ACETAMINOPHEN

What is acetaminophen?

Acetaminophen, or paracetamol or Tylenol, helps reduce fevers, headaches, and muscle or body aches. It is found in many over-the-counter products, and patients can take 325 to 650 mg every 4-6 hours or 1 g every six hours as needed. Unlike other pain relievers like NSAIDs (nonsteroidal anti-inflammatory drugs like ibuprofen), acetaminophen does not have anti-inflammatory properties and is, thus, not beneficial in treating inflammatory conditions.

How can acetaminophen help alleviate certain long COVID symptoms?

The prevalence of post-COVID pain is estimated to be up to 63.3%, and patients with chronic pain can have exacerbated symptoms after COVID.¹ There are multiple possible mechanisms behind post-COVID pain. Post-COVID pain may be caused by the virus entering and attacking musculoskeletal and nervous systems, including the brain.

Acetaminophen can be used to relieve arthralgias, myalgias, and headaches that persist after COVID; however, it does not help with inflammation and should not be used to treat COVID or to reduce the duration of COVID symptoms. Acetaminophen is often preferred for pain relief in older adults due to the potential side effects of NSAIDs.

What evidence supports acetaminophen’s use for long COVID?

There needs to be more studies that have looked at acetaminophen for long COVID symptoms. A survey of 696 COVID patients in Italy reported that acetaminophen was the most commonly used in the post-acute phase of COVID for pain and had a temporary reduction in pain severity.² Because of its established use today, acetaminophen is a reasonable option to use for fevers, muscle pain, or body aches after COVID.³ 

What are some things to watch out for with acetaminophen?

Many OTC products contain acetaminophen, so it is important to follow dosage information and stay within recommended dosages when taking a combination of these products. The recommended maximum daily dose is 4,000 mg to prevent liver damage, but it is best not to exceed 3,000 mg daily, especially in older adults. Acetaminophen may cause nausea, vomiting, and stomach pain and is not recommended in people with liver disease. If you take Tylenol for headaches, you should not take it more than 10-15 days out of the month.

References:

1)    El-Tallawy SN, Perglozzi JV, Ahmed RS, Kaki AM, Nagiub MS, LeQuang JK, Hadarah MM. Pain Management in the Post-COVID Era-An Update: A Narrative Review. Pain Ther. 2023 Apr;12(2):423-448. doi: 10.1007/s40122-023-00486-1

2)    Galluzzo V, Zazzara MB, Ciciarello F, Tosato M, Bizzarro A, Paglionico A, Varriano V, Gremese E, Calvani R, Landi F; Gemelli against COVID-19 Post-Acute Care Team. Use of First-Line Oral Analgesics during and after COVID-19: Results from a Survey on a Sample of Italian 696 COVID-19 Survivors with Post-Acute Symptoms. J Clin Med. 2023 Apr 20;12(8):2992. doi: 10.3390/jcm12082992

3)    Landon E. Which over-the-counter medications are best for COVID-19 symptoms? October 19, 2023. Accessed November 13, 2023. https://www.uchicagomedicine.org/forefront/coronavirus-disease-covid-19/which-otc-medications-are-best-for-coronavirus-symptoms#:~:text=Acetaminophen%2C%20also%20called%20paracetamol%20or,the%20duration%20of%20your%20illness.