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Research · Medication

Acetaminophen

One 1,000 mg dose gave at least half pain relief to about half of adults after surgery, against about 20% on placebo. Pooled trials found no effect on acute low back pain and about 3 points of 100 in osteoarthritis. Labels warn of liver failure, mostly at doses above 4,000 mg a day.

Add to Bio HackChecked 2026-11-13
Status
Sold over the counter in the US as a pain reliever and fever reducer, alone and in combination cold, flu and sleep products. Also in prescription combination tablets with opioids, whose labels carry an FDA boxed warning that includes liver toxicity. In September 2025 FDA began a label change about use in pregnancy.
Also called
paracetamol, APAP, Tylenol, Panadol, Ofirmev, Excedrin (with aspirin and caffeine), Percocet (with oxycodone), Norco (with hydrocodone), Vicodin, Ultracet (with tramadol), Tylenol with Codeine, N-acetyl-para-aminophenol
Taken for
headache, fever, muscle aches, back pain, arthritis pain, toothache, menstrual cramps, cold and flu symptoms, pain after surgery, migraine, exercise performance

Strong several reviews agree · Moderate one review or consistent trials · Limited one or a few small studies · Untested no study in people, listed with what it rests on

Shown to help6

Reported risks8

What people take it for, and what was found

Shown to help6

ModerateVery common

Acute pain after surgery

Shown to give at least half pain relief to about half of adults after surgery with one dose, against about 20% on placebo.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Across 51 trials, about half of participants given a single standard dose had at least 50% pain relief over 4 to 6 hours, against about 20% on placebo. The number needed to treat was 3.5 (95% CI 2.7 to 4.8) at 500 mg, 4.6 (3.9 to 5.5) at 600 to 650 mg and 3.6 (3.4 to 4.0) at 975 to 1,000 mg, with no dose response. About half needed more pain medication within 4 to 6 hours, against about 70% on placebo [1]. An overview of Cochrane reviews of over-the-counter pain relievers found paracetamol and aspirin had numbers needed to treat of 3 or above and success rates of 11% to 43%, and ibuprofen plus paracetamol combinations had numbers needed to treat below 2 [2].
Population
5,762 adults in 51 single-dose trials, 3,277 given paracetamol and 2,425 placebo [1]; 10 Cochrane reviews covering 21 drugs, doses and formulations, mostly tested after third molar extraction [2].
Sources
[1], [2]
Caveats
Single doses followed for 4 to 6 hours. The overview draws on the same Cochrane review, so the two are not independent. Adverse event reporting in the trials was inconsistent and often incomplete [1].
ModerateVery common

Taken with ibuprofen for acute pain

Shown to give at least half pain relief to about 7 in 10 adults after surgery when taken with ibuprofen, against 7% on placebo.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
At least 50% of maximum pain relief over 6 hours was reached by 69% on ibuprofen 200 mg plus paracetamol 500 mg, 73% on ibuprofen 400 mg plus paracetamol 1,000 mg and 7% on placebo, giving numbers needed to treat of 1.6 and 1.5. On ibuprofen 400 mg alone the share was 52%. Median time to rescue medication was 7.6 and 8.3 hours on the combinations and 1.7 hours on placebo. One or more adverse events were reported by 30% and 29% on the combinations and 48% on placebo [3].
Population
1,647 participants in 3 single-dose trials [3].
Sources
[3]
Caveats
Three trials of one dose each. No serious adverse events were reported [3].
Moderate

Tension-type headache

Shown to leave slightly more adults pain free 2 hours after 1,000 mg for a tension-type headache, with 22 treated for one extra person pain free.

