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What Are Tylenol Side Effects In Elderly People? A Comprehensive Guide for 2023

Tylenol Bottle - Tylenol for elderly Approximately 85% of older adults suffer from chronic pain, which impairs their everyday lives. Are you someone who struggles with constant pain too, or does your elderly loved one do? If yes, it’s essential for you to know that there are ways to manage pain effectively, and you or your loved one don’t have to suffer in silence. One of the most popular pain relievers on the market today is Acetaminophen, commonly known as Tylenol. In this blog, we’ll take a closer look at how it can help alleviate pain and possible Tylenol side effects in the elderly.

Overview of Tylenol

Acetaminophen is an over-the-counter (OTC) drug used as an analgesic (to relieve pain) and antipyretic (to reduce fever).In the United States, it is sold under the brand name Tylenol. It’s the first-line agent used to relieve mild to moderate pain. It is also prescribed for treating fever, cold, headache, and flu. Acetaminophen can be administered by oral, rectal, and intravenous routes. It is more commonly taken orally in the form of a caplet, capsule, syrup, or suspension. For adult patients, it can also be taken rectally in the form of a rectal suppository. IV infusions of Acetaminophen are also available. Overdosing on Tylenol can have serious consequences, including liver and kidney failure. It’s also crucial to be mindful of high doses, as well as alcohol intake when using Tylenol. A standard safe dose of Acetaminophen in adults is 325 mg to 500 mg every 4 hours or 500 mg to 1000 mg every 6 to 8 hours. Those adults who are above 80, frail, at risk of hypertoxicity, or have organ dysfunction should not exceed their dosage of more than 2g daily. However, if it has to be taken up for one-time only or short-term duration, the dose can be increased up to 4 g per day depending on the overall health of the elderly patient. Tylenol can be taken on an empty or full stomach with water or milk. However, it is absorbed faster and shows quicker relief in symptoms when taken before meals. On an empty stomach, Tylenol oral disintegrating tablets or liquid provides relief from symptoms after approximately 20 minutes, and on a full stomach, it takes twice as long. It’s best to seek the medical advice of a healthcare professional or doctor, who can review your loved one’s medical history and prescribe the appropriate dosage.

Tylenol (Acetaminophen) Side Effects in Elderly

An older woman reading information on the medication - acetaminophen side effects in elderly Although Tylenol has a lower risk of side effects as compared to other pain relievers, there are a few side effects it can cause in all age groups including older adults due to overdosage or other underlying issues.
  • Nausea
  • Vomiting
  • Constipation
  • Itching
  • Rash
  • Dizziness
  • Drowsiness
  • Confusion
  • Headache
  • Skin hypersensitivity
  • Kidney disease
  • Anemia
  • Stomach Pain
Studies show that Tylenol should be contraindicated in people with active liver disease, malnourishment, or hypersensitivity to Tylenol. Hence, it is advised to discuss your elderly’s history and current health status with your physician before taking this over-the-counter medicine.

Age-Related Factors That Increase Tylenol Side Effects

Certain factors can increase the risk of Tylenol side effects in elderly people. These factors include any pre-existing medical condition, drug interaction due to multiple drug regimens, and age-related changes in metabolism.

Pre-existing Medical Conditions

Elderly individuals may have pre-existing medical conditions such as liver or kidney disease, which can affect their ability to metabolize and eliminate acetaminophen from their bodies. As we age, the function of our organs including kidneys, liver, and stomach declines. Metabolism also slows down. This makes it difficult for the body to process the drugs, which can build up in the body and harm the liver and kidneys.

Drug Interactions with Tylenol

In geriatrics, the term ‘polypharmacy’ is quite common which refers to the use of a variety of drugs to treat various existing health conditions in older adults. Older people often have to cope with multiple medical conditions, hence they are mostly taking more than one medication at one time. The more medication a patient takes, the higher the risk of a drug interaction. So, it is possible to have a reaction if a certain medication interacts with Tylenol and shows a side effect. If an elderly is taking Warfarin and acetaminophen, there can be a risk of bleeding as Tylenol increases the effects of Warfarin. Similarly, Isoniazid (a drug used in the treatment of tuberculosis) can interact with Tylenol and cause the risk of Liver damage. Anticonvulsants like Phenytoin and Phenobarbital can also interact with Acetaminophen and amplify its side effects. In addition, it is important to check with a healthcare provider before combining Tylenol with other prescription or over-the-counter medications. They will be in a better position to assess the risks and benefits of medications and recommend appropriate dosages and monitoring to minimize the side effects.

Alternatives to Tylenol

Although Tylenol is a commonly used medication for pain relief, there are various alternatives that can be effective in pain relief and more suited for certain conditions. These alternatives include both pharmacological and non-pharmacological options.

