Tylenol (Acetaminophen)

Tylenol
Indications:
fever
United StatesUnited KingdomCanadaAustraliaNew ZealandIrelandSingaporeSouth AfricaUnited Arab EmiratesHong Kong

Dosages

Tylenol 500 mg

Quantity Price per pill Total price
180 $0.24 $44.00
270 $0.21 $57.00
360 $0.19 $68.00

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Brand Names

Also known as (by country):
CountryBrand Names
Argentina
Acetolit Alikal Dolor Apracur Antifebril Apracur Te Antifebril Bio Grip-T Causalon Custodial Dirox Doxidol Dristancito Fiebrolex Fiebrolito Flash Guemusin Inmunogrip T Caliente Invernosan Itedal Mejoral Multifebrin Nodipir Nodolex Novo Asat Parageniol Paratral Para Z Mol Parclen PH 4 Plus Plovacal Predualito Qura Plus Tafirol Tafirol T Caliente Termofren Tetradox Vick Vitapyrena Viclor
Australia
Asprol Ceetamol Chemists Own Pain & Fever Childrens Panadol Dymadon Febridol Junior Disprol Kiddy Calm Lemsip Lemsip Headcold Ordov Febrigesic Panacete Panadol Panamax Parahexal Paralgin Parasin Paraspen Parmol Perfalgan Setamol Tempra
Belgium
Algostase Mono Croix Blanche Mono Curpol Dafalgan Dolol-Instant Dolprone Efferalgan Lemgrip Lemsip Lonarid Mono Neuridon Panadol Pe-Tam Perdolan Perfusalgan Sanicopyrine Supadol Mono Tempra
Brazil
Acetamil Acetamol Acetofen Anador PRT Anatyl Baicurina Calpol Cefabrina Cetafrin Cetynol Chalena Contradol Cyfenol Dordendril Dorfen Dorfenol Dorib Dorico Dorsanol Dorvan Emsgrip Febralgin Fervex Gripeonil Gripotermon Pacemol Paracemil Paracen Parador Paralgen Paratermol Piramin Pyrimel Sonridor Termo-Ped Termol Tilekin Trifen Tyflen Tylalgin Tylecetamol Tyleflan Tylephen Tylidol Unigrip
Canada
222 AF Abenol Acet Acetab AF Anacin Alsiphene Anacin-3 Apap Arthritis Pain Artritol Atasol Benylin DM-D-E-A Cold and Sinus Cephanol Childrens Feverhalt Cold and Flu-in-One Fortolin Headarest Infants Tylenol Infant Tempra Multi-gesic Novo-Gesic Pain Aid Free Panadol Pediaphen Pediatrix Relief Robigesic Rounox Taminol Tantaphen Tempra
Czechia
Ben-u-ron Calpol Daleron Effect Comfort Efferalgan Gelocatil Medipyrin Mexalen Panadol Paralen Paramax Rapid Perfalgan
Denmark
Pamol Panam Panodil Paratabs Perfalgan Pinex
Finland
Pamol Pamol F Panadol Para-Hot Para-Suppo Para-Tabs Paraceon Paramax Perfalgan
France
Aferadol Akindol Claradol Compralsol Dafalgan Dolflash Doliprane Dolipraneoro Doliprane Vitamine C Dolko Dolotec Efferalgan Efferalganodis Expandox Febrectol Geluprane Gynospasmine Malgis Oralgan Panadol Paralyoc Perfalgan Sedarene
Germany
Anaflon Anti-Algos Antipanin N Antipanin P Ben-u-ron Captin Contac Erkaltungs-Trunk Dignocetamol Dolarist Dolofugin Doloreduct Dolorfug Dorocoff-"Paracetamol" duracetamol Enelfa Eu-Med P mono Eu-Med Schmerzzapfschen Fensum Finiweh Freka-cetamol Gardan P Gepodan Grippex Grippostad Heissgetrank Kinder-Finiweh Larylin Heissgetrank gegen Schmerzen und Fieber Logomed Schmerz- /Fieber Lonarid Mono Mandrogripp Mogil Momentum Analgetikum Mono-Trimedil Mono Praecimed NeoCitran NilnOcen Octadon N Ophinal Paedialgon Pantalgin Parapaed PCM Perfalgan Pyromed RubieMol Schmerzex Sinpro junior Sinpro N Togal Treupel mono Verlapyrin N Vips Vivimed Vivimed N