The numbers and sources
Effect
For being pain free at 2 hours, the number needed to treat with paracetamol 1,000 mg against placebo was 22 (95% CI 15 to 40) in 8 studies with 5,890 participants, with no difference from placebo at 1 hour. For being pain free or in mild pain at 2 hours it was 10 (95% CI 7.9 to 14). Rescue medication use was lower than on placebo. On limited data, 500 to 650 mg was not superior to placebo, and 1,000 mg did not differ from ketoprofen 25 mg or ibuprofen 400 mg. Adverse events did not differ from placebo (RR 1.1, 95% CI 0.94 to 1.3) [4]. An overview of systematic reviews rated this evidence moderate quality (pain free at 2 hours RR 1.3, 95% CI 1.1 to 1.4) [5].
Population
8,079 adults with frequent episodic tension-type headache and moderate or severe pain at the start, in 23 studies [4]; 36 systematic reviews covering 44 painful conditions [5].
Sources
[4], [5]
Caveats
The overview draws on the same Cochrane review. Comparisons with ketoprofen and ibuprofen were rated low quality [4].
ModerateVery common

Acute migraine

Shown to leave 19% of adults pain free 2 hours after 1,000 mg for a migraine, against 10% on placebo.

The numbers and sources
How common
Very common: more than 1 in 10 people.
Effect
Taken for moderate to severe migraine pain, paracetamol 1,000 mg left 19% pain free at 2 hours against 10% on placebo (number needed to treat 12). Headache relief at 2 hours was 56% against 36% (5.0) and at 1 hour 39% against 20% (5.2). Paracetamol 1,000 mg plus metoclopramide 10 mg did not differ significantly from oral sumatriptan 100 mg for headache relief at 2 hours [6]. In 3 trials of the over-the-counter combination of acetaminophen, aspirin and caffeine, pain fell to mild or none at 2 hours in 59.3% of 602 treated patients and 32.8% of 618 on placebo, and 50.8% against 23.5% were pain free at 6 hours [7].
Population
2,942 participants and 5,109 attacks in 11 studies [6]; 1,220 people with migraine in 3 trials [7].
Sources
[6], [7]
Caveats
The combination trials tested acetaminophen with aspirin and caffeine, not acetaminophen alone [7]. The review authors noted the number needed to treat of 12 is higher than for other commonly used pain relievers [6].
Strong

Knee and hip osteoarthritis pain

Shown to lower knee and hip osteoarthritis pain by about 3 points on a 100-point scale, below the 9 points the reviewers set as clinically important.

The numbers and sources
Effect
In 10 placebo-controlled trials, pain fell 23 points on a 0 to 100 scale on placebo and 3.23 points more on paracetamol (95% CI 1.02 to 5.43), against a minimal clinically important difference of 9. Physical function improved 2.9 points more than on placebo (95% CI 0.95 to 4.89). Effects did not differ between 3.0 g a day or less and 3.9 g or more [8]. An earlier meta-analysis found a similar effect on pain (-3.7 points, 95% CI -5.5 to -1.9) and disability (-2.9, 95% CI -4.9 to -0.9) [9]. An overview of systematic reviews put the pain effect at 0.3 points on a 0 to 10 scale (95% CI 0.1 to 0.6) [5].
Population
3,541 people with hip or knee osteoarthritis in 10 trials at 1.95 to 4 g a day, most followed for 3 months [8]; 13 randomized trials in spinal pain and osteoarthritis [9].
Sources
[8], [9], [5]
Caveats
The reviews share trials and authors. No trial reported quality of life [8].
Limited

Muscle growth with resistance training

One small trial found 4 g a day raised muscle and strength gains from 12 weeks of resistance training in older adults.

The numbers and sources
Effect
Over 12 weeks of knee extensor training, quadriceps volume rose 12.5% on acetaminophen 4 g a day and 8.6% on placebo, and strength rose 19 kg against 15 kg. Muscle protein content, water content and fiber type distribution did not differ between groups [18].
Population
36 adults aged about 64 to 67, 11 on acetaminophen, 13 on ibuprofen and 12 on placebo [18].
Sources
[18]
Caveats
One small trial in older adults. The dose, 4 g a day, is above the 6 caplets (3,000 mg) in 24 hours given in the over-the-counter directions [19].

Mixed results2

Moderate

Fever

Mixed results: a review of children's trials called the evidence against placebo inconclusive, and ibuprofen lowered temperature slightly more in children under 2.

