As Spring rolls around, people who live with seasonal allergies may find that their symptoms begin to return. The pollen count tends to increase, leading to symptoms like sneezing, itchy eyes, and runny nose. Seasonal allergy symptoms can make you feel fatigued and even downright miserable. Fortunately, there are steps you can take to make life more manageable, including taking an antihistamine medication. 

What Are Antihistamines?

Antihistamines, as their name might suggest, block the activity of histamines, a molecule that tells the cells to perform certain processes, such as making stomach acid. Histamine also plays a role in the immune system, working to protect the body from foreign invaders. When a person comes into contact with allergens, histamine causes an overreaction in the body, leading to symptoms like congestion. Since antihistamines block histamine activity, they can treat allergy symptoms. 

What Causes the Body to Release Histamines?

Histamines cause an allergic reaction, because they perceive allergens to be a threat. This causes blood vessels to swell, ultimately leading to allergy symptoms. People who have seasonal allergies have an overreaction to allergens within the environment, whereas people without seasonal allergies do not experience the same symptoms (sneezing, runny nose) in response to allergens. 

Some common causes of histamine release, and allergy symptoms, include certain foods, dust, pollen, mold, pet dander, and latex. Seasonal allergies are often linked to pollen and mold. While antihistamines are often used to treat seasonal allergies, they can also be useful in the case of an allergic reaction to something in the environment, such as dust. People may also use antihistamine drugs to treat hives, rashes, food allergies, and insect bites. 

Types of Antihistamines 

There are two types of antihistamines: H1 blockers which treat allergies, as well as H2 blockers, which are utilized to treat gastrointestinal conditions like acid reflux and ulcers. Within the class of H1 blockers are first-generation antihistamines, which are known to cause drowsiness, and newer second-generation antihistamines, which have a lower risk of causing drowsiness. 

Some common first-generation antihistamines are as follows:

• Benadryl (generic name diphenhydramine)
• NyQuil (generic name doxylamine) 
• Vistaril (generic name hydroxyzine) 
• Dramamine (generic name dimenhydrinate) 

The following are second-generation antihistamines: 

• Claritin (generic name loratadine) 
• Allegra (generic name fexofenadine)
• Zyrtec (generic name cetirizine) 

While newer, second-generation antihistamines came out in the 1980s, first-generation antihistamines remain on the market. 

Antihistamine Side Effects 

Antihistamine drugs are used because they provide relief from seasonal allergies, but that doesn’t mean they are without side effects. The side effect profile can vary between different types of antihistamines, but there are some general side effects that you can expect. 
Some common side effects that are seen with first-generation antihistamines like Benadryl include: 

• Drowsiness
• Dryness in mouth/eyes
• Blurry vision
• Headaches
• Dizziness
• Low blood pressure
• Constipation 

Second generation medications may come with slightly different side effects:

• Stomach pain
• Fatigue
• Headache
• Sore throat
• Coughing
• Nausea/vomiting

If you are concerned about side effects, it is important to look at the labels on medications, including those that are purchased over-the-counter. Sometimes formulations used to treat cold and flu may contain an antihistamine medication. If you regularly take an antihistamine for allergies, and then take a cold medication, you may unknowingly ingest an additional dose, which can worsen side effects. This can be especially problematic if you take too large of a dose of an antihistamine that produces drowsiness. 

Choosing an Antihistamine

There are several different formulations of antihistamines, many of which are available over-the-counter. They come in the form of syrups, liquids, capsules, and tablets. For rashes and skin allergies, there are antihistamine creams available. 

When choosing an antihistamine for seasonal allergies, it may be best to consult with your doctor to determine the best medication for you and to ensure that the selected antihistamine will not interact with any other medications you are taking.

If you are comfortable selecting an antihistamine on your own, it is helpful to read labels for the various antihistamine drugs, as the label will contain a list of uses of the drug. If a drug label indicates that it can be used to treat seasonal allergy symptoms, it is probably a suitable choice. Some medication manufacturers may refer to seasonal allergies as “hay fever” or “allergic rhinitis.” 

