From the Guidelines
Tylenol PM should be used with caution due to the potential risks of liver toxicity from acetaminophen and sedative effects from diphenhydramine, and it is recommended to limit daily acetaminophen intake to a maximum of 4 g and to use the medication for no more than 10 days for pain or 14 days for sleep issues 1.
Important Considerations
- The FDA recommends limiting the amount of acetaminophen per tablet, capsule, or other dosage unit in prescription products to 325 mg to reduce the risk of severe liver injury from acetaminophen overdosing 1.
- Diphenhydramine, a first-generation antihistamine, can cause sedation, performance impairment, and anticholinergic effects, and its use should be approached with caution, especially in older adults and individuals with certain medical conditions 1.
- The medication should be taken as 2 caplets at bedtime, not exceeding 6 caplets in 24 hours, and patients should be advised to avoid alcohol and not use the medication if they have certain medical conditions like glaucoma, enlarged prostate, or liver disease.
Potential Side Effects
- Morning grogginess, dry mouth, and urinary retention are potential side effects of Tylenol PM.
- The sedative effects of diphenhydramine can persist longer than plasma levels of the parent compound, leading to significant daytime drowsiness, decreased alertness, and performance impairment 1.
Recommendations
- Patients should be advised to limit daily acetaminophen intake to a maximum of 4 g and to use the medication for no more than 10 days for pain or 14 days for sleep issues 1.
- Healthcare providers should ensure that patients understand the potential for adverse effects and the availability of alternative medications with a lower likelihood of adverse effects 1.
- If pain or sleep problems persist beyond the recommended usage period, patients should consult a healthcare provider as this medication is intended for short-term use only.
From the Research
Tylenol PM Overview
- Tylenol PM is a medication that contains acetaminophen and is used to treat mild to moderate pain and help with sleep.
- The studies provided do not specifically mention Tylenol PM, but they do discuss the use of acetaminophen for pain management and its potential risks and benefits 2, 3, 4, 5, 6.
Acetaminophen for Pain Management
- Acetaminophen is a first-line treatment option for most patients with acute mild to moderate pain 2.
- It is generally well tolerated, but lower doses should be used in patients with advanced hepatic disease, malnutrition, or severe alcohol use disorder 2.
- Acetaminophen is not effective for chronic pain conditions, according to a systematic review of seven studies 3.
Risks and Benefits of Acetaminophen
- Acetaminophen is a suitable first-choice analgesic for many adults with mild to moderate acute pain, including those with liver, kidney, or cardiovascular disease, gastrointestinal disorders, asthma, or who are older 4.
- However, sleep disorders may be a novel independent risk factor for acetaminophen-associated adverse reactions and liver injury 5.
- Acetaminophen hepatotoxicity is a significant concern, and it is responsible for 46% of all acute liver failure cases in the United States 6.
Important Considerations
- Patients with sleep disorders may be at higher risk of acetaminophen-induced adverse reactions and liver injury 5.
- The use of acetaminophen should be individualized in consultation with a physician, especially for older adults or those with underlying comorbidities 4.
- The mechanisms of acetaminophen-induced cell death and the resulting inflammatory response are complex and involve multiple pathways 6.