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Question: I suffer from osteoarthritis. My doctor says I should keep exercising even though my joints hurt. He says it’s okay for me to take a pain medication like Tylenol in order to remain active. But I’ve read that Tylenol can damage my liver. What am I to do?
Answer: You are right to be concerned about medication safety. But your doctor’s also right that you need to be physically active. So how do you balance these seemingly competing objectives?
I posed your question to two specialists at Sunnybrook Health Sciences Centre: One is a surgeon who performs joint replacement operations and the other is an expert in drug safety.
Let’s start with the surgeon. Dr. Jeffery Gollish, Medical Director of Sunnybrook’s Holland Orthopaedic and Arthritic Centre, says he sees lots of people who feel the same way you do.
Many patients, he says, fear that exercise will lead to additional damage of their joints. The fact that it hurts when they move is taken as a sign that they are doing harm to themselves. And they worry medications that mask their pain will simply allow them to do even more harm.
“The issues of exercise and medication are two areas where the public has misconceptions,” says Dr. Gollish. “They think both are harmful. In fact, both are beneficial.”
Exercise, in general, is good and won’t harm the joints. “The only thing we tell people to stop doing is running – and avoiding any impact activity.”
Patients who are waiting for knee or hip replacement surgery need to keep up their strength and remain flexible, he adds. Patients in better shape tend to have smoother recoveries than those who are out of condition. “If people exercise before surgery, and maintain their flexibility, the likelihood is that their post-operative range of motion will also be better.” And, likewise, “the worse they are pre-op, the harder it is for them to get better post-op.”
At Sunnybrook’s Holland Centre, the assessment process for knee and hip surgery includes patient education about exercise. Indeed, even before patients are referred to a surgeon, they see a specially-trained Advance Practice Physiotherapist.
“The therapist spends time with them, assessing their problem and educating them on what they can do to help themselves from the standpoint of exercise, activity modification and over-the the counter non-prescription medications,” he explains.
“Our experience is that people are coming into the hospital much better prepared for surgery than they were before we adopted this approach… a decade ago.”
And, he says, if medication can relieve pain and enable patients to exercise, that is a good thing.
So let’s now address the safety issue of using drugs in this fashion. Acetaminophen, commonly known by the brand name Tylenol, tends to be the most recommended pain reliever for patients like you who have osteoarthritis. There is ample justification for choosing it, according to Dr. David Juurlink, head of Clinical Pharmacology and Toxicology at Sunnybrook.
“It is an exquisitely safe drug so long as you don’t take too much of it,” says Dr. Juurlink, who is also a researcher at the Institute for Clinical Evaluative Sciences.
“There is a reason why it’s been on the market for decades and is available in so many over-the-counter products.”
He says most patients can safely consume three or even four grams of acetaminophen day-after-day for long periods. “It is when you get to six, seven or eight grams a day that you get into trouble.”
An extra-strength tablet contains 500 milligrams.
“If you take two extra-strength tablets, three times a day, you are consuming a total of three grams a day,” he notes. “You can’t get liver damage from that amount.”
Furthermore, Dr. Juurlink says acetaminophen tends to result in fewer negative reactions than the alternative non-prescription pain relievers. For instance, regular use of non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen (Advil), naproxen (Aleve) and acetylsalicylic acid (Aspirin) – can damage the lining of the stomach, cause gastro-intestinal bleeding and lead to kidney problems.
(It’s important to mention that acetaminophen is a good pain and fever reliever, but it doesn’t have anti-inflammatory properties. If a patient has an inflammatory condition, such as Rheumatoid Arthritis, then acetaminophen won’t be their drug of choice.)
“The NSAIDs have more toxicities at recommended doses than acetaminophen,” he adds. “Put another way, if everyone who was taking acetaminophen became concerned about its safety and switched to an anti-inflammatory drug such as ibuprofen, we’d see a major increase in drug-related problems.”
Dr. Juurlink says, “people shouldn’t be afraid to take acetaminophen, provided they are mindful of the dose.”
That is a very important caveat. He warns that it’s fairly easy for people to unknowingly take too much acetaminophen in part because it is an extremely common ingredient in numerous over-the-counter products including many of the best-selling cold and flu remedies.
For patients who are already consuming three or four grams daily for pain control, they can quickly move into the danger zone simply by self-medicating for a cold or flu.
“The message for people who are taking acetaminophen regularly is check the ingredients on the other products they are using to make sure they don’t include more of it,” he advises.
So, to recap, the message from our Sunnybrook specialists is two-fold: Exercise is good for patients with osteoarthritis. And you can safely take acetaminophen so long as you’re mindful of the dose.
If you are still reluctant to take the pain reliever, that’s fine too, says Dr. Juurlink. “There are no rules that say people with pain have to take a drug for it. Some people choose to live with discomfort rather than risk taking medication. That is a personal choice, and I respect that. ”
Just don’t let the pain be a reason to forego physical activity.
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Paul Taylor, Sunnybrook’s Patient Navigation Advisor, provides advice and answers questions from patients and their families. His blog, Personal Health Navigator, is reprinted on Healthy Debate with the kind permission of Sunnybrook Health Sciences Centre. Follow Paul on Twitter @epaultaylor.
The comments section is closed.
No mention in the article about the potential detrimental effects of mixing Tylenol with alcohol. A major miss.
this was the information I was looking for before taking Tylenol Extra Strength daily. Thank you so much
Comforting explanation on the safe use of Tylenol extra strength for osteoporosis hip pain and difficulty exercising after partial hip replacement after fracture.
Is taking Tylenol arthritis pills daily harmful? I only take 2 pills once a day
I’m 68 years old and take 3 extra strength Tylenol morning and night every day, for arthritis and joint pain im I safe? Thank you
Your advise for what to do with osteoarthritis by balancing exercise and tylenol was very helpful.
My knees are the problem but I will not be afraid anymore to exercise even tho it hurts and to take some tylenol if in pain thank you for such good advise
I just been told I have fatty liver but I have chronic pain and of course get fevers and headaches. Should I take Motrin or Tylenol
Hi Diana, I had the same issue/complaint. My physician sent me to a rheumatologist where I was diagnosed with osteoarthritis. I take 2 tylenol arthritis every 8 hours. As the acetaminophen allowed is 4000mg a day (24 hours) If you have liver, kidney or diabetes issues, it’s not recommended.
