This is a very common question. There are some drugs that need to be taken after meals and there are also those that can be taken even without food. Especially if what you’re grilling in your backyard isn’t ready and back pain or headache starts to kick in.

In the case of Tylenol, we will be discussing the different factors that affect its absorption in the body, thereby answering the question of whether or not it is safe to take it with an empty stomach. 

So to answer the question, yes, Tylenol can be taken on an empty stomach with a glass of water.

But you have to be aware that there are also people who might experience some discomfort. If this happens to you, just be sure to take it with food next time. 

Tylenol is a popular brand of the drug Acetaminophen or Paracetamol, which serves as both an analgesic (pain relief) and antipyretic (lowers body temperature during a fever). It is an OTC (over-the-counter) drug that is widely used for relief of fever and minor pain. Generally, it can be taken on an empty stomach. 

In the following section, we will be providing more information about this medicine. 

What is Tylenol?

Tylenol (Acetaminophen) is a drug that can function both as a pain reliever (analgesic) and a remedy for fever (antipyretic), both of which can be linked to various diseases. You can purchase it over-the-counter or you can opt for a generic counterpart.

What other drugs or substances can interact with Tylenol?

There are a few drug interactions noted with Tylenol or Acetaminophen. It can interact with some antimicrobial drugs, drugs for tuberculosis, oral contraceptives or hormone replacement therapy pills, antihypertensive medicines, anticancer drugs, cholesterol-lowering medications, drugs for gout and arthritis (including gold injectables), HIV/AIDS medications, antipsychotic drugs, NSAIDs (nonsteroidal anti-inflammatory drugs), and drugs to control seizures.

If you are taking any of these drugs or you are under any medication, it is best to consult with your doctor first.  

Taking Tylenol on an empty stomach

The absorption of Tylenol is faster in an empty stomach due to the absence of food that could interfere with the process in the gastrointestinal tract. For patients that are prone to GI irritation, they may have to take Tylenol with food.

Tylenol does not have any significant effect on the stomach compared to Aspirin and Ibuprofen (a common brand name is Advil). The latter two are recommended to be taken after meals because they are acidic drugs and can cause discomfort in the stomach if taken without food.

Tylenol, on the other hand, does not possess that side effect and is therefore safer to intake for those with sensitive gastrointestinal systems. 

Formulation of Tylenol

pills

For Adults

  1. Capsules Extra Strength packs 500 mg Acetaminophen
  2. Tylenol Extra Strength Coated Tablets 500 mg Acetaminophen
  3. Tylenol PM Extra Strength Liquid (for and adults)
  4. Dissolve packs for children 12 years old above and adults (Tylenol)

For Children

  1. Tylenol (for 4 – 11 years old)
  2. Children’s Tylenol for 6-11 years old
  3. Chewable tablets for 2–11 years old
  4. Children’s Tylenol Dissolve Packs for 6 – 11 years old

Recommended dosages

Factors such as age and weight must be considered in dosage calculations for drugs. Children who weigh less than 36 pounds and are 4 years old or below are not allowed to take Tylenol. 

Adult dosage regimen 

  • Capsules Extra Strength packs 500 mg Acetaminophen: 2 powders every 6 hours as needed.
  • Extra Strength Coated Tablets 500 mg Acetaminophen (Tylenol): 2 tablets every 6 hours as needed, not to exceed six tablets within twenty-four hours.
  • PM Extra Strength Liquid for children over 12 years old and adults (Tylenol): 30 ml at bedtime, not to exceed 30 ml within twenty-four hours
  • Dissolve Packs for over 12 years old and adults (Tylenol): 2 powders every 6 hours as needed, not to exceed six packs within twenty-four hours.