Prescription Antihistamines for Seasonal Allergies

Many people do find that seasonal allergy symptoms are relieved with over-the-counter antihistamine drugs, but some patients may benefit from taking a prescription medication. If you have severe seasonal allergies, your doctor may prescribe one of the following antihistamine medications:

• Clarinex: A medication taken by mouth 
• Astelin: An antihistamine nasal spray
• Optivar, Elestat, or Patanol: All eye drops 

Prescription antihistamines can provide relief if you do not respond to over-the-counter medications. Talk to your doctor to determine if you might be a candidate for a prescription antihistamine. 

How to Take Antihistamines

Antihistamine medications should be taken using the dosing descriptions on the medication label. If you are taking a prescription, follow the instructions of your doctor or pharmacist. Do not be afraid to ask a pharmacist how to take an antihistamine medication, even if it is over-the counter.

Be sure to carefully read medication labels. Do not exceed the recommended dose, and be sure that you are not taking multiple products that contain antihistamines, as you might unintentionally exceed the maximum dose and increase your risk of side effects like extreme drowsiness. 

The Bottom Line on Antihistamines

Antihistamines can be incredibly helpful if you live with seasonal allergies, as they can reduce the effects of unpleasant symptoms like constant sneezing and itchy eyes. If you regularly struggle with seasonal allergies, you might find that you need to take an antihistamine daily. On the other hand, some people may be able to take antihistamines only as needed, when allergy symptoms flare up. Your doctor can help you to determine the best dosing regimen for antihistamines and seasonal allergies. 

Sources:

1. https://www.yalemedicine.org/conditions/seasonal-allergies
2. https://medlineplus.gov/medlineplus-videos/histamine-the-stuff-allergies-are-made-of/
3. https://my.clevelandclinic.org/health/drugs/21223-antihistamines
4. https://www.mayoclinic.org/diseases-conditions/hay-fever/symptoms-causes/syc-20373039
5. https://www.webmd.com/allergies/allergy-medications

When you receive a prescription from your physician, you probably view that physician as a source of information about the medication. While your doctor can certainly provide you with answers to your questions, such as why they are prescribing the medication, your pharmacist can also answer questions you have about the prescription. In fact, pharmacists are experts on prescription medications, and they can answer questions that you may not have had time to ask during the course of a doctor’s appointment. Below are five questions you should be asking your pharmacist about your prescription, to ensure you get the most benefit, and the least risk, from your medications.

 

1. What side effects does this medication cause? 

When your doctor prescribes a medication, they have determined that the benefits you derive from the medication will outweigh potential side effects. That being said, it’s still helpful to know what side effects you can expect to experience with a new medication. Be sure to ask about common, minor side effects, as well as severe side effects that may be cause for concern. In many cases, serious side effects are rare, but you need to know what symptoms are indicative of a serious problem that warrants medical attention. 

 

1. Could this medication interact with anything else I am taking?

Before taking a new medication, you also need to be aware of potential interactions with other medications you are taking. Hopefully, your doctor has checked other medications you are prescribed to ensure that they will not interact with your new prescription, but if you are being treated by various providers for multiple health conditions, there is a chance they may miss one of the prescriptions on your list. It is always best to inform your pharmacist of all medications you are taking and ask if the new medication will cause problems with any of the other medications. Sometimes, certain drugs can cause worse side effects when taken together, and in other instances, one medication may reduce the effectiveness of another. Certain foods can even interact with prescription medications, so it can be helpful to ask your pharmacist about any possible food interactions. 

 

1. What should I do if I accidentally miss a dose? 

Even with the best of intentions, you might occasionally miss a dose of your medication. For some drugs, you may be able to get back on track by simply proceeding as usual with taking the medication the following day. In other instances, it may be best to take a double dose the next time you take the medication. Your pharmacist will be able to clarify the best option if you accidentally miss a dose, so that you can continue to get the intended benefits of the medication. 