You can take up to 4000 mg of acetaminophen in a 24 hour period. Advise with your physician or pharmacist if you have liver, kidney, or diabetes before taking the amount allowed (24 hours). I take 2 Tylenol Arthritis 650mg every 8 hours. Hope this helps.
Tylenol recommends a maximum of 3,000 mg a day.
So if tylenol is taken daily in a 250 milligram dose it is safe?
Under dr’s order, I am taking 30 ml (can’t swallow pills) every night along With 10 ml of children’s liquid ibuprofen for bad pain in arms due to osteoarthritis. Is this a saf amount of Tylenol to take?
Very helpful
Helpful in what I had to know
I have chronic kidney disease and osteoarthritis. I felt the Tylenol was making me feel “dopey” and “confused”, so I searched for an alternative. I picked the wrong thing: Proteolytic Enzymes — then I googled Bromelain and discovered it would do more damage to my kidneys. My nephrologist confirmed this. Looks like Tylenol is the way to go for osteoarthritis pain and kidney disease.
Victoria Morrow
I take the 650 mg arthritis Tylenol, two per day for serious arthritis and post-back surgery pain.
Is that too much?
Thank you for all your information. I always feel guilty if I take an occasional Tylenol 500. I had chronic hepatitis about 14 yrs. ago due to medication, but have been in remission for most of those yrs. Am I wrong in continuing what I am doing?
I take Tylenol, 500mm only once a day, actually with fear but relieves my osteoarthritis pain. Now, after reading the above assurance I feel comfortable in taking just once a day or twice to relieve my pain. I do daily exercise prescribed by my physiotherapist too. Thank you.
This article has abated my fear of taking Acetaminophen. I do take up to 7 x 300 mg per day and this allows me to function. I have never taken 8 pills a day and my latest liver readings were normal.
One must be careful however. If I am having a particularly bad day I use ice and heat a lot and take it easy.
Also, I walk a lot, use light weights and do some yoga moves my wife has taught me. They have all worked well.
Chronic pain is just plain nasty.
Thanks again for this article.
I take one extra strength Tylenol with for arthritis daily is that harmful to my kidneys or liver
I was afraid to take Tylenol. Too much can cause liver damage. I take 1000 mg. A day. It’s really not good for brain.
I’m 68 yrs old can I take Tylenol 500 mg everyday . My body is always in pain. I suffer from HBP I take baby aspirin 81 is it still safe???? Very concern
This information has helped me to make some real crucial
decisions on how i choose to
treat the pain in my joints going forward.
THANKS
My husband is on Gabapenten (300 mgs, two pills three times a day) plus Tylenol two pills three times a day). He gets very, very tired and can’t do any exercise. I am worried he is over dosing. His doctor says it’s alright. But I don’t think doctors are always right. He needs relief from back pain. What do you think?
Worried wife
,
great article! thank you….
IS IT SAFE TO TAKE TWO 500 MG. TYLENOL TWICE A DAY FOR MONTHS AT A TIME.
I’m 80 yrs old bad arthritis what’s the diff between Tylenol extra strength or Tylenol arthritis meds im also taking duloxetine Is it safe
I’d CBD good for arthritis ?also what is better the oil or gummies ? What brand is good
Thanks for the information. I have had two minimally invasive back procedures. Recently my L4 shifted forward placing pressure on my L5 right nerve root. This latest injury plus facet arthritis is controlled with an aggressive exercise program under the guidance of a physiotherapist. It’s a must for me to maintain, failure to stretch and keep my core strong, results in unbearable pain.
I have had concerns about medications for pain. Those days when I’m not quite up to the work out due to excess pain, I take 2000mg of acetaminophen. This allows me to function and continue with my workouts.
This information, augmented with regular blood work to check organ function, has reassured me that I can contain this track. My neurosurgeon says the only alternative to pain control practices is spine fusion, which is major surgery. That alternative keeps motivates me to keep that dog on a leash as long as possible n
Cheers.
Thanks for the information. I have had two minimally invasive back procedures. Recently my L4 shifted forward placing pressure on my L5 right nerve root. This plus latest challange plus facet arthropathy is controlled with an aggressive exercise program under the guidance of a physiotherapist. It’s a must for me to maintain, as failure to stretch and keep my core strong, would cause unbearable pain.
As part of my rehab regime I often take 2 500mg acetaminophen tablets. This allows me to function and continue with my workouts.
This information, augmented with regular blood work assured me that I’m ok to contact with the dosage.
Cheers.
Thank U Dr. Duurik u were pretty informational about the Tylenol I have to take at least 4 Tylenol Arithritis every to be able to get up in the morning and to go to bed at night I’ve had Lupus sense 2005 have very bad inflammation terrible all over always aching swolle n feverish but I think um going through Steroid Withdrawl n Gabapentin been very sick for 3 mths no appetite lost tremendous weight in 1mth period chills achy joints very swollen in knees hands feet I have no active life anymore with Husaband,Children,GrandChildren,Dog the tylenol is the only thing that ease up aching in inflammation a couple of hours I can’t take nsaids on BT,4BP pills,Plaquenil,Benlysta,oxycodone if u can could u please give me suggestions on how to help myself it would be gladly appreciated.
Thanks for info, very informative.
My question was never answered, except with various cautions which are good. But all I want to know is….can I take 2/500 gm Tylenol every day every 12 hours, like once at 8:00 am and once at 8:00 pm daily.
Thanks for your advice in advance!
Jack
Hi Jack
The article states the answer to your question. You would be taking 2000mg per day. The article indicates that a thing less than 4000mg is ok, of course in consultation with your GP.
Tylenol 2 pills a day is all I want to take. 500mg in each. Will this help mild arthritis and mild anxiety
Is it safe to take cod liver oil pills togather with acetaminoplole capsule?
1 aw CD
Twice a day, 7 am and 3 pm I take an 8 hr Tylenol arthritis (650 mg) and 2 ibuprofen (200 mg) . Is this addictive?
At 85 able to manage stiffness of knees . Starting acetaminophen
Very good assessment
Is it a problem if you happen to take four Extra Strength Tylenol capsules?