Children’s dosage regimen 

Children’s Tylenol for 4 – 11 years old: (not to exceed five doses in twenty-four hours)

  • 4 – 5 years old; weighing 36 to 47 pounds – 5 ml every 4 hours
  • 6-11 years old, weighing 48 to 95 pounds – 10 ml every 4 hours

Children’s Tylenol (cold and flu) for 6-11 years old; weighing 48 to 95 pounds: 10 ml every 4 hours (not to exceed five doses in twenty-four hours)

Chewables for 2 – 11 years old: (not to exceed five doses in twenty-four hours)

  • 2 – 3 years old; weighing 24 to 35 pounds – 1 tablet every 4 hours
  • 4 – 5 years old; weighing 36 to 47 pounds – 1½ tablets every 4 hours
  • 6 – 8 years old; weighing 48 to 59 pounds – 2 tablets every 4 hours
  • 9 – 10 years old; weighing 60 to 71 pounds = 2½ tablets every 4 hours
  • 11 years old; weighing 71 to 95 pounds – 3 tablets every 4 hours

Children’s Dissolve Packs for 6 – 11 years old (Tylenol) (not to exceed five doses in twenty-four hours)

  • 6 – 8 years old; weighing 48 to 59 pound – 2 powders every 4 hours
  • 9 – 10 years old; weighing 60 to 71 pounds – 2 powders every 4 hour
  • 11 years old; weighing 71 to 95 pounds – 3 powders every 4 hours

Tylenol toxicity results to liver damage

Hepatic injury or liver damage is the worst that could happen to someone who takes large doses of acetaminophen. It is a life-threatening adverse drug effect and is induced by a daily dose that exceeds 4000 milligrams, sometimes even lower. 

The manufacturer of Tylenol, McNeil Consumer Healthcare, decreased the maximum recommended daily dose of the drug and increased the interval between doses on the labels of their products for children that are above 12 years old and adult patients back in 2011. This was done to prevent accidental overdosing of patients and reduce the risk of hepatic injury. 

The manufacturer of Tylenol reduced the maximum daily dose of the Extra Strength and Regular Strength variant of the drug up to 3000 milligrams and 3,250 milligrams a day, respectively. They also increased the interval in between doses for the Extra Strength. Physicians may prescribe higher doses to patients that are more than 12 years old to their own discretion and clinical judgment. 

Lawsuits have been filed against the manufacturer for the adverse effect that they experienced upon taking the recommended dose. There is a very narrow index between the therapeutic dose and the toxic dose of Tylenol which is why health experts always warn people to be cautious of the amount they take. 

For children, the recommended safe dose is 75mg/kg per day. Two 160-milligram Tylenol tablets for children would be enough for a child weighing 40 pounds in a span of 24 hours. 

Toxicity can take effect just within 24 hours. Liver damage is the most common form of severe acetaminophen poisoning. If you combine that with alcohol consumption, there is a higher risk of much more severe liver injury.

Study showed, the use of Tylenol, particularly with alcohol, can readily cause hepatitis and liver failure, liver failure happens frequently. Some of these patients will require a liver transplant because the damage to the liver is so severe.

Tylenol is also safe to be taken by pregnant women. It is the first choice for the management of minor pain and fever during pregnancy. Upon excretion, trace amounts of tylenol can be eliminated in the breast milk but it is still safe for lactating mothers. 

Therapeutic uses of Tylenol

Tylenol is only for short-term therapy since it offers rapid response and immediate effect. It is also eliminated quickly so multiple doses might be needed for illnesses that resist the initial dose. For symptoms that last longer than three days, the patient would need to consult a physician to check if there is a bigger problem. 

Tylenol is an analgesic and an antipyretic, which means it offers relief from pain and reduces the temperature during a fever, respectively. Tylenol can be used for the following health problems:

  • Fever
  • Headache
  • Flu symptoms
  • Common colds 
  • Toothache
  • Backache
  • Menstrual cramps
  • Joint pains
  • Muscle pain
  • Other minor aches/pains

Side effects of Tylenol

Side effects aren’t that common for the majority of people who take Tylenol. But for those who are particularly sensitive and prone to allergic reactions, they may be at risk of anaphylactic shock. The following are some signs of acetaminophen allergy. Make sure to consult a physician immediately if you observe one or more of these signs.