Greece
Anadin Apotel Biocetamol Calmodor Cetinject Dalminette Depon Depon Maximum Depon Odis Dolal Efferalgan Genspir Lonarid Aplo Neo-Kalmol Panadol Par Paramin Perfalgan protAlgon Tempra Tunelzin Zenol
Hungary
Ben-u-ron Efferalgan Febrilin Grippostad Mexalen Panadol Paramax Rapid Perfalgan Rubophen
Italy
Acetamol Adolef Calpol Efferalgan Levadol Minofen Neo-Fepramol Normaflu Panadol Perfalgan Piros Puernol Sanipirina Tachipirina
Malaysia
Acet Arfen Avadol Biogesic Dhamol Dumin Hoemal Naprex Panadol Parafizz Partamol Poro Rapidol Serimol Setromol Uphamol
Mexico
Abatem Ac-Fast Acetafen Acetif Alpirex Amolgen Analmex Analphen Andopan Andox Antidol Biofer Bremotel Brontonyl Calinofen Calpol Colderina Coriver Datril Dismifen Dolgan Flash Dolotemp Doluvital Dolviran Facetol Farpik Febran Febrim Febronyl Ferridal Filanc Frilen Ginol Icetazol Ifutemp Infalgina Magnidol Magnidol-Plus Mejoral Mejoral Acti-Rapido Mejoralito Minofen Minomex Neodol Neodolito Nordinet Infantil Notem Panadol Panofen Parengesico Pharmacen Piraldin Piralgina Piralgina 650 Piralyn Piremol Precifen Prosedal Quitadol Resfin Sedalito Sinedol Soltadol Sons Piral Tafirol Temperal Tempire Tempofin Tempra Tempre Temprin Temzzard Termotrin Terol Tylex Ulpafie Verbalem Wifibrin Winasorb
Netherlands
Daro Darocet Democyl Finimal Junior Hedex Kinder Finimal Lagalgin Momentum Panadol Perfalgan Sinaspril-"Paracetamol" Vicks "Paracetamol"
New Zealand
Cold & Flu Max Disprol Lemsip Cold & Flu Original Pacimol Pamol Panadol Paracare Parapaed Paratabs Perfalgan
Norway
Alvedon Pamol Panodil Paracet Perfalgan Pinex
Poland
Acenol Apap Calpol Codipar Efferalgan Grippostad Novo-Gesic Panadol Perfalgan Tazamol
Portugal
Anadin "Paracetamol" Anti-Gripe Asclepius Atralidon Beluron Ben-u-ron Bisolgrip Calpol Cetol Cofedron Dafalgan Efferalgan Febridol Fludeten Gelocatil Huber Katagrip Kelin Lisopan Molpireos Neogrip Olpira Panadol Panasorbe Pantadolor Paracetol Paramolan Parsel Perdolan Mono Perfalgan Singrips Supofen Takipirina Xumadol Zaramol
Spain
Acecat Acertol Actron Akindol Alginina Analter Antidol Apiretal Aspac Asplin Auxidor Bandol Bolidol Calmanticold Cupanol Dafalgan Desfebre Dolefin "Paracetamol" Dolgesic Dolostop Drazin Duorol Efetamol Efferalgan Eftazid Febranine Febrectal Frenagial Gelocatil Hedex Melabon Infantil Nofedol Panadol Panrectal Parafludeten Pediapirin Perfalgan Pirinasol Prontina Resakal Resolvebohm Sinmol Stopain Sudafed Co Talgo Temperal Tempra Termalgin Termocatil Xumadol Zatinol Zolben
Sweden
Alvedon Curadon Lemsip Pamol Panodil Perfalgan Reliv
Turkey
A-Per Asomal Babinoks Berko-Setamol Calpol Efferalgan Efpa Ekosetol Geralgine Gripin Minafen Minoset Noral Panadol Para-Nox Paracet Parasedol Parol Paroma Pirofen Polmofen Sedalon Setamol Tamol Tempo Termacet Termalgine Tylol Vermidon Volpan
United States
Acephen Aceta AlbaTemp Alka-Seltzer Advanced Formula Apacet Apap
ManufacturerBrand Names
Alkem LaboratoriesPuc

