addiction

Is tylentol pm addictive.  I cannot go to sleep without taking two of them.  I have been doing this for several years. Is it dangerous-I know tylenol is hard on the liver.  I drink very rarely

[Alison L, RPh]

Tylenol PM (Acetaminophen and Diphenhydramine) is not considered to be an addictive product. The reason Tylenol PM helps you sleep at night is due to the Diphenhydramine which is a sedating antihistamine that is used in many OTC night time formulations. Diphenhydramine can cause side effects such as excessive daytime sedation, dry mouth, and urinary retention and thus its use long term as a sleep aid may not be preferred, but it is not addictive. If you stop use of the Tylenol PM, it may take up to 2-4 weeks for you to adjust to falling asleep without the medication, but there should be no other problems. The current recommended maximum daily dosage of acetaminophen, commonly known as Tylenol, is 4000mg (4 grams) in a 24 hour period and one tablet of Tylenol PM contains 500mg of Acetaminophen and 25mg of Diphenhydramine. Therefore, if you take 2 tablets (1000mg or 1 gram) each night you are not exceeding the maximum daily dosage. The problem would become if you are taking other OTC or prescription products that contain acetaminophen, have a pre-existing liver problem, or consume moderate-large amounts of alcohol on a regular basis. Multiple OTC cough and cold products and prescription pain medications are combined with acetaminophen for its multiple effects and thus it is easy to exceed the daily maximum without knowing. The FDA has put a product advisory/warning on all products that contain acetaminophen due to the negative long-term effects on the liver. The FDA has not released any statements on lowering the maximum dosage and the data that was in the clinical trial which brought about this warning were in patients who exceeded the 4000mg/day for a long period, had pre-existing liver problems, or had liver damage due to alcohol consumption.

[Angelhair7]

Thank you for your response to this question-I appreciate your help.

[allmymarbles]

Instead of cutting yourself off completely from Tylenol PM, why not reduce your dosage to only one pill for a couple of weeks and then stop altogether. I am not thinking of addiction, but your dependence on an aid to help you sleep and weaning yourself to natural sleep.