Pharmacological Options

These include drugs that target the pain receptors of the body and reduce the symptoms.
  1. Opioid Analgesics: They act on opioid receptors to relieve severe and acute pain. Oral opiates are more common in palliative care and senior care. Frequently used opioids in the elderly are Morphine, Codeine, Oxycodone, etc. They also come as a combination with acetaminophen in a ‘weaker opioid’ form.
  2. NSAIDs: Non-steroidal Anti-Inflammatory Drugs (NSAIDs) are another first-line choice of drugs after Tylenol. They are widely used for the management of pain, fever, and inflammation. Most frequently used NSAIDs are ibuprofen, naproxen, diclofenac, and aspirin.
  3. Corticosteroids: Corticosteroids are anti-inflammatory drugs that act like natural steroids and relieve symptoms of pain, edema, and inflammation. They are mostly used for treating short-term pain caused by long-term conditions. to long-term conditions. Commonly used corticosteroids include cortisone, hydrocortisone, and prednisone.

Non-pharmacological Options

Apart from drugs as a choice of treatment, there are some interventions that can be helpful in managing pain and improving movement in the body. Here are a few of them:
  1. Physical therapy: This consists of exercises, manual techniques, joint mobilizations, and soft-tissue manipulations. It aims to reduce pain, restore mobility and improve strength, and function in the elderly.
  2. Acupuncture: It involves the insertion of thin needles into specific points on the body to relieve pain and improve overall well-being.
  3. Massage: Geriatric massage therapy can help relieve tension and improve blood flow to painful areas. It also improves the flexibility and performance of muscles, hence enabling seniors to move without pain.
  4. Heat or cold therapy: Heat or cold therapy can also be useful for pain relief. The heat helps to soothe and relax tight muscles, while cold therapy can reduce swelling and reduce pain.
Older woman putting medication into boxes - acetaminophen for elderly

Comparison of Acetaminophen to Ibuprofen

Acetaminophen and Ibuprofen, both are over-the-counter analgesics. However, there are some differences in their mechanism of action, uses, and side effects. Let’s take a look.
Acetaminophen buprofen
Trade Names Tylenol Advil, Motrin
Class Analgesic, Antipyretic Non-steroidal Anti-Inflammatory Drugs (NSAIDs)
Mechanism of Action Stops the body from making prostaglandins in the central nervous system, which helps to lower pain and fever. Stops the body from making prostaglandins in the central nervous system, which helps to lower pain and inflammation
Indications Pain, Fever Pain, Fever, Inflammation
Contraindications Hypersensitivity to Tylenol, Active Liver Disease Hypersensitivity to Ibuprofen, Gastrointestinal bleeding, severe kidney disease, stomach ulcers, heart disease
Drug Interactions
Warfarin Yes Yes
Aspirin No Yes
SSRIs Antidepressants No Yes
SNRIs Antidepressants No Yes
Antihypertensive Drugs (Losartan, Valsartan) No Yes
Antimetabolite (Methotrexate) No Yes
Mood Stabilizer (Lithium) No Yes

Which One Is Better For Elderly People?

Bottle of pills - acetaminophen side effects elderly Since older people might usually experience chronic pain due to degenerative changes in their bodies, they need a drug choice that is safer for long-term use. Acetaminophen is used in treating mild and moderate pain like low back pain while Ibuprofen is mostly used for relieving pain and inflammation associated with inflammatory problems like Rheumatoid Arthritis. Due to its anti-inflammatory action, Ibuprofen might be argued as more effective. But it belongs to non-steroidal anti-inflammatory drugs (NSAIDs) which have shown more and relatively serious side effects in elderly people as compared to Acetaminophen. These side effects commonly include intestinal bleeding, and kidney, liver, and heart diseases. Hence, Ibuprofen can be recommended only for a short duration if necessary. On the other hand, Acetaminophen has a better safety range, is well-tolerated, and has a lower risk of side effects when used as a long-term drug of choice. However, discuss this with your loved one’s physician before you buy or administer drugs to them.


Tylenol is one of the most commonly used over-the-counter pain relievers for the elderly as well as all other age groups. Due to its well-established efficacy and low risk of side effects, it is preferred over nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, diclofenac, and opioid analgesics as well. However, it’s important to understand the potential side effects of Tylenol for the elderly and follow recommended dosages and administration guidelines to avoid complications. Overall, when used responsibly and under the guidance of a physician, Tylenol can provide effective relief for elderly people dealing with pain. If your elderly loved one is dealing with pain from mobility issues or medical conditions, they may need someone to assist with personal care. Amy’s Eden provides exceptional caregivers who will ensure your loved one is taken care of in their home or where they call home. Contact us today to see how we can assist your senior relative with personal care and manage their pain.

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