Tylenol (acetaminophen) is the most popular OTC drug which is used as an antipyretic (fever reducer) and analgesic (pain reliever). It is not used for relieving inflammation. This drug is used in combination with other drugs viz., naproxen sodium, ibuprofen and aspirin.

Aspirin is often administered for its anti-pyretic, analgesic and minor blood-thinning properties. However, this does not apply for all analgesics or antipyretic drugs. Tylenol is a non-aspirin drug and it does not have blood thinning property.

Its exact mechanism of action is unknown. However, it may work by reducing the production of prostaglandins, which are responsible for causing inflammation and swelling. It also lowers the body temperature by acting on the heat-regulating center of the brain. 

Still there are various misconceptions about the use of Tylenol; how it affects the body; whether it is used as an anti-inflammatory drug or for its blood-thinning action. 

This post will address all the uses and benefits of taking Tylenol (acetaminophen) and the associated risk factors in taking it as a general antipyretic and analgesic medication (Ameer, B. and Greenblatt, D.J., 1977).

How Does it Work?

Acetaminophen is a selective cyclooxygenase-2 inhibitor that blocks the COX-2 enzyme at the inflammation site. However, its mechanism of action is still uncertain. The prevailing hypothesis is that the COX enzyme has two active sites, viz., peroxidase and cyclooxygenase.

Where all NSAIDs work actively at the cyclooxygenase site, tylenol (acetaminophen) acts on peroxidase site instead, which prevents the formation of tyrosine free radical and helps alleviate the pain.

Another study states that the metabolites of acetaminophen act on the central nervous system. One of its metabolite i.e. AM404 acts on COZ enzyme and endocannabinoid system, which are involved in the pain pathways (Ouellet, M. and Percival, M.D., 2001).

Is Tylenol a Blood Thinner?

Often people have misconceptions about the blood thinning property of Tylenol. This misconception arises because it is prescribed in combination with other analgesics that have this property.

But Tylenol is not a blood-thinning agent. Tylenol is widely used for the treatment of fever and pain, whereas Aspirin (Acetylsalicylic acid) is one such drug which is used both as analgesic and blood thinner.

The recommended maximum dose of tylenol for a healthy adult is 3000 – 4000mg. However, the probability of its overdose is a common issue which is the major cause for acute liver failure.

Person taking tylenol in combination with the other drug should be careful and vigilant w.r.t the recommended dose.

Blood Thinners v/s Tylenol 

Blood thinners are classified as drugs which help in preventing blood from clotting, which can otherwise cause severe heart problems such as stroke, heart attack and cardiac arrest.

These drugs do not break the clot which is already formed in the blood but stop these clots from getting bigger. Examples include warfarin, aspirin and heparin etc.

Both aspirin and tylenol are well known OTC analgesics, however, aspirin has an additional property of thinning blood.

It works by inhibiting the formation of thromboxane A2 in the blood, which is responsible for clotting of blood at the time of any wound or injury. It is helpful in prevention of strokes, heart attacks and blockage of arteries or veins.

Is it Safe to take Blood Thinners and Tylenol together?

Doctors prescribe the medications after detailed examination of all concerned parameters. Tylenol is a convenient and safe painkiller and antipyretic but it does not possess blood-thinning properties unlike aspirin.

If a patient has a history of liver disorder such as cirrhosis or hepatitis, the doctor would not prescribe tylenol in any case as it would potentiate the disease. Tylenol (acetaminophen) increases the international normalized ratio (INR) in a dose-dependent manner.

Excessive or concomitant use of tylenol and warfarin can result in interaction leading to INR beyond the therapeutic range and consequent bleeding. 

Patients who are taking tylenol with warfarin and are at high risk of bleeding, require close INR monitoring.

If a person takes blood thinners, such as Coumadin, Eliquis or Plavix, doctor may recommend tylenol for pain as opposed to ibuprofen or aspirin. 

Is it Safe to take NSAIDs with a Blood Thinner?

NSAIDs  are available over the counter without any prescription; still these should be taken with all precautions as they might have risks associated with it. The possible side effects of NSAID include high blood pressure, upset stomach and renal problem.

In this case, people who take blood thinner and NSAID in combination face major issues as NSAIDs elevate the risk of bleeding. 

In addition to risk of excess bleeding, there is increased risk of heart attack. It is therefore advised to take NSAIDs as per the recommendation of a registered practitioner (Leong, D. and Wu, P.E., 2020).

Uses of Tylenol

Tylenol is used to relieve fever, pains and aches associated with several conditions. 

It helps in relieving pain in mild arthritis but does not show its effect with the underlying inflammation, swelling and redness. It is as effective a drug as aspirin if the pain is not due to inflammation.

This drug is recommended in mild discomfort from migraine, backaches, fever, cold and sore throat, toothache, menstrual cramps and in reaction to vaccine or booster shots (Gerriets V, Anderson J, Nappe TM).

Side Effects of Tylenol

Tylenol is the best OTC pain reliever at the prescribed dose for the pain caused due to headache, arthritis or toothache etc. but it might cause side effects in some individuals. These side effects can be severe which are listed below (Gerriets V, Anderson J, Nappe TM).

In such cases it is advised to stop taking tylenol and contact the healthcare professional for further treatment. The side effects are-

  • Difficulty in breathing or swallowing
  • Rash, itching, peeled or blistered skin
  • Hoarseness
  • Swelling
  • Kidney damage
  • Liver damage
  • Thrombocytopenia (Reduced platelets)

Do not take Tylenol in case of any liver problems. Its most severe side effect is liver damage which may be either due to its overdose or chronic or concomitant use with alcohol or other drugs that also damage the liver.


Tylenol is a non-aspirin OTC fever reducer and pain reliever. It is considered a safe, reliable and effective drug for reducing pain and fever but it does not show any effect on swelling or inflammation.

It shows its effect by acting on the peroxidase site of COX enzyme, which prevents the formation of tyrosine free radicals and helps alleviate the pain. 

Tylenol does not have any blood-thinning property as aspirin does. This is usually a misconception among the masses as this drug is prescribed in combination with other analgesics which have blood-thinning properties. 

Also, it should be taken as per the recommended dose. Its overdose or chronic use or concomitant use with alcohol or other drugs can damage the liver.

Also, this drug should be taken after recommendation from the registered health practitioner if it is taken in combination with the blood thinners.


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