Thank you so much. I have mild arthritis in the neck and shoulder area. It bothers me a lot some days and so I take just one Tylanol 325mg. and it gets much better and in fact I don’t notice pain with just the one. So I take it sometimes for 1 week but lay off for a longer time until it flares up. I also walk some 30 to 40 minutes per day 7 days per week and I am 82 years of age and no on any medications except a hypothyroid pill once a day for some 26 years. I do take a supplement of beet Juice and heart directed products such as Omega 3 and other minerals and vitamins directed to heart health. My blood pressure is average of 115/74. And my cholesterol levels are 169 over all with a Ldl of 94 or possibly lower on that now. Thankful for all of this to God and also to those in the medical field who worked with me allowing me to find alternative supplenments rather than chemicals to do the job.
wonderful, clear information- thank you
I came here today because I stopped taking acetaminophen for back pain because I think it is causing skin issues on my scalp and face. However, my back pain came back with a vengeance yesterday after 5 weeks of being off of acetaminophen, so I’ll have to live with the skin issues unless or until I can find something else that is just as effective.
This article is somewhat reassuring, but I hope it’s not outdated.
Hi! I have done ablation I have done prostatectomy I have type 2 diabetes and strong arthritic pain on my hens I take every 12 hours Tylenol for arthritis is that ok?
You should be fine, but I would check with your doctor if you are taking meds for diabetes.
I didn’t get the answer to the question,is it safe to use norco or lortab on a regular basis for pain?
Use a search engine or ask your doctor.
At 77, I’ve reached the point where the knee cartilage is gone. I also enjoy a good Bordeaux. My concern is the tie-in between acetaminophen/alcohol/liver damage. Any helpful comments appreciated.
Leave out the bordeaux if you are taking acetaminophen.
i take one tyn every day for my pain . Is it ok im 67 yrs old
Generally speaking, you should be fine. You should check with your doctor if you’re taking other meds though.
Thanks for the answers, I just didn’t want to take too much Tylenol. My problem now is my knees, my right one I’ve had replaced, but the pain is in both knees, the left being worse.
So I guess arthritis is even in my replacement knee.
You could try devil’s claw and a combo product containing glucosamine chondroitin, MSM, and hyaluronic acid (California Gold Nutrition at iHerb). I think taking both products have helped my knee pain.
I received the pneumonia needle over two years ago and at the time I took a bad reaction from the needle. Ever since I have been having pain and discomfort in the liver area. Should I be concerned? Still having days of pain, lots of gas and sometime pain higher on the right side.Had two cats scans and no results of damage to liver. Still having pain and lots of gas. Should I be concerned? I have been taking the Tylenol for severe arthritis since many years, down to two before bed time. Should I continue to take the Tylenol?
Very helpful article
If you can’t get regular Tylenol will Tylenol Arthritis (8hr) serve the same purpose.
Thank you
What about Celebrex instead of acetaminophen for osteo-arthritis pain control? Do both have liver side-effects?
What is the relative risk of side effects of one of them versus the other?
If I am not supposed to take Tylenol for more than 10 days. How long must I wait before taking it after that?
Can going under an anesthetic for an operation for a 83 year old lady cause mental problems
More studies have shown that Tylenol at high dose can also effect your kidneys. I was taking 4,000 milligrams per day for 10 months both Family Dr. and pain management recommendations . It can cause Anemia, reduced number of platelets in blood. I have both. You can find the information on medicinenet website. Switched to Aleve but concerned I was Diagnosed several yrs ago (6) with colitis. Have been in remission for 3 years. So it dies have effect on kidneys. I have had ongoing kidney infection for 5 months. So be careful
How long can I take Tylenol for Arthritis
Great info.
I appreciated the article regarding pain meds. I too was concerned about the amount of Tylenol taken and length of time. I have spinal stenosis and go to the limit of grams. I now feel I no longer need to worry. I had back surgery in 2010 and a neurostimulator implant in 2016. Exercise is on board.
What do i take RA, i cant pick up anything, not even my blanket without hurting, my arms hurt like i ‘ve been boxing for hrs. My body is tired
What do i take for RA im tired my arms, hands, wrists hurt have no energy
My Dr told me that Tylenol IS an anti inflammatory though I disagreed with him. Are there any new studies on this subject? I think I should leave this doctor! Agree?
Can I take 4 extra strength Tylenols daily for pain for the rest of my life? I’m 73 and otherwise healthy.
So if I’m taking two 650 mg a day I should be ok. I’m 77 yrs old. I take NO other medicines at all I’m Blessed there. Had left hip replacement need right one. But no I’m not doing it I’m worse after than before. Can’t walk a block. Can’t stand 15 min.
Ty
Thank you. Ive been wondering if my usual 2 to 4 500 mil tylenol per day was toxic in the long term. I feel better now
This was marvelous! Calming, soothing, and very simply but thoroughly explained. Thank you for posting this information.
I just turned 102 and drink beer on a daily basis. For the past few years this has led to gout in my toes. I still live on my own and can’t seem to give up the beer which would be the logical step to take to alleviate the painful condition. I tried various remedies including my favorite aspirin powder but it only got worse. My daughter introduced me to Tylenol and it worked like a charm. I’ve been taking 1 pill every 4 hours along with beer and the pain has been greatly relieved. I’ve also been taking liver pills to combat any potential organ damage.
Thank you…you answered questions in which i have had for a long time now…I am happy and so relieved in knowing my that it is okay to take arthritis tylenol in moderation on a daily basis…thank you again.
Cindy
Very informative article. Thank you.
Thank you for the information. It is SO USEFUL to know that I can take 2 tablets of Tylenol Arthritis twice a day without damaging my liver (for my oesteoarthritis)
Sheila
I am suffering from s1 joint dysfuntion and I have to live on 3000 mg a day for awhile…That is the only pain med I can take. I have been on it for 6 weeks now…hope that’s not too long. The pain is the morning is so bad…then the Tylenol work..I still limp and use a walker..hooe that ends soon.. s1 joint dysfuntion is a real bummer..
Thank you for your help in this. You answered my exact questions that were rolling around in my head.
After reading this article, I still don’t know if Tylenol Arthritis is more risky than Tylenol Plus for myself at age 88.
What is maximum dosage for someone who is taking 5 mg of eloquist a day?