The numbers and sources
Effect
A Cochrane review of 12 trials in children judged the trial evidence that paracetamol lowers fever more than placebo to be inconclusive. In 2 trials with 120 children, the share without fever by the second hour did not differ significantly between paracetamol and sponging (RR 1.84, 95% CI 0.94 to 3.61) [12]. In children under 2, ibuprofen lowered temperature more than acetaminophen within 4 hours (SMD 0.38, 95% CI 0.08 to 0.67) and at 4 to 24 hours (SMD 0.24, 95% CI 0.03 to 0.45), with similar serious adverse events (OR 1.08, 95% CI 0.87 to 1.33) [13]. In intensive care patients with fever and suspected infection, 1 g of intravenous acetaminophen every 6 hours did not change days free of intensive care (23 against 22) or deaths by day 90 (15.9% against 16.6%) [14].
Population
1,509 children in 12 trials [12]; 241,138 children under 2 in 19 studies, 11 of them randomized [13]; 700 intensive care patients with a temperature of 38°C or higher [14].
Sources
[12], [13], [14]
Caveats
Outcomes varied between the children's trials and none reported the review's primary outcome [12]. The intensive care trial measured recovery, not comfort.
Limited

Common cold symptoms

Limited evidence: four trials in adults with a cold found mixed results, with nasal obstruction improved in two and sore throat or malaise not improved in two.

The numbers and sources
Effect
A Cochrane review found 4 trials and did not pool them because designs and outcomes differed. Nasal obstruction improved on acetaminophen in 2 of the 4. One found less runny nose and no difference in sneezing or coughing. Sore throat and malaise did not improve in 2 of the 4. Headache and achiness improved more than on placebo in 2 studies and did not differ in 1. No study reported how long cold symptoms lasted [15].
Population
758 adults with a common cold in 4 trials, 3 of them lasting 4 to 6 hours [15].
Sources
[15]
Caveats
Short trials with inconsistent results. One used acetaminophen combined with pseudoephedrine [15].

Not shown to help2

Strong

Acute low back pain

Not shown to lower pain, disability or time to recovery in adults with acute low back pain at up to 4 g a day.

The numbers and sources
Effect
In a trial of 1,652 people, median time to recovery was 17 days on regular paracetamol, 17 days on as-needed paracetamol and 16 days on placebo (regular against placebo HR 0.99, 95% CI 0.87 to 1.14). Adverse events were reported by 18.5%, 18.7% and 18.5% [10]. Pooled, paracetamol did not lower pain intensity (mean difference -0.5 on a 0 to 100 scale, 95% CI -2.9 to 1.9) or disability (0.4, 95% CI -1.7 to 2.5) in the short term [9]. A Cochrane review found no difference from placebo at 1, 2, 4 and 12 weeks in pain, function, quality of life or sleep quality at 4 g a day [11].
Population
1,652 adults with acute low back pain, 550 on regular dosing, 549 on as-needed dosing and 553 on placebo [10]; 13 randomized trials [9]; 1,825 participants in 3 trials [11].
Sources
[10], [9], [11]
Caveats
The Cochrane review included 3 trials and pooled 2. For chronic low back pain it found only very low-quality evidence, from one trial that was later retracted [11].
Moderate

Endurance exercise performance

Not shown to change endurance performance overall in 10 crossover trials, with small gains in time-to-exhaustion tests and when taken 45 to 60 minutes before exercise.

The numbers and sources
Effect
Pooling 10 randomized, double-blind crossover studies, endurance performance did not differ between paracetamol and placebo (Cohen's d 0.09, 95% CI -0.04 to 0.22). A small effect appeared in studies that gave it 45 to 60 minutes before exercise (d 0.14, 95% CI 0.07 to 0.21) and in time-to-exhaustion tests (d 0.19, 95% CI 0.06 to 0.33), and none in time trials (d 0.05, 95% CI -0.12 to 0.21) [16]. In one of the trials, 13 trained male cyclists finished a 10-mile time trial in 26 min 15 s on acetaminophen and 26 min 45 s on placebo, at a mean power of 265 against 255 W [17].
Population
141 participants in 10 crossover studies [16]; 13 trained male cyclists [17].
Sources
[16], [17]
Caveats
Small studies of single doses. The subgroup results come from fewer studies than the main analysis [16].

