Evie Summers
Tylenol PM is a combination medicine used to treat occasional insomnia associated with minor aches and pains. It contains acetaminophen, which can reduce fever, mild to moderate pain, and can be used as a sleep aid. However, Tylenol PM has been linked to several health risks and side effects, including liver damage, severe skin reactions, and an increased risk of dementia. In rare cases, acetaminophen may cause a severe skin reaction that can be fatal. Furthermore, an overdose of acetaminophen can cause death, and the medication should not be used for longer than two weeks to treat sleep problems. There are also concerns about the potential for misuse, especially when combined with alcohol, which can increase the risk of liver damage.
| Characteristics | Values |
|---|---|
| Brand Name | Tylenol PM |
| Active Ingredients | Acetaminophen, Diphenhydramine HCl |
| Use | Temporary relief of occasional insomnia associated with minor aches and pains, headaches, back pain, joint or muscle pain, tooth pain, menstrual cramps, allergies, common cold, or flu |
| Side Effects | Skin reactions, constipation, confusion, bladder problems, elevated mortality risk, car accidents, falls, depression, cancer, liver damage, heart problems, seizures, coma, death |
| Warnings | Do not use for more than 2 weeks for sleep problems, do not use to make a child sleepy, do not use with other drugs containing acetaminophen, avoid alcohol, may cause drowsiness |
| Overdose Symptoms | Nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, dark urine |
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What You'll Learn
Liver damage from acetaminophen overdose
Acetaminophen, the active ingredient in Tylenol PM, can cause liver damage and even liver failure in overdose quantities. In 2012, the FDA suggested lowering the maximum daily dose for adults to 3 grams, with no more than 650 mg taken every 6 hours. Overdose symptoms can take up to 12 hours to appear, and medical attention should be sought immediately if overdose is suspected.
Acetaminophen toxicity can occur when a person knowingly takes more than the recommended maximum daily dose or accidentally when a person takes multiple products containing acetaminophen and exceeds the recommended maximum daily dose. The maximum recommended acetaminophen dosage is 4 grams per day for adults and 90 mg/kg/day for children. People with underlying liver disease or those with chronic alcohol consumption are at an increased risk of developing hepatotoxicity (liver damage from chemicals) when using acetaminophen.
Consuming alcohol while taking acetaminophen can increase the risk of liver damage. The risk of overdose is also heightened when taking acetaminophen with other drugs that can cause drowsiness, such as opioid medication, sleep medicine, muscle relaxers, or medicine for anxiety or seizures.
The initial symptoms of acetaminophen toxicity can take up to 12 hours to appear. Doctors will attempt to begin treatment within eight hours of ingestion for the best outcome. The majority of patients survive acetaminophen toxicity with supportive care, including intravenous fluids, anti-nausea medication, activated charcoal, and antidotal therapy.
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Side effects of diphenhydramine
Tylenol PM is a combination medicine used to treat occasional insomnia associated with minor aches and pains. It is not meant to be used for more than two weeks to treat sleep problems. It contains acetaminophen, and an overdose of this can cause liver damage or even death. Tylenol PM also contains diphenhydramine, an antihistamine that blocks the activity of acetylcholine, a brain chemical that plays a role in muscle activation and brain functions like alertness, learning, and memory.
Diphenhydramine is an anticholinergic drug that can be taken as a medication by itself or in combination with pain relievers, fever reducers, and decongestants. It is used to treat allergies and allergic reactions and can also prevent and treat motion sickness or symptoms of Parkinson's disease. It is usually taken as needed and should be taken exactly as directed on the prescription label or by a doctor.
- Drowsiness: This usually wears off around eight hours after a dose. Do not drive, use machinery, or engage in activities requiring mental alertness if feeling drowsy.
- Dizziness: This may cause difficulty concentrating or feeling unsteady on your feet. If this occurs, stop what you're doing and sit or lie down until you feel better. Do not drive or operate heavy machinery if feeling dizzy.
- Skin rash: If you experience a new skin rash or eczema where you've applied the cream, or if your existing eczema worsens, stop using diphenhydramine and consult a doctor.
- Allergic reaction: In rare cases, a severe allergic reaction (anaphylaxis) may occur. Symptoms include swelling of the lips, mouth, throat, or tongue, rapid breathing or difficulty breathing, and a tight throat or swallowing issues. Seek immediate medical attention if you experience these symptoms.
- Other side effects: Less common side effects include constipation, confusion, and eye pain or changes in vision. Report any unusual or persistent side effects to your doctor or pharmacist.
It is important to note that the above list may not be exhaustive, and individuals should always refer to the leaflet inside their medicine packet for a full list of potential side effects. Additionally, diphenhydramine may interact with other medications, vitamins, or supplements, so it is crucial to inform your doctor or pharmacist before taking this drug.
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Increased risk of dementia
While Tylenol PM is a combination medicine used to treat occasional insomnia associated with minor aches and pains, it is not recommended for use in treating sleeplessness without pain or sleep problems that occur often. Over-the-counter (OTC) sleep medications such as Tylenol PM have been linked to an increased risk of dementia.
