Tylenol is an over-the-counter (OTC) pain reliever and fever reducer that’s a brand name for acetaminophen. This medication is commonly used alongside other pain relievers, such as aspirin, ibuprofen, and naproxen sodium.
While some people take aspirin because of its mild blood-thinning effects, Tylenol isn’t a blood thinner. However, there are still some important things to know about Tylenol and how it works when deciding between using it and other pain relievers, including blood thinners.
Although acetaminophen has been around for over 100 years, scientists still aren’t 100 percent certain how it works. There are many working theories.
One of the most widespread is that it acts to block certain kinds of cyclooxygenase enzymes. These enzymes work to create chemical messengers called prostaglandins. Among other tasks, prostaglandins transmit messages that signal pain and lead to fever.
Specifically, acetaminophen may stop prostaglandin creation in the nervous system. It doesn’t block prostaglandins in most of the body’s other tissues. This makes acetaminophen different from nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen that also relieve inflammation in the tissues.
While this is the most prevailing theory about how Tylenol works, researchers are also studying how it may potentially affect other aspects of the central nervous system. This includes receptors like serotonin and endocannabinoid.
It may seem unusual that doctors don’t know exactly how Tylenol works. However, there are many medications available in today’s market with a similar story that are safe when used as directed.
Tylenol is largely a safe and effective pain and fever reducer. Because doctors think Tylenol works mostly on the central nervous system, it’s less likely to irritate the stomach when compared to aspirin and ibuprofen.
Also, Tylenol doesn’t have effects on blood and blood clotting as aspirin does. This makes it safer for individuals who are already on blood thinners or at risk for bleeding.
Doctors usually recommend Tylenol as the pain reliever of choice when a woman is pregnant. Taking other pain relievers, such as ibuprofen, is associated with greater risks for pregnancy complications and birth defects.
Tylenol can damage your liver if you take too much of it.
When you take Tylenol, your body breaks it down to a compound called N-acetyl-p-benzoquinone. Normally, the liver breaks this compound down and releases it. However, if there’s too much present, the liver can’t break it down and it damages the liver tissue.
It’s also possible to accidentally take too much acetaminophen. The acetaminophen found in Tylenol is a common additive to many medications. This includes narcotic pain medications and pain relievers that may contain caffeine or other components.
A person could take a recommended dose of Tylenol and be unaware that their other medicines contain acetaminophen. That’s why it’s important to read medication labels carefully and always tell your doctor about all the medications you’re taking.
Also, for those who desire a pain reliever that also has blood-thinning or inflammation-relieving properties, Tylenol doesn’t offer these.
Both Tylenol and aspirin are OTC pain relievers. However, unlike Tylenol, aspirin also has some antiplatelet (blood-clotting) properties.
Aspirin blocks the formation of a compound called thromboxane A2 in platelets in the blood. Platelets are responsible for sticking together to form a clot when you have a cut or wound that’s bleeding.
While aspirin doesn’t prevent you from clotting entirely (you’ll still stop bleeding when you have a cut), it does make the blood less likely to clot. This can be helpful in preventing strokes and heart attacks that may be due to blood clots.
There’s no medication that can reverse the effects of aspirin. Only time and the creation of new platelets can accomplish this.
It’s important to know that aspirin is also found in some other OTC medications, but it isn’t as well-advertised. Examples include Alka-Seltzer and Excedrin. Reading medication labels carefully can ensure you aren’t accidentally taking aspirin in more than one way.
If you take blood thinners, such as Coumadin, Plavix, or Eliquis, your doctor may recommend taking Tylenol for pain as opposed to aspirin or ibuprofen. Some people do take both aspirin and another blood thinner, but only under their doctors’ recommendations.
Doctors won’t usually recommend taking Tylenol if you have a history of liver problems. This includes cirrhosis or hepatitis. When the liver is already damaged, a doctor may suggest taking a pain reliever that doesn’t potentially affect the liver.
Tylenol, NSAIDs, and aspirin can all be effective pain relievers. However, there may be some scenarios where one pain reliever is better than another.
I’m 17, and I need a pain reliever. What should I take?
Avoid taking aspirin, as it increases the risk for Reye’s syndrome in those ages 18 and under. Tylenol and ibuprofen can be effective and safe when taken as directed.
I have a muscle sprain and need a pain reliever. What should I take?
If you have a muscle injury in addition to pain, taking an NSAID (such as naproxen or ibuprofen) may help to relieve inflammation that causes pain. Tylenol will also work in this instance, but it won’t relieve inflammation.
I have a history of bleeding ulcers and need a pain reliever. What should I take?
If you have a history of ulcers, stomach upset, or gastrointestinal bleeding, taking Tylenol can reduce your risks for further bleeding when compared to aspirin or ibuprofen.
Tylenol can be a safe and effective pain reliever and fever reducer when taken as directed. It doesn’t have blood-thinning effects as aspirin does.
Unless your doctor tells you otherwise, the only time you should avoid Tylenol is if you’re allergic to it or if you have a history of liver problems.