Doses studied

The single-dose pain trials used 500 to 1,000 mg, and the headache and migraine trials 1,000 mg [1][4][6]. The osteoarthritis trials used 1.95 to 4 g a day for up to 3 months, and the low back pain trials up to 4 g a day [8][11]. The liver enzyme, blood pressure and resistance training trials all used 4 g a day [20][21][18].

The over-the-counter label for 500 mg caplets gives 2 caplets every 6 hours for adults and children 12 and over, no more than 6 caplets in 24 hours, for no more than 10 days unless directed by a doctor. It warns that severe liver damage may occur above 4,000 mg in 24 hours [19]. The prescription hydrocodone combination tablets contain 325 mg of acetaminophen each [22].

Risks

Reported risks6

ModerateCommon

Raised liver enzymes at 4 g a day

Shown to raise liver enzymes, with abnormal liver tests in 7.0% on paracetamol against 1.8% on placebo in osteoarthritis trials.

The numbers and sources
How common
Common: between 1 in 100 and 1 in 10 people.
Effect
In the osteoarthritis trials, abnormal liver function tests occurred in 70 per 1,000 on paracetamol and 18 per 1,000 on placebo (RR 3.79, 95% CI 1.94 to 7.39) [8]. In healthy adults given 4 g a day in a controlled inpatient setting, ALT rose above 3 times the upper limit of normal in 31% to 44% of the 4 acetaminophen groups and in none of 39 on placebo. Median peak ALT was 2.78 times that on placebo (95% CI 1.47 to 4.09) [20].
Population
3,541 people with osteoarthritis in 10 trials [8]; 145 healthy adults, 106 on acetaminophen alone or with an opioid and 39 on placebo, for an intended 14 days [20].
Sources
[8], [20]
Caveats
The reviewers called the clinical importance of the enzyme rises uncertain [8]. The band here is taken from the pooled 7.0%. The healthy-volunteer trial was single-blind [20].
LimitedHow often is not known

Boxed warning on prescription combinations: liver failure

FDA states acetaminophen has been associated with acute liver failure, at times resulting in liver transplant and death, mostly at doses above 4,000 mg a day.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The boxed warning on hydrocodone and acetaminophen tablets states that acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most cases involved doses above 4,000 mg a day and often more than one product containing acetaminophen. The label adds that the risk is higher with underlying liver disease and with alcohol [22]. The over-the-counter label warns that severe liver damage may occur with more than 4,000 mg in 24 hours, with other drugs containing acetaminophen, or with 3 or more alcoholic drinks every day [19]. Of 662 consecutive patients with acute liver failure at 22 US centers over 6 years, 275 (42%) were attributed to acetaminophen. The median dose taken was 24 g. Overdoses were unintentional in 48% and intentional in 44%. Among unintentional cases, 38% took two or more acetaminophen products at once and 63% used combinations containing a narcotic. Overall 65% survived, 27% died without a transplant and 8% received a transplant [23].
Population
People taking acetaminophen, as described in the labels [22][19]; 662 patients with acute liver failure at 22 US tertiary centers, 1998 to 2003 [23].
Sources
[22], [19], [23]
Caveats
The registry counts people who already had liver failure, so it gives no rate among users [23].
ModerateHow often is not known

Blood pressure

Shown to raise daytime systolic blood pressure by 4.7 mm Hg against placebo in adults with hypertension taking 4 g a day for 2 weeks.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In a crossover trial in adults with hypertension, 1 g four times a day for 2 weeks raised mean daytime systolic pressure from 132.8 to 136.5 mm Hg, against 133.9 to 132.5 on placebo, a placebo-corrected rise of 4.7 mm Hg (95% CI 2.9 to 6.6). Diastolic pressure rose 1.6 mm Hg (95% CI 0.5 to 2.7) [21]. In people with coronary artery disease, 1 g three times a day for 2 weeks raised mean ambulatory pressure from 122.4 to 125.3 mm Hg systolic and 73.2 to 75.4 diastolic, both significant against placebo [24].
Population
110 adults with hypertension randomized, 103 completing both periods [21]; 33 people with coronary artery disease [24].
Sources
[21], [24]
Caveats
Two small crossover trials of 2 weeks at 3 to 4 g a day. Neither measured heart attacks or strokes.
LimitedHow often is not known