I have Osteoarthritis and I have been suffering from it for over 20 yrs, However, I started taking Tylenol Acetaminophen approx 7 to 10 yrs ago and I have never ever taken more than the 650 mm for each tablet , I take 2 per the directions on the Bottle, I only take two every 24 hrs, to ease the worse pain when I am doing normal daily work and chores. However, if I forget to take it after 24 hrs I wake up from my sleep many times during the night and that’s when I take 2 tablets 1350 mm. again and not again until 24 hrs has passed. Per what I have been taking for the pain for close to 10 yrs, am I in danger of liver damage? , I honestly don’t believe I have done damage to my liver, as my Doctor has me take test for liver damage, and so far, nothing has showed badly in my enzymes. I would appreciate your opinion by return email to
lucy1405@aol.com
So happy that I stumbled upon this information that cleared up all my questions. I will sleep better knowing that I now understand the dosages of OTC meds that I take. Thanks to everyone who contributed to this.
I like this article I would like to know more about pain management and drugs to reduce pain
This was the best explanation of this question that I have ever read. Thank you many times to Paul Taylor.
Thank you for your advice on acetaminophen and exercise. My mother is in early stages of dementia and has a really bad knee. I will try to work with her on the knee strengthening exercises the Dr. Gave her. And again I thank you much. Cheryl (daughter).
I am a style 1 diabetic and I also have Crohn’s disease. I was diagnosed with osteoarthritis and I am in pain all of the time. I was instructed to take 8 extra Tylenol per day or 6 Tylenol arthritis per day. Does this sound safe? I do walk 2.5 miles per day, and I exercise for one half hour, and soak in Epsom salts for about one half hour. I still am experiencing bad pain. Today I went to the medical marijuana dispensary. I haven’t tried this yet. Any suggestions? PLEASE!!!!
Is it harmful to drink wine while taking Tylenol long term? My husband takes 6 extra strength Tylenol every day for severe arthritis pain. He has about two glasses of wine with dinner every Friday and Saturday night only. Is even that small amount of alcohol too much for someone who takes Tylenol every day?
Would like to know the qualifications of the expert: Physician? Doctorate in Pharmacy? Rheumatologist? Toxicologist? ….. Thanks
I have been taking 2 Tylenol 3 a day for almost two years. What is the long term affect of taking this medication for two years?
Thank you for the good clear information as I was worried about damage to my liver. I can now take the Tylenol without worrying and continue with the exercise. Thanks.
TO WHOMEVER IN MAY CONCERN: MY DR. PRESCRIBED 560 MG. OF ACETAMINOPHEN FOR MY KNEE PAIN. SHE SAID TO TAKE THIS THREE TIME A DAY. AFTER READING THIS REPORT IF FEEL THAT THIS AMOUNT IS WAY TOO MUCH AND COULD DAMAGE MY LIVER AND OTHER ORGANS…PLEASE ADVISE…THANK YOU….JRRUZZO@YAHOO.COM
I have restless leg syndrome, hip and neck pain . I have tried lots of remedies and sometimes in desperation I take a Tylenol p.m. for sleep but I have been afraid of taking it every night because of fearing liver damage. Reading this article it sounds like taking it long term would be okay. Am I right?
Yes, at least in my experience. I am a chronic pain patient due to a condition called Ehlers-Danlos Syndrome and arthritis caused by the former. I have been taking 1,300 mg of Tylenol daily for 7 years. So far, so good.
Thank you for sharing your experience, Adrienne.
Is the dosing for Tylenol any different if you are on blood thinners (Xaralto for example) ??
I’m a 73 year old female taking Eliquis anticoagulant. I was told I can take Tylenol up to 3gm a day safely. I weigh under 135 pounds. We are all different people so ask doc and pharmacist for guidance
Great information for concerns about arthritis pain relief. Only thing you left out here was alcohol consumption with Tylenol increases its dangers. I’ve read where you could have up to three drinks with the recommended dose you mentioned above and should be ok if its not daily, etc.
I take Tylenol 1000mg at night with Gabapentin 300mg for post Chemotherapy neuropathy. My liver enzymes have been fine so far but will it also cause kidney damage? I have chronic arthritis pain also.
Thank you for this information.
I have TN..Trigeminal Neuralgia …Tylenol is the only thing that helps me with Electric shocks that comes with it..I take a total of 6 daily at 500mgo..is this too much?
36, arthritis of both hips, lower spine, right knee, hands and wrists. Have been struggling to work for a long time. Have IBS and gastritis and my digestive system cannot handle NSAIDS. I am on Glucosamine Chondroitin and Tylenol. Doctors told me in my area nothing was wrong with me and that I was a healthy young man. Seen an orthopedist and he noted all of my failed surgeries and referred me to a rheumatologist. Hoping the Glucosamine kicks in but have read it can take a few months for it to really work. I appreciate the clarification of Tylenol usage as I also have a fatty liver and have had many concerns. My days start out rough, sometimes improve after movement, but ultimately by end of the day pain is borderline unbearable. Unfortunately, there is no miracle drug for pain.
Thank you. I. Did NOT know about the 3 gram threshold
I take 2 Percocet 5/325 daily….1 pill every 12 hours…and in between 2 Tylenol 500 mg each…am I safe….or can I cancel Percocet and take 2 Tylenol 500 mg every 6-8 hours for all pain. Recently had surgery to remove abscess on lower spine and 2 laminectomies.
My doctor has recommended 2 Aleve and 2 Tylenol Arthritis taken at the same time to relieve joint (hip to be replaced) pain. Is this a safe pain relieving regimen?
Thank you soooo much for your information
Very good article. Confirms what I had learned from other medical articles. I was using Advil for 2 years for osteoarthritis of the knees, but now I use Tylenol Arthritis. 2 650 Milligram pills every 8 hours. If I play tennis I may take one 400 mg Advil pill an hour before. I have been unable to find a safe anti inflammatory drug since Tylenol, as you say, does not reduce inflammation. Perhaps I could use ice after activities for reducing inflammation.
Knee replacement is scheduled for 3 Oct 2018 at Toronto Western. So as you say the goal is to remain active and keep muscles in good shape. Knee impact on a frequent basis, like walking, is the big
problem. Excersises need to be isometric in nature, i.e static to reduce joint impact, e.g. 90 degree wall sits for the quads.