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Description

What Is Tylenol?

ACETAMINOPHENWhen taken in therapeutic doses, Tylenol (Acetaminophen or Paracetamol) is an analgesic-antipyretic with minimal adverse effects for the majority of people. However, when consumed in massive amounts, it is a strong hepatotoxin that can cause liver necrosis.

A massive, single overdose (> 10 g or > 30 regular-strength or > 15-20 extra-strength pills) taken in a suicide attempt is the primary cause of the majority of acetaminophen-related liver injuries. A therapeutic amount that is administered in tiny doses over time may accumulate to a level high enough to cause liver damage. Even a single therapeutic dosage of 3 g or several dosages of 4-8 g per day for two-seven days can cause liver damage in alcoholics. Patients may also be more vulnerable to hepatic harm from repeated therapeutic dosages of the drug if they have preexisting hepatic illness, malnutrition, or wasting conditions.

How Does It Work?

Acetaminophen is quickly absorbed when taken orally at therapeutic quantities; peak plasma concentrations are obtained in 30 to 60 minutes. It is metabolized in the liver by conjugating (70% to 80%) with sulfate or glucuronide, which is then eliminated in the urine. The medication is oxidized to produce catechol metabolites and 3-hydroxy- and 3-methoxy-acetaminophen in about 5% to 10% of cases.

The cytochrome P-450 mixed-function oxidase (MFO) system breaks down an additional 5-10% of the medication to produce the reactive metabolite N-acetyl-p-benzoquinone imine (NAPQI). Usually, the cysteine moiety of cytosolic glutathione interacts with this hazardous intermediate, resulting in the excretion of thioethers in the urine. The hazardous metabolite attaches to essential hepatocyte proteins and causes cell death if it exceeds the cellular glutathione level.

How to Take

It is recommended that oral tablets, capsules, or gel caps be taken with a full glass of water. Tylenol can be taken with or without food.

Rectal suppository:

  • Open the suppository package.
  • Place inside the rectum.
  • If the suppository is overly soft, run some cold water over it or chill it for half an hour in the refrigerator.

Probability of Hepatic Damage

The following factors determine the possibility that a high dose of the medicine can cause liver damage.

Patient's Age

Compared to adults, young children often experience a far lower incidence of hepatotoxicity from acetaminophen overdose.

Total Amount Consumed

In most cases, the total hazardous single dose exceeds 15 g. However, lower single dosages of 3 to 6 g have occasionally been toxic.

Blood Level Reached

Blood levels four and ten hours after consumption are correlated with the degree of liver damage. The harm is frequently serious if blood levels are more than 300 mg/dL after four hours. Generally, levels less than 150 mg/dL are safe. A nomogram that aids in predicting liver damage linked to certain Tylenol blood levels was assessed four to twelve hours after use.

The Functions of the P-450 MFO Mechanism

When Tylenol is consumed in large dosages (> 10 mg), the pace of formation of the toxic metabolite influences the toxicity of the medicine. The drug's ability for the liver to sulfate and glucuronidate is exceeded, leading to an increase in the absolute and relative levels of the hazardous metabolite being metabolized by the P-450 MFO system. Additionally, the biotransformation of Tylenol to the hazardous metabolite is accelerated by prior activation of the P-450 MFO system by persistent alcohol consumption or by medications known to activate the P-450 system, such as barbiturates and phenytoin.