Deaths, heart, stomach and kidney events in long-term users

Linked to more deaths, cardiovascular events, gastrointestinal bleeds and kidney function loss at higher doses in cohort studies of regular users.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
A systematic review found 8 cohort studies. One of two reporting mortality found the relative rate rose with dose from 0.95 (95% CI 0.92 to 0.98) to 1.63 (1.58 to 1.68). All four reporting cardiovascular events found a dose response, one with risk ratios from 1.19 (0.81 to 1.75) to 1.68 (1.10 to 2.57). One reported gastrointestinal events or bleeds rising from 1.11 (1.04 to 1.18) to 1.49 (1.34 to 1.66). Three of four reporting kidney outcomes found a dose response, one with odds of a 30% or greater fall in estimated glomerular filtration rate from 1.40 (0.79 to 2.48) to 2.19 (1.4 to 3.43) [25].
Population
Adults in 8 cohort studies comparing paracetamol use with no use [25].
Sources
[25]
Caveats
Observational. The authors state that channelling bias, where paracetamol is chosen for people already at higher risk, may have had an important impact on the results [25].
LimitedHow often is not known

Serious skin reactions

The label warns that acetaminophen may rarely cause serious skin reactions, including Stevens-Johnson syndrome and toxic epidermal necrolysis, which can be fatal.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The prescription combination label states that acetaminophen may rarely cause serious skin reactions such as acute generalized exanthematous pustulosis, Stevens-Johnson syndrome and toxic epidermal necrolysis, which can be fatal. It also describes postmarketing reports of hypersensitivity and anaphylaxis, with swelling of the face, mouth and throat, breathing difficulty, hives and rash [22]. The over-the-counter label carries an allergy alert for severe skin reactions, with skin reddening, blisters and rash as symptoms [19].
Population
People taking acetaminophen, as described in the labels [22][19].
Sources
[22], [19]
Caveats
The labels give no rate and cite no study.
ModerateHow often is not known

With warfarin

Shown to raise INR by 0.62 on average in people taking warfarin-type blood thinners, more at higher daily doses.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In 7 randomized trials in people on vitamin K antagonists, acetaminophen raised INR by a mean of 0.62 against placebo (95% CI 0.46 to 0.78), with a 0.17 rise per daily gram (95% CI 0.004 to 0.33). No trial reported a major bleed [28]. The over-the-counter label tells people taking warfarin to ask a doctor or pharmacist before use [19].
Population
225 people on vitamin K antagonists in 7 randomized trials [28].
Sources
[28], [19]
Caveats
Small trials that measured INR, a clotting test, not bleeding events.

Mixed results2

LimitedStudied in pregnancyHow often is not known

Use in pregnancy

Mixed results: cohort studies linked use in pregnancy to slightly more autism and ADHD in children, and a sibling comparison in the same cohort found no link.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
In a Swedish cohort, risk at age 10 without and with exposure in pregnancy was 1.33% against 1.53% for autism, 2.46% against 2.87% for ADHD and 0.70% against 0.82% for intellectual disability. Without sibling control, ever-use was associated with autism (HR 1.05, 95% CI 1.02 to 1.08) and ADHD (HR 1.07, 95% CI 1.05 to 1.10). Comparing full siblings, there was no association with autism (HR 0.98, 95% CI 0.93 to 1.04), ADHD (HR 0.98, 95% CI 0.94 to 1.02) or intellectual disability (HR 1.01, 95% CI 0.92 to 1.10), and no dose response [26]. In September 2025 FDA began a label change to reflect evidence suggesting that use in pregnancy may be associated with a higher risk of conditions such as autism and ADHD. FDA stated that a causal relationship has not been established, that contrary studies exist, and that acetaminophen is the only over-the-counter drug approved to treat fever in pregnancy [27]. The over-the-counter label directs pregnant or breastfeeding users to ask a health professional before use [19].
Population
2,480,797 children born in Sweden from 1995 to 2019, of whom 185,909 (7.49%) were exposed during pregnancy [26].
Sources
[26], [27], [19]
Caveats
Observational. The FDA statement names the Nurses' Health Study II and the Boston Birth Cohort among studies that found an association, and those were not read for this page [27].
LimitedHow often is not known