  • Rashes on your skin
  • Itching
  • Swollen tongue
  • Dyspnea (difficulty in breathing)

Anaphylactic shock is a serious and potentially life-threatening allergic reaction. But it should be remedied by an anti-allergy drug. The side effects that you should look out for when taking Tylenol are:

  • Headache
  • Nausea
  • Stomach pain
  • Vomiting
  • Sweating
  • Lightheadedness

You can also take Tylenol even with an empty stomach. But if you feel some discomfort which may manifest in one or more of these signs, just take it after meals the next time. 

  • Dysuria (difficulty in urination)
  • Dark stools
  • Severe stomach pain

Precautions when taking Tylenol

Caution text overlay
  • The ideal storage condition for the drug is at room temperature which is usually between 20-25 °C. Do not store it in areas with high temperature or humidity to avoid the risk of degrading the drug and compromising its quality. 
  • Do not take the drug if not necessary. Once the symptoms are no longer felt, discontinue medication.
  • If you are pregnant or breastfeeding, please make it a point to consult first with a doctor before taking Tylenol. Even though it is generally safe for use, it won’t do any harm to take precautions. The long-term use of acetaminophen has been found to have effects on the developing fetus such as ADHD and autism. 
  • Do not combine Tylenol with other Acetaminophen-containing drugs that also have the same content to prevent accumulation of the drug in the body. 
  • If the patient has impairment in some organs, especially the liver, kidneys, lungs, and the heart, they must also consult with a doctor as there may be some dosage adjustments to be made for their case. 
  • Avoid taking more than the recommended dose for your age to avoid developing liver damage. 
  • Alcohol intake combined with intake of Tylenol will increase the chances of hepatic injury. Although small amounts are okay, it is still best to avoid it as much as possible. 
  • If you notice the appearance of skin rashes after taking the drug, it may be a sign of an allergic reaction. Discontinue medication if this happens and consult with your doctor for an alternative drug. 
  • Consult with your doctor if the pain or discomfort persists for more than ten days. 
  • For a fever that does not go away after three days, visit your physician to see if you might have another condition. 
  • You have to chew the chewable Tylenol tablet before you swallow it to ensure that the drug is thoroughly absorbed by your system. 
  • Store the medicine in a secure place that cannot be reached by children. 

Tylenol Contraindications

Allergy

If you are a highly sensitive person and are prone to allergic reactions, we suggest not to take Tylenol or any other drug with acetaminophen. Ibuprofen can be a good alternative. 

Liver diseases

Like we’ve already mentioned before, the liver is the most susceptible organ when it comes to acetaminophen toxicity. For patients with impaired hepatic function, acetaminophen is contraindicated. Some liver-associated diseases that can be aggravated by Tylenol are liver cirrhosis, liver cancer, hepatitis, liver impairment, or dysfunction. Also, if you experience nausea and vomiting after taking Tylenol, consult your doctor if you can opt for non-oral administration of analgesic/antipyretic drugs like Propacetamol.

Blood-thinning medications

Drug interaction can also occur with blood-thinning drugs like warfarin and aspirin so these drugs should not be taken in combination with acetaminophen as it will increase the likelihood of bleeding disorders. Other drugs that have noted interactions with Tylenol are the following:

  • Carbamazepine
  • Isoniazid
  • Phenytoin
  • Probenecid
  • Barbiturates
  • Dapsone
  • Lamotrigine
  • Busulfan
  • Flucloxacillin
  • Phenylephrine

Taking Tylenol on an empty stomach

Pain really interrupts how we normally go about our day. It causes us discomfort and a feeling of being unwell and we become unproductive because of it. It’s difficult to start the day with a positive mind if the first thing that greets us when we wake up is pain. 

Water is essential

Taking Tylenol on an empty stomach is not the same as taking it without water. The regular Tylenol tablet would need you to swallow it with water. But if you are taking the chewable tablet, you should not take water with it. 

There aren’t a lot of reports that state serious side effects of taking Tylenol without meals. It is generally safe for an empty stomach. As a matter of fact, there were even some people that say the efficacy is enhanced in this case. 

Empty stomach sometimes increases drug efficacy

The presence of food in the stomach adds to the bulk of the content that your gastrointestinal tract needs to absorb. If you take a drug shortly after eating food, the digestive system works to absorb both the drug and the nutrients of the food. 