Sufficient Stocks of Glutathione

Glutathione levels in hepatic tissue are essential for the harmful effects of Tylenol when the toxic metabolite depletes more than 70% of the hepatic glutathione stores or when the tissue glutathione levels are low due to prior fasting, malnutrition, or alcohol use, toxicity, and cell necrosis result.

Alcoholics' Hepatotoxicity

Therapeutic dosages of Tylenol in alcoholics have been associated with severe hepatotoxicity in several cases. This is because starvation lowers the clearance of the poisonous metabolite since it lowers hepatic glutathione levels, and persistent alcohol consumption increases the synthesis of hazardous metabolite by the previously induced P-450 MFO system.

The centraxonial location of the hepatic injury is in line with the location of the enzymes in charge of the drug's metabolism. Centrally dilated and congested sinusoids are common. There is modest inflammatory infiltration and severe hemorrhagic hepatocellular necrosis but no steatosis.

Research on Diagnosis

With less significant increases in serum alkaline phosphatase, serum levels of glutamic-oxaloacetic transaminase (aspartate aminotransferase) and glutamic-pyruvic transaminase (alanine aminotransferase) are typically increased into the thousands. Most of the time, early and serious coagulation abnormalities are present together with an elevated prothrombin time. Values more than twice the normal range indicate a dire prognosis. Bilirubin levels are often somewhat high.

There is variation in the severity of the liver injury. Four to eighteen days following drug consumption, fulminant hepatic failure may progress and result in death.

Other Organs Damage

Overuse of Tylenol can harm other organs. It is possible to experience renal failure accompanied by acute tubular necrosis and cardiac injury, as shown by abnormalities in the ECG.

Recuperation

Within three months, the hepatic architecture returns to normal if the patient recovers from the acute episode.

Overdose

Treatments of overdose have included cholestyramine or activated charcoal administration to lessen the drug's absorption from the gastrointestinal tract, or hemodialysis or hemoperfusion to increase the drug's clearance from plasma. These methods are all ineffective.

Precautions

According to a study that examined umbilical cord blood samples, infants who were exposed to the most Acetaminophen were around three times as likely to receive an autistic spectrum disorder or ADHD diagnosis in childhood. 

If you're using it to treat a fever, measure your temperature before taking any acetaminophen dose and record the result. If the temperature is 38° C (100° F) or above while you are getting chemotherapy, call your doctor immediately. Inform your doctor if the fever persists for more than two days if you are not undergoing chemotherapy.

Avoid taking more pills than your doctor has prescribed. Overdosing on pills can seriously harm the liver.

Inform your physician if you have severe renal disease or liver disease.

Restrict alcohol intake if you take Tylenol regularly. 

Specific medical tests may be impacted by acetaminophen use. For instance, some blood sugar tests may give diabetic patients inaccurate results.

Acetaminophen is an active element in several combination drugs (such as cough and cold remedies). Before taking Tylenol, carefully read the labels of all other medications you take.

Keep out of children's reach and away from heat, direct light, and moisture.

Please call your doctor, pharmacist, or nurse for further information about this drug.

Side Effects

Here is the table with the most common side effects of Tylenol.

Side Effect Description
Nausea A feeling of discomfort in the stomach, often leading to the urge to vomit.
Liver Damage Prolonged or excessive use of Tylenol can lead to liver toxicity.
Allergic Reaction Some individuals may experience allergic responses, such as rash, itching, or swelling.
Headache Ironically, one of the side effects can be a headache, although Tylenol is primarily used to relieve headaches.
Stomach Pain Abdominal discomfort or pain may occur, particularly if Tylenol is taken on an empty stomach.
Dizziness Feeling lightheaded or unsteady, especially when standing up quickly after taking Tylenol.
Reviewed by
Jennifer Bowles
Pharmacologist