Providence, Rhode Island — A local pharmacist is raising alarms about the potential dangers of a widely used over-the-counter medication. Dr. Ethan Melillo has expressed strong concerns regarding Tylenol PM, a popular nighttime pain reliever that generates nearly $1 billion in sales each year. He argues that the drug, which combines acetaminophen and diphenhydramine, is often misused and could lead to severe health issues, including organ damage and cognitive decline.
Dr. Melillo warns that regular use of acetaminophen can cause significant liver damage, especially when daily doses exceed 4,000 milligrams—the equivalent of more than eight Tylenol PM pills. He points out that many consumers may not be aware that acetaminophen is an ingredient in various pharmaceutical products beyond Tylenol PM, which amplifies the risk of unintentional overconsumption. While he does not recommend eliminating acetaminophen from one’s medicine cabinet, he stresses the importance of using it judiciously.
The doctor highlighted that liver disease affects approximately one in three Americans, which totals around 100 million people. He attributes this troubling trend in part to the widespread use of acetaminophen. The U.S. Food and Drug Administration previously mandated that manufacturers limit acetaminophen doses in combination medications to no more than 325 milligrams per tablet or capsule to mitigate the potential for liver injury. Yet, Tylenol PM has 500 milligrams per tablet, leading to concerns about its safety.
In addition to the risks associated with acetaminophen, Dr. Melillo points out that the drug’s other active ingredient, diphenhydramine, can compromise cognitive functions. As an antihistamine, it blocks histamine, which promotes alertness, resulting in drowsiness. However, frequent use may also pose risks for memory loss, particularly in older adults. Research has shown that prolonged daily use of anticholinergic medications like diphenhydramine can increase the risk of dementia by 54 percent compared to short-term use.
Further complicating the matter, studies have indicated that acetaminophen can alter perceptions of risk, leading users to underestimate the dangers of certain activities. A recent study from The Ohio State University found that participants who ingested acetaminophen rated high-risk activities, such as bungee jumping and starting a new career, as less dangerous than those who took a placebo. This altered risk perception might contribute to unsafe behaviors among users.
For those struggling with sleep, Dr. Melillo recommends consulting a healthcare professional to explore alternative prescription options rather than relying on over-the-counter medications like Tylenol PM or Benadryl, which can lead to dependency. “If you use it occasionally, that’s perfectly fine, but you shouldn’t make it your go-to solution for sleep,” he cautioned.
Dr. Melillo’s insights serve as a reminder to consumers about the importance of being informed when it comes to medication usage. A more cautious approach may help prevent long-term health complications associated with seemingly harmless pain relievers taken too frequently.