03-07-2025
Doctor reveals the common medication he 'hates'... and warns it could cause organ failure
A top doctor has warned that a common medication could cause lasting damage like organ failure and dementia.
Dr Ethan Melillo, a pharmacist from Rhode Island, says one of the medications he 'hates' is Tylenol PM, one of America's top-selling nighttime painkillers that grosses nearly $1billion a year.
But Dr Melillo warns the 17 cent pills designed to provide relief from headaches and minor aches and pains is 'misused' by many patients.
He cautioned that if it is used on a regular basis, it can cause liver damage as it contains acetaminophen.
Meanwhile, diphenhydramine, which induces sleepiness, can cause memory loss.
When acetaminophen is broken down in the liver, a small amount of a toxic byproduct called NAPQI is produced.
Normally, the body's natural antioxidant - glutathione - neutralizes NAPQI. However, when high doses of acetaminophen are taken, or if glutathione levels are low from factors like alcohol use or malnutrition, the liver's capacity to process and eliminate NAPQI becomes overwhelmed.
When NAPQI is not properly detoxified, it can accumulate in the liver and bind to essential cellular proteins, leading to cell injury and potentially liver failure.
Dr Melillo says the risk of liver damage increases significantly when the dose of acetaminophen exceeds 4,000mg daily in adults. This equates to more than eight Tylenol PM pills.
He highlights that acetaminophen is an ingredient in many medicines, not just Tylenol PM, so he recommends checking to see which products contain it and the quantities.
He doesn't recommend against acetaminophen completely but says it should be used sparingly and not habitually.
He says the prevalence of it is one of the reasons why there is so much liver damage in the US.
Liver disease in some form affects one in three Americans, adding up to 100million.
In January 2011, the FDA asked manufacturers of combination drugs containing acetaminophen to limit acetaminophen doses to no more than 325 mg in each tablet or capsule.
This is because there's no data showing that taking more than 325 mg per dosage unit provides additional benefit while outweighing the increased risk of liver injury.
Despite the recommendations, each Tylenol PM tablet contains 500 mg of acetaminophen to relieve pain and 25 mg diphenhydramine to help you go to sleep.
Previous research also found that acetaminophen could alter the perception of risk by making certain activities seem less dangerous.
Participants in the study ingested two acetaminophen tablets (1,000 mg) of the drug or a placebo and were asked to rate certain activities based on risk.
Those under the influence of the of the drug rated activities like bungee jumping, skydiving or starting a new career in your mid-30s as less risky than those who took the placebo.
The 2020 study, conducted by The Ohio State University, built on previous work that determined acetaminophen impacts the user's psychosis, as it was found to reduce positive and negative emotions, such as hurt feelings, concern of other's suffering and even their own joy.
Dr Melillo also dislikes Tylenol PM for its other main ingredient, diphenhydramine.
This is an antihistamine, which means it blocks histamine, a chemical in the body that promotes wakefulness, leading to drowsiness and helping with sleep.
Dr Melillo says that most people will be more familiar with the medication by its brand name, Benadryl.
Explaining why he isn't a fan of diphenhydramine, he said it could 'possibly cause memory loss.'
Diphenhydramine is an anticholinergic medication, meaning it blocks the neurotransmitter acetylcholine, which is essential for memory and cognitive function.
By blocking its action, diphenhydramine can impair these functions, leading to memory loss.
One study found that taking an anticholinergic for the equivalent of three years or more on a daily basis was associated with a 54 percent higher dementia risk than taking the same dose for three months or less.
The other side effects of diphenhydramine, Dr Melillo says, include dry mouth and urinary retention (an inability to empty the bladder).
He says for older patients, these symptoms can prove particularly troublesome as they could trigger other age-related health conditions.
If people need help sleeping, the pharmacist advises talking to a doctor about prescription medications that are available instead of turning to Tylenol PM or Benadryl, which they could become dependent upon.
He adds: 'If you're someone who takes this on a blue moon, then that's fine, it's not a big deal.
