Acetaminophen vs Paracetamol

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Please pass the Acetaminophen, or is it Paracetamol?

First discovered in 1893, this bitter white, odourless pill has reached new heights with over 200 million packets of this ‘friendly’ painkiller being sold annually, it has been called the workhorse of the pain killer world, considered to be (mostly) as one of the cheapest, safest and most effective painkillers on the market. Known around the world as Paracetamol, in the United States it is called Acetaminophen, marketed under a variety of names such as Aceta, Tylenol, Tapanol, Apap, and many more.


Yes, at under 10c per pill, it is not only one of the cheapest painkillers on the market, but one of the cheapest medications on the market.

Most effective?

Acetaminophen has been shown, along with other compounds, to be effective in treating back pain, migraines, osteoarthritis, fever, headaches, insomnia, cold symptoms and the list goes on and on. It is definitely one of the most versatile and widely used medications, and its effectiveness could be proved in this alone.


This is where the arguments begin. In 2011, a study conducted by Professor Michael Doherty, a rheumatologist at Nottingham University was surprised to note the potential dangers of acetaminophen. In a study of almost 900 patients, aged 40 and older who took paracetamol, ibuprofen or a combination of both for chronic knee pain over 13 weeks, his findings showed that one in 5 patients on acetaminophen lost the equivalent of a unit of blood through internal bleeding, the same proportion as ibuprofen.

It was studies like this that led the FDA to reduce the maximum dose of acetaminophen in tablets or capsules to 325mg, to try reduce the risk of accidental overdoses. According to Dr John Dickson, a retired general practitioner, “It can cause kidney and liver problems, and causes as much gastrointestinal bleeding as the NSAIDs (non-steroidal anti-inflammatory drugs).”

The maximum dose of acetaminophen over a 24 hour period is 4g, but as little as 5g can cause liver complications, and it can be easy to overdose accidentally by taking more than one product containing it at the same time.

It is worth mentioning that yes, all medications have some side-effects, and it is important to explore these side effects, especially if you have any other underlying health problems. Does the benefit outweigh the risk? For the majority of Americans, whether as a placebo or not, acetaminophen has been accepted as one of the go to painkillers for the average ache and pain.