Can you build a tolerance to Tylenol?
By
Dr Milena Locci de Oliveira (PhD)
Author bio
Dr Milena Locci de Oliveira is a Pharmacist and Doctor of Philosophy in Sciences from the University of São Paulo (USP). She has experience in microbiology, analytical toxicology, and clinical pharmacokinetics. She writes and reviews content on these topics.
Dr Milena’s Highlights:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration in the areas of Pharmacometrics and Population Pharmacokinetics, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
“Science can be translated, and it is essential that everyone has access to quality information to make informed decisions” – Dr Milena Oliveira, PhD.
Professional Experience:
With a decade-long career as a researcher, Dr Milena has amassed extensive experience in conducting research projects in microbiology, analytical toxicology, and clinical pharmacokinetics.
Her expertise also extends to the preparation of technical and scientific reports, literature reviews, data analysis, and scientific communication, both oral and written.
Dr Milena has served as a Clinical Pharmacist, providing expert supervision and guidance to teams during the challenging times of the COVID-19 pandemic, particularly in the ICUs of two reference hospitals for patient hospitalization.
In her most recent role, Dr Milena worked on the implementation of the deliberatives of the São Paulo State Government Pharmaceutical Assistance Coordination. These decisions were aimed at ensuring medication access within the Unified Health System.
A widely multidisciplinary background enabled Dr Milena to become a professional capable of integrating scientific knowledge into private initiatives, education, and healthcare, delivering consistent services in patient safety and population health.
Professional Memberships & Affiliations:
Dr Milena Oliveira is a member of the Regional Council of Pharmacy of the State of São Paulo, Brazil.
Education:
-PhD in Sciences, University of São Paulo, Brazil, 2019.
-University College London (UCL) – Semester of remote collaboration, 2018.
-Bachelor in Biochemical Pharmacy, University of São Paulo, Brazil, 2013.
Relevant Published Work & Citations:
Oliveira ML de, Rocha A, Nardotto GHB, Pippa LF, Simões BP, Lanchote VL. Analysis of daunorubicin and its metabolite daunorubicinol in plasma and urine with application in the evaluation of total, renal and metabolic formation clearances in patients with acute myeloid leukemia. Journal of Pharmaceutical and Biomedical Analysis. Nov 2020. 191:113-124.
Abstracts. CPT: Pharmacometrics & Systems Pharmacology. 2020 Nov; 9 (S1).
Pippa LF, Oliveira ML de, Rocha A, de Andrade JM, Lanchote VL. Total, renal and hepatic clearances of doxorubicin and formation clearance of doxorubicinol in patients with breast cancer: Estimation of doxorubicin hepatic extraction ratio. Journal of Pharmaceutical and Biomedical Analysis. 2020 Jun 5; 185:113-231.
Godoy ALPC, De Jesus C, De Oliveira ML, Rocha A, Pereira MPM, Larangeira DF, Lanchote VL, Barrouin-Melo SM. Determination of Allopurinol and Oxypurinol in Dogs Plasma by High-Performance Liquid Chromatography with an Ultraviolet Detector: Application for Pharmacokinetic Studies. J Chromatogr Sep Tech. 2017; 8 (4).
Clímaco EC, Oliveira ML de, Pitondo-Silva A, Oliveira MG, Medeiros M, Lincopan N, et al. Clonal complexes 104, 109 and 113 playing a major role in the dissemination of OXA-carbapenemase-producing Acinetobacter baumannii in Southeast Brazil. Infection, Genetics and Evolution. 2013 Oct;19:127–33.
Conference Papers:
Oliveira, M. L.; NARDOTTO, G. H. B.; PIPPA, L. F.; ROCHA, A.; SIMOES, B. P.; LANCHOTE, V. L. . Daunorubicin metabolism and urinary excretion in patients with acute myeloid leukemia. In: 84th Annual Meeting of the German Society for Experimental and Clinical Pharmacology and Toxicology (DGPT) and the 20th Annual Meeting of the Association of the Clinical Pharmacology Germany (VKliPha), 2018, Göttingen. Naunyn-Schmiedeberg’s Arch Pharmacol, 2018. v. 391. p. S76-S76.
Oliveira, M. L.; NARDOTTO, G. H. B. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . The low contribution of urinary excretion in the elimination of daunorubicin and its metabolite daunorubicinol in patients with acute myeloid leukemia. In: 49th Brazilian Congress of Pharmacology and Experimental Therapeutics., 2017, Ribeirão Preto. Livro de Resumos, 2017. p. 64-64.
Oliveira, M. L.; PIPPA, L. F. ; ROCHA, A. ; SIMOES, B. P. ; LANCHOTE, V. L. . Quantification of daunorubicin and its metabolite daunorubicinol in human plasma by LC-MS/MS. In: I International Meeting of Environmental Health and Toxicology (IMEHTOX), 2016, Ribeirão Preto. Livro de Resumos, 2016.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. . PFGE typing of Carbapenem-Resistant Acinetobacter baumannii isolated from different University Hospitals. In: V International Postgraduate and Research Symposium, 2012.
Clímaco, E.C. ; SILVA, A. P. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Lincopan, N. ; Darini A.L.C. Relação clonal entre linhagens de Acinetobacter baumannii produtoras de carbapenemases da família OXA em quatro hospitais no Brasil. In: XXI Latin American Congress of Microbiology, 2012, Santos. XXI Latin American Congress of Microbiology, 2012.