If you take Tylenol on an empty stomach, then it will be totally absorbed since there are no other substances that compete for absorption in the digestive system. Faster absorption means faster onset of therapeutic effect. 

Other ingredients can have significant effects

Tylenol arthritis produces a different effect than regular Tylenol. The dose of the former has to be higher than the latter. Also, Tylenol arthritis requires higher dosing than regular Tylenol. It also has a modified drug release design which is in the form of an extended-release capsule meaning that the drug is released by portions and not all at once to sustain its levels in the body without the need for multiple dosing. It works for a span of eight hours. 

Take note of Diphenhydramine

The active ingredient of Tylenol PM is Diphenhydramine which is a first-generation antihistamine drug used for treatment of allergies. Diphenhydramine can be used for the management of common colds and sometimes can be used to relieve high fever. But the side effect that comes with this drug and all other first generation antihistamines is 

drowsiness or sedation. This is why some people use it to help themselves sleep. 

It’s not irritating to the GIT but it still depends on the person. Other common side effects include stomach upset, diarrhea, constipation, and nausea and these happen if you take the drug on an empty stomach. 

Tylenol products tend to have side effects that include GI irritation so you should always make it a point to read the ingredients of the product to know what you are really taking and the possible impact it might have on your body. If you have a sensitive digestive system, it’s much better to take the drug with food.  

Food interactions with Tylenol

Taking Tylenol with food leads to the combination of both substances upon digestion and absorption in the GIT. The food is initially digested by the acids in the stomach, and further digestion and absorption occurs in the small intestines. 

The nutrients from the food you eat are absorbed via the small intestines, particularly the villi, along with the drug Acetaminophen. Since there is a bigger volume of substances that need to be absorbed from the food, the absorption of the drug is delayed and therefore it won’t take effect immediately or as quickly as you expect. 

Although, there are some scenarios wherein the drug would chemically react with the food. One example is the interaction between grapefruit and the drug Atorvastatin. Grapefruit hastens the degradation of the drug, resulting in a lower efficacy.

So far, there aren’t significant food interactions noted with Tylenol or Acetaminophen so it is safe to take it on an empty stomach or with food. 

Reminders for patients taking Tylenol

  1. There are many types of drug formulations of Tylenol that are indicated for different kinds or levels of pain. The indications of a particular product can be found on the label or the package insert. 
  2. Always remember to supplement with water the drugs that you are taking. Water is very essential for the homeostasis of the body and for the cells to function properly. Healthy cells are important for the drug to exert its effects. 
  3. Get enough hours of sleep to help your body recover from whatever illness you may have. 
  4. Live a healthy lifestyle and boost your immune system to protect yourself from worse illnesses and allow the drug to take effect. 

What does a healthy lifestyle entail?

  • Getting at least 8 hours of sleep a day. 
  • Regular exercise and balanced diet
  • Staying hydrated (at least 8 glasses of water a day)
  • Keeping away from addictive drugs and excessive alcohol consumption

Ibuprofen vs Acetaminophen

Both drugs are analgesics, which means they are indicated for the relief of mild to moderate pain. Ibuprofen is also indicated for inflammation. It belongs to a class of non-steroidal anti-inflammatory drugs or NSAIDs. 

This class of drugs are not prescribed to just anyone as there are significant adverse effects and contraindications noted with it. NSAIDs are known to cause gastrointestinal distress and toxicities are common in the renal and cardiovascular system. You should consult with a doctor first before taking any NSAIDs. 

FAQs

Is Tylenol safe for children?

With the correct dose, Tylenol is safe to be taken by children and adults alike. However, children below 4 years old are not advised to take it. For other ages, please refer to the recommended dosages above.

What happens upon taking Tylenol on an empty stomach?

Provided that you do not have comorbidities or organ impairment, it should be safe to take Tylenol on an empty stomach without the risk of adverse effects. This also helps in increasing the drug’s absorption rate so it can exert its effect faster.

What other pain relievers can be taken on an empty stomach?