With alcohol

The label warns of severe liver damage with 3 or more alcoholic drinks a day. One short trial in alcoholic patients found no rise in AST.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
The over-the-counter label warns that severe liver damage may occur with 3 or more alcoholic drinks every day while using the product [19]. The prescription combination label states that the risk of acute liver failure is higher in people who drink alcohol while taking acetaminophen [22]. In patients entering an alcohol detoxification center, 1,000 mg four times a day for 2 days did not change liver tests against placebo. Mean AST on day 4 was 38.0 against 37.5 U/L, and AST rose above 120 U/L in 4 patients on acetaminophen and 5 on placebo [29].
Population
201 patients in alcohol detoxification, 102 on acetaminophen and 99 on placebo, with baseline AST and ALT of 120 U/L or below [29].
Sources
[19], [22], [29]
Caveats
The trial gave 2 days of treatment after alcohol had been eliminated, and excluded people with raised enzymes at entry [29].

Checked, no increase found1

LimitedStudied in children

Asthma flare-ups in children

One trial found as-needed acetaminophen did not raise asthma flare-ups against ibuprofen in young children with mild persistent asthma.

The numbers and sources
How common
How often is not known: the sources give no rate.
Effect
Over 46 weeks of follow-up, asthma exacerbations averaged 0.81 per child on acetaminophen and 0.87 on ibuprofen (relative rate 0.94, 95% CI 0.69 to 1.28). At least one exacerbation occurred in 49% and 47%. Asthma-control days (85.8% and 86.8%) and rescue inhaler use did not differ [30].
Population
300 children aged 12 to 59 months with mild persistent asthma, given acetaminophen or ibuprofen as needed for fever or pain [30].
Sources
[30]
Caveats
One trial with no placebo group, so it compares the two drugs with each other.

Claims tested and not found

  1. That acetaminophen eases acute low back pain. In 1,652 adults, time to recovery was 17 days on regular or as-needed paracetamol and 16 days on placebo [10], and a Cochrane review found no difference from placebo in pain or function at any time point up to 12 weeks [11].
  2. That acetaminophen makes asthma worse in young children. In 300 children with mild persistent asthma, exacerbations did not differ between as-needed acetaminophen and ibuprofen (0.81 against 0.87 per child, relative rate 0.94, 95% CI 0.69 to 1.28) [30].
  3. That treating fever with acetaminophen speeds recovery in intensive care. In 700 patients with fever and suspected infection, days free of intensive care were 23 on acetaminophen and 22 on placebo, and 90-day deaths were 15.9% and 16.6% [14].