 

1. Are there any special directions for taking this medication?

Some prescription drugs are taken on an as-needed basis, whereas others may be taken following a specific schedule, or at specific times of day. It’s important to understand special directions for taking your medication so that you can get the greatest possible benefit from it. Ask your pharmacist exactly how you should take the medication if you are unsure. This can include asking whether you should take it in the morning or at night, if you should always take it at the same time of day, and whether you should take it with food/drink. Instructions are likely printed on your prescription bottle, but it is helpful to clarify verbally with your pharmacist. 

 

1. What should I do if I need to stop taking this medication? 

In some cases, you may need to stop taking a medication. For instance, if you become pregnant or experience serious side effects, you may determine that taking the medication is no longer in your best interests. Asking a pharmacist what you should do if you need to stop taking a medication is important. In some instances, you may need to taper off of the medication to avoid withdrawal symptoms or other side effects. If you have a serious health condition, your pharmacist may refer you to your doctor to ask questions about stopping your medication. In some instances, such as if you take insulin for diabetes, it may be dangerous to stop taking medication. A pharmacist will be able to inform you about the appropriateness of stopping a medication for a particular health condition. 

 

The Bottom Line

You should never be afraid to ask your pharmacist about one of the medications you are taking. A pharmacist is a valuable member of your healthcare team, and part of their role is to ensure that you understand what medications you’re taking, what they do, how to take them, and what you can expect (ie: side effects) while taking the medication. A physician will hopefully provide you with information about your prescriptions, but even so, you may still have questions for your pharmacist. Do not hesitate to ask; it is important that you understand all of the important details about medications you’re taking. 

 

At the end of the day, asking questions may be life-saving. For example, certain medications can interact with grapefruit, and in some cases, the interaction effect can be severe. Interactions between grapefruit and prescription medications can result in kidney damage, irregular heart rhythm, and a serious condition called rhabdomyolysis, which causes profound muscle damage. If you do not ask questions about medication interactions, you may miss out on important, and potentially life-saving, information. Usually, warning labels are printed on medications, but it can be easy to miss them. Ultimately, you won’t regret asking questih hi ons of your pharmacist. 

 

Sources:

1. https://www.cantonmercy.org/healthchat/the-five-best-questions-to-ask-a-pharmacist-about-your-prescription/
2. https://uihc.org/health-topics/five-questions-ask-your-pharmacist
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589309/

Tylenol is the brand name for the pain medication acetaminophen. This medication is often available over-the-counter, and it can be used to treat mild to moderate aches and pains, such as those from menstrual cramps, sore throats, muscle pain, headaches, tooth aches, and back pain. Tylenol is also used to reduce fever, and while it is safe in the recommended doses, high doses can come with consequences, including liver problems. Learn the details here. 

Tylenol and Liver Damage

Tylenol is safe and effective for managing pain when taken in small doses over short periods. Experts recommend that adults limit their Tylenol dosage to no more than 4,000 milligrams per day, and that they take the medication for no longer than 10 days, unless a doctor recommends otherwise. Doses for children and teens are lower, based upon their body weight.

 

Taking more than the recommended dose of Tylenol can lead to liver damage, which can be fatal or require transplant in some cases. This is because the liver is responsible for processing medications like Tylenol and filtering toxins out of the body. With too high of a dose of Tylenol, toxins build up more quickly than the liver can filter them out, resulting in damage.

 

You generally do not have to worry about liver damage if you take the occasional dose of Tylenol for pain or fever. With typical doses, the liver is able to process Tylenol without incident. On the other hand, taking excessive doses, whether intentional or unintentional, can lead to overdose and acute liver failure. 

 

Fortunately, most cases of Tylenol-related liver damage are temporary and reversible, and liver functioning returns to normal with treatment. 