Peter
My struggle to is is that I’m having stem cell so is stem cell you’re not supposed to take an NSAID because that takes the work of the stem cell so the only medication I’m left with a tall is Tylenol or tumeric. Tylenol seems to work for me and for me to have a life as being able to move without pain I think I’m just going to have to make sure I keep it under the desk of two a day and live a long healthy life with my liver. I am not one for pain and I don’t like to exercise when I’m in pain so thank goodness for Tylenol arthritis is there any other Med that will do the same thing without damaging the body
Is it possible to use 2 grams of Tylenol and have alcohol after?
For the benefit of other readers…
Alcohol should NOT be consumed when taking any dosage of acetaminophen.
This is a great article. I have RA and am taking Actemra and cannot take ibuprofen or any NSAIDS. I take Tylenoll arthritis once in a while and it really does help with pain management. Drinking a lot of water is important. Exercise is key to maintaining mobility, however you have to listen to your body.
I am a 93 year old female, in excellent health except that I have worn out both shoulders. The doctor says there is no cartilage left, but I am too old for shoulder replacements. He gave me steroid shots which worked for a while. but now I have pain. I have taken 2 regular strength tablets 15 times in thaeast 25 weeks. Am I hurting my liver?
Norah be sure to drink a lot of water to flush our your kidneys and liver. You should be fine.
Excedrin extra strength is a combination of acetomenophen and aspirin. Package says 1 geltab is 500mg. and dose is 2 geltabs, so that would be 1000mg. for 1 dose. When showing the breakdown they’re showing it for 500mg which is only 1 tab. This is my preferred nsaid, trying to keep it down to 3 geltabs in 24hr period for arthritis and possibly carpel tunnel if the wrist and shoulder are not arthritis.
Is 4000 mg per day, carefully managed, be safe over several weeks or months?
This is just what I have been looking for to reinforce my activity level. I was taking ibuprophen but stopped and started taking 2 extra strength Tylenol for Arthritis for pain. I exercise a lot, snowshoe, crosscountry ski, spin class 3 x a week, go to the gym to do balance and physio exercises with weights and have started swimming 5 days a week. My pain level is bad sometimes, especially when walking long distance. Walking sticks help a lot. I am going to Toronto for a stem cell replacement in my knee so I am hoping eventually this will hrlp regenerate cartilage and lessen pain….and I do not always have to rely on walking sticks…Debbie Olson. Great article. Just what I needed to read…keep moving…snd exercise does not hurt your condition but helps. Thank you. So now I can tell all those people who keep telling me to slow down that that isn’t right. Thanks.
I have stage 3 kidney failure and arthritis strength650 for pain so what is the safe amount for me to take daily. Thank you
My osteoarthritis has really hit me hard. Had what I thought was groin stuff from very active lifestyle, sports wise, turned out to be the start of osteo. I am 64 year old female and have played many sports at a pretty competitive level. Had a hip exray and my MD told me it was degenerative osteoarthritis. I have been trying all kinds of pain relievers including extra strength tylenol with ibprofen chasers. Heat and cold treatments and taken Turmeric with curcumin, golden raisins soaked in Bombay sapphire gin. Voltaren doesnt even touch the pain. My pain in hips and knees and down thighs is extreme. I have a high pain tolerance so it is pretty severe. I have started taking Advil with tylenol but only a couple of pills a day because I am scared of kidney or liver damage. Any other ideas for me?
Thank you. I was wondering the same things.
I have been taking 4 Extra Strength Tylenol every day now for over a year for cancer pain. My oncoligist advised not to take more than 2g daily because of possible liver damage from long term use. Some days I can get away with 3 Tylenol but am still very concerned about liver damage with long term use.
For the benefit of other readers…
If you’re concerned about liver damage from taking acetaminophen long-term, have your liver checked annually. Tip I received from a spine researcher who takes acetaminophen regularly to control his back pain.
Alcohol increases the side effects of Tylenol , so if you are taking a low dose of Tylenol
a small amount of alcohol most likely would be ok.
Thanks! Just the advice I needed! I am ninety, just got this, am miserable, take NO other meds! I am athletic, but everything hurts. I will start exercising in the pool!!
I did not make it clear, that “THIS” is arthritis in my hip. Tylenol AND swimming, can’t wait to see if it works. I will have an annual physical in two weeks. USUALLY the doctor says I am the healthiest person he has ever seen. Not THIS time! I, also, was concerned about NOT having alcohol. I do love my glass of wine, maybe even two, at “happy-hour” time. Any more advice on this?
My name is Lynn. Would a 325 mg. Tylenol effectivly relieve my post surgery knee pain,as a 500mg. Tylenol? I have been taking a 500mg. at night sometimes,when pain would shoot through my knee. I want to cut back to a smaiier doseage. Do you think a 325mg. would be effective?
(smaller)
Great article! Just the answers I was looking for. I am an active 58 yr old male who exercises 4-6 times a week and waiting for knee replacement surgery. Never thought that Tylenol Arthritis would relieve the pain but it DOES!!! Give it a chance, it’s working for me
How many you take a day
This doctor doesn’t speak to the dangers of alcohol and fasting while taking Tylenol. Little skeptical.
This is a precise and authoritative answer to the specific question I need to ask. The warnings on the drug label do not provide the details and context you offer. Thank you very much.
I am taking tylenol, 2 tablets 3 times a day for a bad cold. I also have osteoarthritis, particularly in my thumbs. Doesn’t help at all. I am a classical pianist and just work through the pain. Wish something would help my hands. Surgery is not a solution. I researched it. it would shorten my thumbs. Are they serious? pianists need their reach. i’d like to strangle the therapist who suggested it. Medical and rehab professionals should know who they are dealing with before they blithely say, oh, this will help and you won’t hurt all anymore. And they don’t know it would destroy my ability to play. It’s a good thing I did the research.
For the benefit of other readers…
Sounds like Harriet might have suffered from repetitive strain injury (RSI). I’ve experienced issues with RSI because of too much computer useage. In my experience, acetaminophen is useless for RSI most likely because RSI involves inflammation.
Because of the governments putting fear of Dr’s loosing their license, my only choice is Tylenol that I take every day & have for many years because Dr’s refuse to treat my intractical RSD pain. I hate them for this midevil, unfair treatment. Can’t take NSAIDS due to stomach problems. What’s a person in my position to do besides suffer greatly or just end it all, which I’ve considered.
I truly appreciate the information on the dosage of acetaminophen..Is it safe to take Tylenol P.M. every night safely?