Related

NSAIDs

Sources

  1. Toms L, McQuay HJ, Derry S, Moore RA. Single dose oral paracetamol (acetaminophen) for postoperative pain in adults. Cochrane Database of Systematic Reviews. 2008. https://doi.org/10.1002/14651858.CD004602.pub2
  2. Moore RA, Wiffen PJ, Derry S, Maguire T, Roy YM, Tyrrell L. Non-prescription (OTC) oral analgesics for acute pain - an overview of Cochrane reviews. Cochrane Database of Systematic Reviews. 2015. https://doi.org/10.1002/14651858.CD010794.pub2
  3. Derry CJ, Derry S, Moore RA. Single dose oral ibuprofen plus paracetamol (acetaminophen) for acute postoperative pain. Cochrane Database of Systematic Reviews. 2013. https://doi.org/10.1002/14651858.CD010210.pub2
  4. Stephens G, Derry S, Moore RA. Paracetamol (acetaminophen) for acute treatment of episodic tension-type headache in adults. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.CD011889.pub2
  5. Abdel Shaheed C, Ferreira GE, Dmitritchenko A, et al. The efficacy and safety of paracetamol for pain relief: an overview of systematic reviews. Medical Journal of Australia. 2021. https://doi.org/10.5694/mja2.50992
  6. Derry S, Moore RA. Paracetamol (acetaminophen) with or without an antiemetic for acute migraine headaches in adults. Cochrane Database of Systematic Reviews. 2013. https://doi.org/10.1002/14651858.CD008040.pub3
  7. Lipton RB, Stewart WF, Ryan RE, Saper J, Silberstein S, Sheftell F. Efficacy and safety of acetaminophen, aspirin, and caffeine in alleviating migraine headache pain: three double-blind, randomized, placebo-controlled trials. Archives of Neurology. 1998. https://doi.org/10.1001/archneur.55.2.210
  8. Leopoldino AO, Machado GC, Ferreira PH, et al. Paracetamol versus placebo for knee and hip osteoarthritis. Cochrane Database of Systematic Reviews. 2019. https://doi.org/10.1002/14651858.CD013273
  9. Machado GC, Maher CG, Ferreira PH, et al. Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ. 2015. https://doi.org/10.1136/bmj.h1225
  10. Williams CM, Maher CG, Latimer J, et al. Efficacy of paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet. 2014. https://doi.org/10.1016/S0140-6736(14)60805-9
  11. Saragiotto BT, Machado GC, Ferreira ML, Pinheiro MB, Abdel Shaheed C, Maher CG. Paracetamol for low back pain. Cochrane Database of Systematic Reviews. 2016. https://doi.org/10.1002/14651858.CD012230
  12. Meremikwu MM, Oyo-Ita A. Paracetamol versus placebo or physical methods for treating fever in children. Cochrane Database of Systematic Reviews. 2002. https://doi.org/10.1002/14651858.CD003676
  13. Tan E, Braithwaite I, McKinlay CJD, Dalziel SR. Comparison of Acetaminophen (Paracetamol) With Ibuprofen for Treatment of Fever or Pain in Children Younger Than 2 Years: A Systematic Review and Meta-analysis. JAMA Network Open. 2020. https://doi.org/10.1001/jamanetworkopen.2020.22398
  14. Young P, Saxena M, Bellomo R, et al. Acetaminophen for Fever in Critically Ill Patients with Suspected Infection. New England Journal of Medicine. 2015. https://doi.org/10.1056/NEJMoa1508375
  15. Li S, Yue J, Dong BR, Yang M, Lin X, Wu T. Acetaminophen (paracetamol) for the common cold in adults. Cochrane Database of Systematic Reviews. 2013. https://doi.org/10.1002/14651858.CD008800.pub2
  16. Grgic J, Mikulic P. Effects of Paracetamol (Acetaminophen) Ingestion on Endurance Performance: A Systematic Review and Meta-Analysis. Sports. 2021. https://doi.org/10.3390/sports9090126
  17. Mauger AR, Jones AM, Williams CA. Influence of acetaminophen on performance during time trial cycling. Journal of Applied Physiology. 2010. https://doi.org/10.1152/japplphysiol.00761.2009
  18. Trappe TA, Carroll CC, Dickinson JM, et al. Influence of acetaminophen and ibuprofen on skeletal muscle adaptations to resistance exercise in older adults. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology. 2011. https://doi.org/10.1152/ajpregu.00611.2010
  19. Tylenol Extra Strength (acetaminophen) caplets, Drug Facts label. DailyMed, US National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=103d109d-f520-409c-8da2-eb6b0fbec891
  20. Watkins PB, Kaplowitz N, Slattery JT, et al. Aminotransferase elevations in healthy adults receiving 4 grams of acetaminophen daily: a randomized controlled trial. JAMA. 2006. https://doi.org/10.1001/jama.296.1.87
  21. MacIntyre IM, Turtle EJ, Farrah TE, et al. Regular Acetaminophen Use and Blood Pressure in People With Hypertension: The PATH-BP Trial. Circulation. 2022. https://doi.org/10.1161/CIRCULATIONAHA.121.056015
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