Oliveira, M. L.; Clímaco, E.C. ; OLIVEIRA, M. G. ; Darini A.L.C. . Dissemintion of OXA carbapenemases genes in carbapenem-resistant Acinetobacter baumannii in University Hospital of Juiz de Fora, MG. In: 8th CIFARP – International Congress of Pharmaceutical Sciences, 2011, Ribeirão Preto.
Clímaco, E.C. ; Oliveira, M. L. ; OLIVEIRA, M. G. ; Darini A.L.C. . Avaliação do sequenciamento parcial do gene rpoB e de seus flanqueadores para identificação de espécies de Acinetobacter na rotina laroratorial. In: 2° International Symposium on Clinical Microbiology, 2010, Florianópolis.
You can view some of Dr Milena’s work below and links to her professional profile.
Linkedin: https://www.linkedin.com/in/dra-milena-locci-de-oliveira-28986042/?locale=en_US
ResearchGate: https://www.researchgate.net/profile/Milena-Oliveira-6
Escavador: https://www.escavador.com/sobre/5394254/milena-locci-de-oliveira
Lattes: https://buscatextual.cnpq.br/buscatextual/busca.do
Scopus: https://www.scopus.com/authid/detail.uri?authorId=57199779361
Scholar: https://scholar.google.com/citations?view_op=list_works&hl=pt-BR&user=1YUBDIQAAAAJ
Can you build a tolerance to Tylenol?
No, you can not build a tolerance to Tylenol. Tylenol doesn’t affect your body as narcotic analgesics do, and you can’t build tolerance, dependence, or addiction to Tylenol.
Acetaminophen, the active ingredient present in Tylenol, is known to be the safest painkiller and can be used by anyone, even infants. It is also safe to take with other medications, like antibiotics. The medication does not cause any significant long-term damage if you stick to standard doses (1).
However, Tylenol is a mild hepatotoxic and using it for a long time can cause damage to your liver (2). Healthy individuals may not get affected, especially if they use Tylenol only as needed.
However, people with hepatic insufficiency should use this medication carefully. There’s no other known issue with the long-term use of Tylenol. If you feel that it does not control your pain effectively, it probably means that your pain is not mild and needs a stronger painkiller than Tylenol.
You can use NSAIDs for such pain and taking them with meals can mitigate the gastrointestinal side effects. In case of severe pain, reach out to your healthcare provider.
Tylenol, in general, is considered a safe option to pair with complex medications, like antidepressants, anticonvulsants (gabapentin), anxiolytics, antipsychotics, etc.
However, individual responses to medications can vary, as some people could be allergic to this medication or some may not take it because of hepatic insufficiency.
How is Tylenol different from medications that cause tolerance?
Tylenol is different from medications that cause tolerance in several ways. While medications like Opioids, Benzodiazepines, and Stimulants can lead to tolerance over time, Tylenol does not typically cause the same level of tolerance development (3).
Tylenol is a mild analgesic and antipyretic medication commonly used to relieve pain and reduce fever. It works by blocking certain chemicals in the body that contribute to pain and fever.
Unlike medications that affect the brain’s receptors or chemicals, Tylenol primarily acts on the peripheral nervous system and does not produce the same addictive or tolerance-inducing effects as other drugs.
However, Tylenol has been a topic of research for a decade, as some cases of psychological side effects, such as hallucinations, have been reported. However, experts have indicated that such cases could be linked to other contributing factors.
Common medications that cause tolerance
Some common medications that can cause tolerance include:
- Opioids: These are strong pain-relieving medications that interact with specific receptors in the brain and body. Prolonged use can lead to the body becoming less sensitive to their effects, requiring higher doses for pain relief.
- Benzodiazepines: These are drugs commonly used to treat anxiety and sleep disorders. Over time, the body may develop tolerance to their sedative effects, leading to the need for higher doses.
- Stimulants: Medications like amphetamines or methylphenidate, often used for attention deficit hyperactivity disorder (ADHD), can lead to tolerance. This means their beneficial effects on focus and attention may reduce with ongoing use.
- Antidepressants: Some antidepressant medications, particularly those that target specific brain chemicals like serotonin or norepinephrine, may lead to tolerance over time.
- Sleep aids: Certain sleep medications, especially those from the benzodiazepine or Z-drug class, may cause tolerance if used regularly for an extended period.
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References
1.-
Gerriets V, Anderson J, Nappe TM. Acetaminophen. 2022 Sep 18. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–. PMID: 29493991. https://www.ncbi.nlm.nih.gov/books/NBK482369
2.-
Mitchell RA, Rathi S, Dahiya M, Zhu J, Hussaini T, Yoshida EM. Public awareness of acetaminophen and risks of drug-induced liver injury: Results of a large outpatient clinic survey. PLoS One. 2020 Mar 4;15(3):e0229070. doi: 10.1371/journal.pone.0229070. PMID: 32130228; PMCID: PMC7055817. https://pubmed.ncbi.nlm.nih.gov/32130228/
3.-
Stewart J, Badiani A. Tolerance and sensitization to the behavioural effects of drugs. Behav Pharmacol. 1993;4(4):289-312. PMID: 11224198. https://pubmed.ncbi.nlm.nih.gov/11224198/