I fell on my new knee one year after getting it. I fell into both knees on concrete. On my new knee beside the scar I have a clump of scar tissue combined with veins. It is very painful so I cannot be on my feet too long. Two Drs. Have said they wouldn’t operate. Could I have a third opinion from your Hospital? Who would be a good surgeon to see about this. If you could tell me who then my Dr. Can refer me? Thank you, sincerely,
Carol
I would like to have an opinion on my Knee scar tissue plus veins that happened after I fell a year after getting a new knee onto concrete with both knees. One is very painful still , the new knee one, it still swells and I have to use Tylenol for Arthritis.
I would like an opinion from a surgeon from Sunnybrook Hospital pls.
Am 95 years old, with neuropathy in both legs due to back surgery a few years ago. Now have painful osteoarthritis in left hip (no cartilage whatever left leg–left hip) and cannot put any weight on my left leg – hip pain is excruciating. Fell awhile back, landed hard on both knees and now unable to walk – using a wheelchair. Refuse an electric wheelchair, want to walk (sitting down) to keep legs moving. Take one Tylenol with breakfast and one at bedtime. It seems to lessen the hip pain somewhat. Was concerned about taking Tylenol like “forever” but your website has relieved my concern
I am already taking arthrotec for my osteoarthritis which for me is a fantastic pill to take pain away,2 per day, but were recently cut back to one as the pharmacist alerted my doctor of a high risk of stroke or heart attack,anything over 100 mg was risky,I was taking 150 daily.Was given the generic brand in place,pharamcist said it was the same thing??I am awaiting my second knee replacement,already had the hip replaced,best thing that happened to me,perfect.The problem is that the arthritis has got into both my arms and caused sleeplessness,the doctor recomended Tylenol for arthritis.This article is very helpful and I will start taking one a day before before bedtime,did before but was afraid of the risks so stopped.Hopefully the dosage the article said to not go over will cause no harm.This article really does explain things,been searching for a long time to get this info,thanks
Thank you so much I take Tylenol for pain and worried about liver damage. You have answered my question and put my mind at ease I never take over 3 gr
Excellent, informative article. Thank you very much.
This helped. Thanks!
I take one extra strength Tylenol daily. Hope it is ok. Or on most days.
If you read the article above, it tells you all that you need to know.
I just recently came across this website and must say that it is very informative. My personal problem started in the early 50’s when deployed overseas and damaged my back and after 5 surgeries, fusions etc, Surgeons no longer want to do anymore surgery at my age of 80. I stay in continuous pain on and off during the day up to 8-9 on the 0-10 scale. I’m wearing a 100 mcg Fentanyl patch plus take Percocet 10/325 2X’s a day. My question is about taking a 650MG Arthritis Tylenol with the 10/325 Percocet 2 X’s per day. It would bring the total Tylenol consumption up to 1950 MG in a 24 hour period. My question is this more Tylenol than recommended?
I will be visiting my pain management doctor in the near future and trying a electronic stimulator on a trial basis to see if it will reduce the pain. So I’m asking your opinion on whether it’s OK to take that much Tylenol and if you might want to add your opinion on the electronic stimulator.
Thanks for a great website with a diversity of questions & answers.
My father as had 3major back surgeries in the mid 90’s for a bone that he had broked lifting a trash can working for the old trash company “*BFI*” which is no longer a trashing company that was filled half way with concrete blocks and stones. When the performed the 1st surgery at Christiana Hospital they had broken a bone accidentally towards the middle of his back so they ended up putting 2rods, screws and a cage in his back. Well after the surgery he was having more pain then when he had broken his back so had M.R.I’s done and come to.find out 1 of the screws was bent and 1 of the other screws was broken from the bone to cage so the had to perform another surgery and.during the 2nd surgery they tried to fix everything as best as possible. Welp since then he had M.R.I’s, Catscan’s nd X-Ray’s done and his L4&5 Disks are detierierating, his rods and 2 Outta 9 screws are bent and he’s have massive swelling now sine 2009 and his lower back has been bruised and has been yellowish black and blue. Well my question is since 1996 he has been taking Four 10/325 Oxycodone tablets a day which is 325mg of acetaminophen in each tablet nd takes 1300mg’s of acetaminophen a day sice 1996 till current which is now 2017. I’m curious if him taking that much acetaminophen a day is doing serious harm to his health and body beings he’s been taking that much acetaminophen now for 11years??? Not to mention also has been taking Oxycontin 40/80mg 2times day as well since 1998 I believe till 2015 then lowered from two 40&80mg Oxycontin a day to one 40&80 a day. How much harm is it doing to his body my question is and my other question is if continues taking that much acetaminophen a day what can happen??? Id appreciate your answer and advice and you can email me at traditionalarttattoo@yahoomail.com
A very good article. Gave me a good perspective on dosage for arthritis.
tylenol arthritis is 650 mg how many a day is safe?
6
Diane, if I were you, I’d be tempted to try 500 mg instead, just for the sake of keeping the effective dose as low as you can. Millions of people take 2 500mg 3x a day with no ill effects.
Perhaps you’ve already tried this, but just a thought.
Arthritis-strength is sometimes much better at relieving pain than extra-strength. Extra-strength doesn’t work nearly as well for me as athritis-strength at controlling pain in my back.
Tylenol Arthritis 650mg is time released. Taking 6 a day is approximately equivalent to taking 8 Extra Strength a day, but it stays active longer due to being time released. No one has mentioned this. The 500mg ones will peak and wear off before the next dose.
My name is Gloria James I suffer from a bad case of RA I am under a doctor’s care and have been put on different medications that I was not please with one that actually made me lose some of my hair, besides that I am not a big fan of taking a lot of medication. However I do take Tylenol sometimes usually one or two tablets a day is it safe to do so.
I was concern because I hear that years of using Tynenol can harm your liver
This article was so appreciated! It was like you read my mind about the fear of exercise and pain management. I have lower back pain but love yoga, pilates and walking and was fearful of making it worse. Physical therapy was expensive and useless. Advil helped but seemed like after a few days it grew less effective necessitating prescription meds which, ugh, wrecked my stomach. Tried Tylenol and had a eureka moment! Just two extra strength pills relieved ALL pain and tension in my back for a full 12 hours. Wow! So most days i take two tablets and done. I am def´ not a drinker and try to skip as many days as i can. Managing pain and exercising is a dream come true. Thanks thanks thanks!