A 2015 study published in JAMA Internal Medicine found that the regular use of diphenhydramine, an anticholinergic drug found in Tylenol PM, was associated with a significantly increased risk of dementia. Anticholinergic drugs block the activity of acetylcholine, a brain chemical that plays a role in memory and learning. As a result, these drugs can cause side effects such as confusion and constipation.
Research has shown a strong association between routine sleep medication use and the risk of incident dementia. A study of 2,336 older adults in Finland found a significant association between the use of pharmacological sleep medication for over 60 days and worse cognitive function. Another study using nationally representative data from older adults aged 65 and above in the United States found that routine sleep medication use was associated with a greater risk of incident dementia across all models.
The potential link between sleep medication use and dementia is a growing concern, especially as sleep difficulties are common among older adults. While existing research has not established a direct cause-and-effect relationship, the association suggests that long-term use of OTC sleep medicines may increase the risk of dementia, with the risk increasing with more frequent use.
It is important to note that insomnia and daytime sleepiness can also lead to dementia, and people with dementia often suffer from sleep disorders. Therefore, it is crucial to explore alternative approaches to treating insomnia before resorting to medications, as they can interfere with brain chemistry.
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Mortality risks
Tylenol PM is a combination medicine used to treat occasional insomnia associated with minor aches and pains. It contains acetaminophen and an antihistamine. Antihistamines can cause drowsiness, making them useful as a sleep aid. However, misuse of antihistamines in very young children can lead to death.
Acetaminophen, also known as paracetamol, is a common painkiller. It is generally safe for adults at recommended doses but can be dangerous, even fatal, at high doses. An overdose of acetaminophen can cause severe liver damage, and even death. It is important to be aware that acetaminamine is present in many non-prescription and prescription medications, and accidental overdose is possible. Alcohol use, especially when combined with acetaminophen, may also damage the liver, so it is recommended that those taking acetaminophen avoid alcohol.
Diphenhydramine, the antihistamine found in Tylenol PM, can lead to serious heart problems, seizures, coma, or death if too much is taken. It is an anticholinergic drug, which means it blocks acetylcholine, a brain chemical that plays a role in muscle activation and brain functions like alertness, learning, and memory. As a result, diphenhydramine can cause side effects such as constipation and confusion.
There are also broader concerns about the use of sleeping pills. Sleeping pills have been associated with car accidents, falls, and depression, all of which could contribute to elevated mortality risks. Sleeping pills have also been linked to specific types of cancer, including lymphomas and cancers of the lungs, colon, and prostate. While no causal relationship has been established, the evidence suggests that sleeping pills are not a safe or effective long-term solution for insomnia.
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FDA warnings
Tylenol PM is a combination medicine used to treat occasional insomnia associated with minor aches and pains. It is not meant to be used for treating sleeplessness without pain or for sleep problems that occur often. It is also used to treat minor aches and pains such as headaches, back pain, joint or muscle pain, tooth pain, or menstrual cramps. It is also used to treat symptoms of allergies, the common cold, or the flu.
The FDA has issued several warnings regarding the use of Tylenol PM:
Liver damage
Tylenol PM contains acetaminophen, which can cause severe liver damage if taken in excess. The FDA warns users not to exceed the daily limit of acetaminophen when using Tylenol PM or any other medication containing acetaminophen. Drinking alcohol while taking acetaminophen may also increase the risk of liver damage.
Allergic reactions
Acetaminophen may cause severe and potentially fatal skin reactions in rare cases. Symptoms may include hives, difficulty breathing, and swelling of the face, lips, tongue, or throat. The FDA advises users to seek medical help immediately if they experience any of these symptoms.
Diphenhydramine
Tylenol PM also contains diphenhydramine, an anticholinergic drug that can block the activity of acetylcholine, a brain chemical involved in muscle activation and brain functions like alertness, learning, and memory. Taking too much diphenhydramine can lead to serious heart problems, seizures, coma, or even death. The FDA warns against using Tylenol PM with any other medicines that contain acetaminophen or diphenhydramine, as it can result in a fatal overdose.
Misuse in children
The FDA warns that Tylenol PM is not for use in anyone younger than 12 years old. Death can occur from the misuse of antihistamines in very young children. It should not be used to make a child sleepy and should be kept out of the reach of children.
Long-term use
While the FDA has not issued specific warnings about the long-term use of Tylenol PM, studies have linked regular, long-term use of OTC sleep medicines like Tylenol PM to potentially serious side effects, including an increased risk of dementia.
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Frequently asked questions
Yes, Tylenol sleeping pills can cause death if they are overdosed on. An overdose of acetaminophen, an ingredient in Tylenol, can cause fatal liver damage. Additionally, taking too much diphenhydramine, another ingredient in Tylenol, can lead to serious heart problems, seizures, coma, or death.
Some of the side effects of Tylenol sleeping pills include constipation, confusion, and an elevated risk of car accidents, falls, and depression. Studies have also linked the regular, long-term use of Tylenol sleeping pills to an increased risk of dementia.
If you overdose on Tylenol sleeping pills, it is important to get medical help right away, even if you feel well. Overdose symptoms may include nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, and dark urine.
