Is Tylenol (acetaminophen) safe during pregnancy?

Occasional use of Tylenol (generic name acetaminophen and paracetamol) is usually considered safer than other similar medications and NSAIDS for treating minor fever, cold, flu and sinus. It is currently classified as the over-the-counter fever reducer and pain medication of choice for pregnant women. However, it is always recommended to consult your doctor to assess any potential risks before considering taking acetaminophen [1].

Tylenol FDA Pregnancy Category

Category B – The medication does cross the placenta, but no evidence of any harm has been found in animal studies [2].

Intravenous (IV) Tylenol has been included in FDA Category C due to lack of study in humans as well as animals [3].

How much Tylenol can you take while pregnant?

The regular strength dosage is 325mg, usually taken once every four hours. While taking the extra strength Tylenol (650mg) in pregnancy, taking one dose every four hours is usually considered safe [4]. Make sure to take the dosage recommended by your doctor to minimize the potential negative effects.

The dosage should never exceed 4000mg within a 24 hour period [5]. Long term studies have shown an association between Tylenol overdose and an increased risk of maternal and fetal liver damage as well as fetal death.

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What are the risks of taking Tylenol while pregnant?

The possible complications and potential adverse effects on the baby are still under research. Regular usage and overdosing is considered unsafe, increasing the chances of liver failure in the mother as well as then baby (later in pregnancy) [1].

Does taking Tylenol in pregnancy increase the chances of ADHD in the baby?

According to a study published by the American Medical Association in their journal ‘Pediatrics’, the endocrine disruptive properties of Tylenol may affect the fetal brain development due to exposure to abnormal hormones in the uterus.

The research carried out in the Danish National Birth Cohort between 1996 and 2002 studied 64,322 children. Over 50% of them were born to mothers who took Tylenol in their pregnancy and had a higher risk of developing hyperkinetic disorders (HKD) and attention-deficit/hyperactivity disorder (ADHD) before or at 7 years of age. Evidence of possible association between prolonged use of acetaminophen and an increased risk of ADHD were also found in the study [6, 7].

Use of Tylenol during pregnancy and risk of autism

One study found a possible correlation between the use of Tylenol and an increased risk of having a baby with autism or autism spectrum disorder (ASD).

Tylenol in pregnancy and risk of asthma

According to a study carried out in New Zealand, use of Tylenol by the mother in her pregnancy might increase the chances of her child having asthma early in life.

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Is it safe to take Tylenol combination products during pregnancy?

Tylenol PM

Tylenol PM is the trade name for a combination of acetaminophen and diphenhydramine (Benadryl). While both the medications are usually considered harmless when taken separately, their combination has been reported to interfere with the fetal growth and lead to withdrawal symptoms of seizure and breathing difficulty after birth [8].

Tylenol with codeine

A stronger pain-relief medication, the varieties of acetaminophen/codeine – Tylenol 1, 2, 3 and 4 – are not recommended for expecting mothers unless absolutely necessary. All the combinations of the drug are assigned to Pregnancy Category C [9] and are especially contraindicated in the last trimester due to risk of developmental problems and withdrawal symptoms in the newborn [10].

Tylenol multi-symptom (cold, cough, flu, sinus and arthritis pain)

The multi-symptom remedies are combinations of acetaminophen and various allergy and cold medications such as antihistamines, dextromethorphan, guaifenesin as well as expectorants. Such combination drugs are usually not recommended in pregnancy due to a lack of controlled research in human pregnancy regarding their possible effects on the fetus [1, 11].

Tylenol while breastfeeding

Tylenol does enter the breast milk [2], but multiple studies carried out with women at different postpartum stages found little evidence of any serious potential risk to the nursing infant.

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