How Does Tylenol (Acetaminophen) Work? (2024)

Tylenol (acetaminophen) is primarily used to reduce fever and manage mild to moderate pain. Unlike aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), Tylenol does not directly affect your blood or contain strong anti-inflammatory properties. Instead, it works in the brain and spinal cord.

Tylenol cools down the body to reduce fevers, and it raises the body's pain threshold to relieve mild to moderate aches and pains.

This article discusses how Tylenol works in the body and what to expect when taking it.

How Does Tylenol Work?

The exact mechanism of action of Tylenol is not well understood. However, we know it works in the brain and spinal cord.

Theories about Tylenol's mechanism of action have been discussed in the context of common NSAIDs, which are popular for decreasing pain and inflammation. Tylenol does not work in the same way as these drugs.

NSAIDs, such as Advil or Motrin (ibuprofen), inhibit or block a specific compound called cyclooxygenase (COX). COX compounds are responsible for the formation of hormone-like substances called prostaglandins and contribute to inflammation.

The way the body breaks down Tylenol is more complex than how it breaks down NSAIDs. Tylenol does not have as much of an effect on COX compounds. NSAIDs are more potent COX compound blockers that decrease prostaglandin formation much more than acetaminophen can, which contributes to its anti-inflammatory effects.

Tylenol, however, works in the brain and spinal cord. Because of this, Tylenol is a great medication for fever, as it is an antipyretic, which is a type of drug that reduces the body's temperature. This medication can cool the body down and increase the pain threshold to improve pain tolerance, thus reducing mild to moderate pain to a more manageable level.

What Is Tylenol Used For?

Tylenol has a broad spectrum of uses for pain; however, it is used differently depending on your age group.

For example, Tylenol can help reduce symptoms related to the following health conditions and illnesses in adults:

• Osteoarthritis (OA) or bone pain
• "Painsomnia" (sleepless nights due to pain)
• Muscle aches
• Headache
• Cold and flu

Common pain management conditions that Tylenol can treat in children include:

• Teething
• Earache
• Sports injuries
• Cold and flu
• Fever

Children 2 years and under can take Tylenol for certain purposes. Always ask a healthcare provider or pharmacist before giving your baby Tylenol, as it should be dosed properly according to their weight and tolerance.

Does Tylenol Affect the Liver?

Tylenol is primarily processed by the liver and later eliminated through the urine.

Tylenol is notorious for its risk of damaging the liver if it is not used properly. The following can increase the risk of liver damage or toxicity while taking Tylenol:

• Consuming large amounts of alcohol
• Having a fatty or damaged liver
• Taking more than 3,000 milligrams (mg) of Tylenol daily over an extended period

Always speak with your healthcare provider or a pharmacist about what products are OK to take with your Tylenol, as many other medications contain the same active ingredient (acetaminophen). Acetaminophen is present in many combination cough-and-cold medications or even in some more potent pain medications or opioid-combination medications (e.g., Tylenol #3, which contains acetaminophen and codeine).

If taken appropriately, Tylenol is safe and beneficial. It's generally recommended to avoid taking acetaminophen-containing products for an extended period, depending on your health status.

Are There Any Drugs I Shouldn’t Take With Tylenol?

Most drugs are relatively safe to take with acetaminophen. However, some should be avoided. These include:

• Alcohol
• Gleevec (imatinib), a drug to treat cancer
• Isoniazid, an antibiotic to treat mycobacterial infections
• Metopirone (metyrapone), a drug used to detect adrenal insufficiency

When taken at the same time, these drugs can interfere with Tylenol and cause a toxic buildup of acetaminophen in the body.

Always speak to your healthcare provider about what medications you are taking while also taking acetaminophen.

Alternatives to Tylenol

If you cannot take Tylenol, alternative options are available to help manage your pain.

NSAIDs

Some other medications include NSAIDs for minor or acute pain. The following are some common NSAIDs found over the counter (OTC) and a few that may need to be prescribed by a healthcare provider.

Examples of commonly used NSAIDs include:

• Advil, Motrin (ibuprofen): OTC or prescription
• Aleve, Naprosyn (naproxen): OTC or prescription
• Aspirin: OTC
• Celebrex (celecoxib): Prescription
• Ketorolac: Prescription
• Mobic (meloxicam): Prescription

Opioids

Opioids can be prescribed for severe pain that alternative pain medications cannot treat. They are considered addictive and have more potential for abuse than other pain medications. If you've been prescribed opioids, talk with your healthcare provider about how to safely and properly take them.

Commonly prescribed opioids include:

• MS Contin (morphine)
• Methadose (methadone)
• OxyContin (oxycodone)
• Hydrocodone

Summary

Tylenol can effectively reduce fevers and manage mild aches and pains. Unlike NSAIDs, Tylenol is not an anti-inflammatory drug. Instead, it works in the brain and spinal cord to regulate the body's temperature and improve your pain threshold. Because of how it works, Tylenol is a better option than NSAIDs for treating fevers and aches and pains not caused by inflammation.

The author would like to recognize and thank Jaycob Mathew Peña for contributing to this article.