsive and Tylenol just happens to be what they have at home, and they take it.”

Because Tylenol is viewed as harmless, the teenager may be attempting to scare their parents, but think nothing bad will happen.  Parents may also fail to lock up the drug. 

The symptoms of liver damage can take time to appear.  They include loss of appetite and nausea.  If you think your child has taken too much acetaminophen, get to an emergency room as soon as possible.