Aside from Tylenol, other drug brands containing Paracetamol are also safe to take on an empty stomach. Do not take ibuprofen and other NSAIDs as well as Aspirin if you have not taken any food yet as these are acidic drugs and will irritate your stomach. 

Which is more effective: Tylenol or Ibuprofen?

Both drugs are effective analgesics and antipyretics. The only difference between the two is that ibuprofen has anti-inflammatory properties. Tylenol does not possess anti-inflammatory activity. As a result, ibuprofen is a better pain reliever for inflammatory conditions like gouty arthritis and other joint problems. 

Tylenol has the advantage of being non-irritating to the stomach since it can be taken without food. Ibuprofen needs to be taken with food.

According to the meta-analysis conducted by Dr. David Perrot and his team of researchers from the Sydney Children’s Hospital, here are the findings of the efficacy and safety profile of Ibuprofen and Acetaminophen in their analgesic and antipyretic activity:

  • Acetaminophen with a recommended dose of 7-15mg per kg body weight is equally effective as Ibuprofen with a recommended dose of 4-10 mg per kg body weight to relieve mild, moderate, and severe pain. 
  • “There is no indication that the drugs differ in safety from each other or placebo,” says the researchers. But they still recommended conducting further studies on the subject. 

What is the time for the onset of action of Tylenol?

It depends on the type of formulation. Regular Tylenol preparations have to undergo dissolution in the stomach and then it goes into the small intestine for absorption into the systemic circulation to exert its effect. Refer below for the time it takes for the different formulations to have a noticeable effect:

  • Orally disintegrating tablets, oral Tylenol liquid: 20 minutes
  • Oral tablets, extended-release tablets: 30 to 45 minutes
  • Intravenous acetaminophen: 5 to 10 minutes.

If you take Tylenol with food, expect for the time to double before you notice its effect because food decreases the absorption rate of Tylenol so it will take longer for the therapeutic effect to take place. 

Is it safe to combine Meloxicam and Aleve with Tylenol?

Meloxicam and Aleve (Naproxen) are under the drug class NSAIDs and are used for mild to moderate pain associated with inflammatory conditions. These are prescribed to relieve pain from headaches, migraine, menstrual cramps, arthritis, sprains, muscle cramps, and toothache. 

You can combine NSAIDs with Acetaminophen for pain that is resistant to NSAIDs. But if you are going to use NSAIDs, just stick to one particular drug. Do not use multiple NSAIDs at a time to prevent unwanted adverse effects. 

Some side effects you should watch out for are usually related to the gastrointestinal system like bloating, diarrhea, constipation, irritation of the mucosal lining, nausea, and vomiting. NSAIDs can also affect normal renal function and alter the normal blood circulation that goes to the kidneys.

Patients may experience sodium and fluid retention which leads to edema and hyperkalemia. Cardiovascular and circulatory toxicities are also possible. Severe cases can result in a stroke or a heart attack. asthma , headache, and insomnia are also notable side effects of NSAIDs.

Tylenol can be combined with either Meloxicam or Aleve but the latter two should never be taken together. If the pain still persists, we highly suggest consulting a doctor for appropriate diagnosis and medication. 

What to do if a dose is missed?

If the physician prescribed you with a dosing regimen for acetaminophen, stick to the schedule as much as possible. If you missed it by a few hours, just take the medicine when you remember to do so. 

But you should always remember not to take the next dose too early. 4 hours is the minimum time interval between succeeding doses of Acetaminophen. Make sure that you take another dose after 4 hours to prevent overdosing. 

Double dosing is also discouraged. But usually, acetaminophen should only be taken when necessary and within the appropriate time interval as indicated in the label or as prescribed by a physician. 

Conclusion – Can you take Tylenol on an empty stomach?

The final answer to this question is yes. You can take Tylenol on an empty stomach. This is the ideal way of taking it. One tablet accompanied by a glass of water. 

Although, exemptions can be made for people with compromised gastrointestinal systems and sensitive stomachs. They should take Tylenol with food or after eating their meals. 

Either way, always remember to drink water along with it.