Thank you! Answered my questions well.
Didn’t really answer my question is it safe to tale aleve in morning for anti-inflamatory and extra strength Tylenol at night for pain
Thankyou! This was extremely helpful!
thank you I have learned a lot about Tylenol . I will take the least amt per day . juli
This was very imformativè
This is crazy!.. No one should take more than 3000mg or 3 grams of Tylenol per day. This is the current limit set by the FDA. They dropped it from 4000 mg due to increased liver toxicity incidents. The most important thing not addressed here is how dangerous even moderate alcohol intake is while taking Tylenol regularly. It has a synergistic damaging effect on the liver! If you’re a moderate or even modest drinker, avoid Tylenol, or use only small doses occasionally and never take it concurrently with alcohol. Also, as mentioned, many other OTC combination products for a variety of ailments contain Tylenol. So be wary and read ingredients of products and adjust your separate Tylenol dose accordingly.
“They dropped it from 4000 mg due to increased liver toxicity incidents.” I believe the toxicity incidents had more to do with taking 4000 mg and taking other OTC or prescription drugs that also contained acetaminophen. Fred is correct about avoiding alcohol if you are taking acetaminophen because both tax the liver.
Hello,
I came across this site and wanted to ask a question. My doctor has me on NORCO, switched me from Percocet. I honestly don’t want to be on ANY medication, as a veteran I have a real bad back, but I believe the main issue is a tumor attached to my spinal nerves at the L3. There is acetaminophen in them which is my biggest worry, 325mg to a pill to be exact. I don’t take them everyday and I keep it right below 1000mg in a day when I do take them, which is probably 2-4 times a week. My total protein in my last test was 1-10th of a percent high, the doctor said that it was fine it could have been dehydration. The rest of my liver functions test was within normal range. Do I have anything to worry about? All the talk about acetaminophen and liver damage has me freaking out, I have been seeing pain management for 7 months now. I did tell her I wanted off of anything that contains APAP since I will be using medication for an indefinite amount of time, 3 neurosurgeons have turned down doing my surgery thus far.
I really appreciate the time you took to explain all of this. I had a hip replacement 4 weeks ago and was worried about taking too much tylenol, yet I needed relief. I feel so much better now. I also concur with what you said about exercising before joint replacement. I did that for 5 painful years and I was in good shape before my replacement and I am making a remarkable recovery. Good advice!
What if the person taking 6 to 8 tablets of extra strength Tylenol daily is 78 years old, is not active and has many health issues? How dangerous is that? P.S. This person is taking it for bad headaches. Sincerely, concerned daughter
You should encourage your mother to talk to her doctor about why she has so many bad headaches. And she should ask her doctor about the dose she is taking.
I take Tramadol, Methocarbamol and gabapentin. Do they contain acetaminophen?
The acetaminophen/Tylenol daily dosage information was very helpful. Puts my mind at ease knowing I can take the only medication that helps with my shoulder pain without liver damage.
Thank you for the thoughtful information. I’m having problems with TMJ / jaw problems and acetaminophen gives me some relief, as well as help me sleep at night / wake up w/o soreness. My wife stresses not to take too much, so I refrain often. Now I know I can take 1 to 2 grams comfortably w/o creating another problem.
Very thorough and common sense approach for me,thank you..I take a bay aspirin eavery morning and Avalide 300mg but I have lots of pain that really revvs up after sunset..
I can’t tell you how happy I was to read your article. I’ve been taking two 650 mg extended Tylenol geltabs for over three months, one in the morning and one at bedtime. I have so much pain in my thumbs that my hands were becoming useless.
Every day I lived in fear of liver damage and was sure I already had some so would have to soon stop the Tylenol, but I just couldn’t because it helped so much. The pain is almost gone with the Tylenol, my hands are weak, but very usable. The day I could button my blouse was a major breakthrough. What scared me was the instructions on the bottle that said not to take Tylenol more than ten days. I am so far under 6 grams I am not going to worry anymore. Thank you so much for this article.
I would like to mention that because I have to take Effient every day (3 stents in my heart) along with one full strength aspirin daily I hope I am still in the safe zone. Could you comment on that for me, is it OK am I still safe?
For the benefit of other readers: If I were Jane, I would research interactions of acetaminophen with any other prescription drug or herbal remedy that she is taking and/or talk to her doctor. Acetaminophen affects liver enzymes, so can change the effectiveness of some prescription drugs and herbal remedies.
Can I take 1 tylenol daily like everyday because I have back pain raking 1 tylenol everyday could I still be at risk for liver damage
I suggest that you read the article above, it tells you precisely how much you can take on a daily basis.
I suffer with Arthritis pain on both hips and the knee, I take 1 Tylenol arthritis pain tablet every night before I go to be, and it works quite well, I am not able to sleep if I don’t take this pill
Late reply, so this is more for the benefit of future readers. I’ve taken arthritis-strength acetaminophen regularly for almost two years. My routine: 8-9 days of 2 to 3 doses (4 – 6 caplets) followed by a 3 day break.
Thank you, Kurt. In 2017 I was diagnosed with polymyalgia rheumatica and was told the only cure was prednisone. I took 15 mg of prednisone and am finally weaned off. It did give me relief, but I did not like the side effects. I’m 72 and I have joint/muscle pain and just found out it is “probably” osteoarthritis as my inflammation markers were normal. I dislike getting into a drug routine again but want to stay active. But, as many people are here, I am very active and want to continue to be that way ! I read a lot about the various medications and determined that I would try Extra Strength Tylenol (500 mg/day – often with a day off). It doesn’t cure the pain but does allow me to do the activities I like to do ! Very informative and I feel more secure in taking more, if need be, after hearing your routine.
If I am understanding this correctly, I can safely continue to take 6 Tylenol Arthritis pills per 24
hr. period for as long as I need it, or forever. It equals 3900 mg. or just under 4 grams. Is this correct? It does help my osteoarthritis when I do this, but no meds make it go away completely.
If Tylenol (acetaminophen) does make the pain go away, you may want to have a discussion with your doctor about using another non-prescription pain medication. As you say “no med” may make it go away completely. But it’s at least worthwhile talking to your doctor about which one is best for you – and the appropriate dosage.
