What are the risks of taking Tylenol (Acetaminophen) in the third trimester of pregnancy?

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Last updated: May 29, 2025View editorial policy

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From the Guidelines

Tylenol (acetaminophen) is considered the first-line medication for acute treatment of pain or fever during the third trimester of pregnancy, due to its relatively safe profile compared to other options like NSAIDs. When used as directed, the risks associated with Tylenol are generally low, but it's essential to be aware of potential complications, such as liver damage if taken in excessive amounts 1. Some studies suggest a possible link between Tylenol use during pregnancy and childhood asthma or attention disorders, although these findings are still controversial and require further research. Additionally, high doses of Tylenol taken for prolonged periods may lead to reduced fetal blood flow. To minimize risks, it's recommended to take the lowest effective dose (usually 500-1000 mg) every 6 hours, not exceeding 3000 mg in 24 hours.

  • Key considerations for Tylenol use in the third trimester include:
    • Taking the lowest effective dose to minimize potential risks
    • Not exceeding the recommended daily limit of 3000 mg
    • Limiting the duration of use to a few days, unless advised otherwise by a healthcare provider
    • Informing your doctor about any medications you're taking during pregnancy
  • Compared to NSAIDs like ibuprofen or aspirin, Tylenol is preferable in late pregnancy, as it does not cause serious complications like premature closure of the ductus arteriosus or decreased amniotic fluid levels, as noted in the context of migraine treatment during pregnancy 1.

From the Research

Risks of Taking Tylenol in 3rd Trimester

  • There is no direct evidence in the provided studies that specifically addresses the risks of taking Tylenol in the 3rd trimester of pregnancy.
  • However, the studies suggest that acetaminophen (Tylenol) is generally well tolerated and can be used safely in patients with various conditions, including liver disease 2, 3.
  • One study notes that lower doses of acetaminophen should be used in patients with advanced hepatic disease, malnutrition, or severe alcohol use disorder 4.
  • Another study states that paracetamol (acetaminophen) is a suitable first-choice analgesic for mild to moderate acute pain in adults with liver, kidney, or cardiovascular disease, gastrointestinal disorders, asthma, or who are older, and that no evidence supports routine dose reduction for older people 3.
  • The studies that discuss third-trimester pregnancy complications do not mention the use of Tylenol or acetaminophen specifically 5, 6.
  • Therefore, it appears that there is no direct evidence to suggest significant risks associated with taking Tylenol in the 3rd trimester, but it is always best to consult with a healthcare provider for personalized advice 2, 4, 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

The therapeutic use of acetaminophen in patients with liver disease.

American journal of therapeutics, 2005

Research

Pharmacologic Therapy for Acute Pain.

American family physician, 2021

Research

Prompt evaluation and treatment of third-trimester bleeding.

JAAPA : official journal of the American Academy of Physician Assistants, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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