Sorry, I meant to say if Tylenol does NOT make the pain go away
Sorry also, I meant to say that 6 Tylenol/per day takes the edge off. but no medicine I have tried completely takes it away. And by this I meant advil, aspirin etc. including Tylenol.
Thank you for the clarification, very helpful!!
%featured%This information helped me so much.My dad has had very bad arthritis in his neck and shoulders for many years.The doctor recommended him to take 2 tylenol arthritis pills a day rather than naproxen as it is not damaging to the kidneys or liver.After reading this article I feel that it is definitely ok to take this amount and hopefully it will help to relieve his pain!%featured%
‘He says most patients can safely consume three or even four grams of acetaminophen day-after-day for long periods. “It is when you get to six, seven or eight grams a day that you get into trouble.”’
What? Anything over 4g of Acetaminophen is considered an overdose. Who is taking 6-8 grams a day … and surviving?
My PCP told me that if you’re taking a daily dose and you have any liver concerns, you don’t want to go above 2g.
Your PCP is correct. New rule is not to ever go over 3 grams. With daily dose, you most definitely want to go under the max dose, too.
I will give aectaminophen a try. I am in severe pain due to spinal stenosis plus atrthritis for L5 and L4.
i found this information very helpful. Thank you!
Thank you for all the info on tylenol as I have A-Fib and other meds,now I have a nerve disease on right side of my body which is so painful,I will be going to the pain clinic to see if their procedures are the best for me I am 82 yes old and have been active all my life.Tylenol is only pill I can take now I will be increasing them to 4 extra st.a dayshould I take 6-500gr
Why do you never read anything about excedrin. It works fine for me
Exedrin is an NSAID
This artical is tremendously re-assuring as I frequently take 1 or 2 Tylonol extra strength at night to releave low back and tired legs resulting in a better nights sleep.
Thanks. I feel so much better. Have kidney damage as result of NSAIDs but need to control pain enough so I can go for walks and play tennis Tylenol xtra strength or with codeine helps.
So can you take it every day or not?
“…most patients can safely consume three or even four grams of acetaminophen day-after-day for long periods. ‘It is when you get to six, seven or eight grams a day that you get into trouble.’ ”
– “Day-after-day” means “daily” or “every day” to most people…
Thank You for clearing all the misconceptions out there, I guess it is important to look at the credentials of who rights all the negative statements about tylenol I am glad I came across your professional facts, I thank You again from the bottom of my heart You’re a life saver.
Thank you I don’t have any of the above conditions but I do go a week or two with tension headaches and I have a fear of medication. I take one a day sometimes for a week. This helped me a great deal!
Ruth, when I was in the hospital I was given a pill called ciprofloxacin it cost information in my muscles my back neck right hand , The doctor gave me steroids my neck and back is OK but now I have arthritis in my right hand The doctor said take three Tylenol’s a day as needed for pain and information, why did that happen when I took That pill.
Thank you for making the Tylenol information so clear, now I won’t be reluctant to take it.
Came across this and found it very helpful. Dr prescribed Naproxen and tylenol for arthritis for inflammation of shoulder muscles and arthritis in neck discs 4,5 and 6. Have been in pain for months so we’ll see if this helps. Physio, massage therapy and chiropractors made pain even worse.
what is difference between ExtraStrength Tylenol and Tylenol Arthritis
Extra strength 500mg. Tylenol Arthritis 650mg
is it ok to take 3 arthritis plls a day
I am a style 1 diabetic and I also have Crohn’s disease. I was diagnosed with osteoarthritis and I am in pain all of the time. I was instructed to take 8 extra Tylenol per day or 6 Tylenol arthritis per day. Does this sound safe? I do walk 2.5 miles per day, and I exercise for one half hour, and soak in Epsom salts for about one half hour. I still am experiencing bad pain. Today I went to the medical marijuana dispensary. I haven’t tried this yet. Any suggestions? PLEASE!!!!
Try CBD oil, if you’re not in a state where it’s illegal (there’s only a few left, but check to be sure.) Thorne Labs has a good reliable one, which you need to be careful about since there’s a lot of fraud going on. You can purchase it either directly from their website or Amazon. Make sure they’re not price gouging on Amazon (last time I checked they weren’t and I have it on autoship). It may take a while to start to work, or work immediately depending on your body. It should help with both your Crohns and osteo. Please get online and read, read, read the info about it to help you out. Good luck!
WARNING….over 40% of the CBD oils are “fake” and several deaths have occured. I would NOT use ANY of these products as they’re too dangerous UNLESS you purchase from someone who makes their own products and doesn’t use fake junk…its been all over the news last few days…Scary!
https://www.usatoday.com/story/news/health/2019/09/16/vaping-lung-illness-cbd-cheap-synthetic-marijuana-used-sub/2339545001/
Amazon does not have the cdb oil that uses the flowers the last time I checked. So don’t buy it on amazon
No it’s not safe
Try getting help from a naturopath or alternative medicine for Crones and osteoarthritis. You can cure naturally…speaking from experience
Be very careful of so-called natural and homepathic remedies. Check the brand, ingredients, and dosage with your doctor BEFORE you start any of these products. 1) you can spend a lot of money on something that ultimately doesn’t cure/change/improve your condition(s). 2) even “natural” remedies can adversely react with other medications. Please be informed.
Hi Sandy,
Thank you for sharing. What naturopathic or alternative medicine do you recommend for osteoarthritis? I am trying to avoid tylenol and ibuprofin.
Thanks,
Vicki
I’m the same! Only 52 years old Let me know how it works please
Is Tylenol Arthritis an anti-inflammatory also besides a pain reliever
Tylenol is not an anti-inflammatory. Advil is an anti-inflammatory.
I’m 68 yrs old can I take Tylenol 500 mg everyday . My body is always in pain. I suffer from HBP I take baby aspirin 81 is it still safe???? Very concern
You can take 500mg of Tylenol every day— as long as you have no known liver ailments. That is not a large dose at all. That is only 1/2 gram.
Dont know!
Good infirmatipn
I have rotator cuff issues. I’ve had several injection of steroids for the pain subsides for awhile and returns . I’ve also had therapy it got worst . The Dr in Humana doesn’t want to send me to a specialist. I was told by another physician I needed surgery. What is your advice what can I take for pain . I am not able to taken any narcotics drugs .