Alcohol and Tylenol-Related Liver Damage

While taking large doses of Tylenol can lead to liver damage, the risks are increased among people who abuse alcohol. A recent study found that in chronic alcohol users, the risk of liver toxicity is increased if people use Tylenol soon after the body is cleared of alcohol.

 

A large body of research has found that consuming alcohol and Tylenol together causes liver toxicity, and long-term consumption of alcohol makes liver toxicity worse. 

Based upon what has been learned from research, if you are a heavy alcohol drinker, the risk of Tylenol liver damage may be higher.

 

Tylenol in Patients with Liver Disease 

Another factor that can increase the risk of Tylenol liver damage is existing liver disease.  Individuals with chronic liver disease are more likely to suffer an unintentional Tylenol overdose, because they have weaker liver function when compared to someone without liver disease. Among those with liver disease, doses lower than the recommended daily maximum can cause liver damage. That being said, Tylenol is still considered the safest pain-reliever for those with liver disease.

Signs of Tylenol-Related Liver Damage

If you’ve overdosed on Tylenol and are at risk of liver damage, you will experience some of all of the following symptoms:

 

• Stomach pain or cramping
• Loss of appetite
• Diarrhea
• Nausea and vomiting
• Shortness of breath
• Irritability or confusion
• Extreme sleepiness
• Sweating excessively
• Fainting
• Reduced urination
• Dark urine
• Blurred vision
• Pain under the ribs
• Jaundice (yellow skin/eyes)

 

The above symptoms after Tylenol use indicate that you are likely suffering from an overdose, which makes it important to seek immediate medical treatment. Failing to seek medical care can result in permanent liver damage, or even death. 

Treating Liver Damage from Tylenol

 

Since Tylenol-related liver damage can be fatal or severe enough to require a liver transplant, it is critical to seek medical treatment as soon as possible after experiencing Tylenol overdose symptoms. The goal of medical care is to prevent absorption of Tylenol, remove Tylenol from the bloodstream, and/or reduce the toxic effects of Tylenol on the liver. This can be achieved by giving certain medications, such as activated charcoal, inducing vomiting, and providing antidotes to reduce the toxicity of Tylenol. With prompt medical treatment, you can reduce the risk of severe liver damage from Tylenol overdose. 

Reducing the Risk of Liver Damage from Tylenol 

Tylenol-related liver damage is possible, but it’s also preventable. You can lower your risk of liver damage from Tylenol by taking the following precautionary measures:

 

• Do not take more than the recommended daily dose of Tylenol. 
• Refrain from mixing Tylenol with alcohol. 
• Ask a doctor about the safe amount of Tylenol consumption if you have liver disease. 
• Be sure to check over the counter and prescription medication labels, as you may not realize that you’re using products containing Tylenol. Any product that includes acetaminophen as an ingredient is the same as Tylenol, and you may unknowingly be ingesting multiple sources of Tylenol and exceeding daily limits.
• Ask a doctor how much Tylenol you can safely give to your child or teen.
• Seek immediate medical care if you show symptoms of Tylenol overdose. 

The Bottom Line

So, can Tylenol damage the liver? It is possible to suffer Tylenol related liver damage if you take large doses of this medication. In most cases, it is safe to use Tylenol for short-term pain relief and fever reduction if you do not exceed the recommended maximum dose of 4,000 mg per day. If you use more than this dose, your risk of Tylenol liver damage is higher. The risks may be elevated even more in people who abuse alcohol or suffer from chronic liver disease.

 

If you’re worried about liver damage from Tylenol, consult with a doctor about the safe amount of Tylenol use for you. Be careful to read all medication labels to accurately track your daily Tylenol consumption, and be sure not to use more than the daily maximum. If you follow these steps, Tylenol is much less likely to damage your liver. 

 

Sources:

1. https://medlineplus.gov/druginfo/meds/a681004.html
2. https://my.clevelandclinic.org/health/diagnostics/22157-acetaminophen-level-test
3. https://www.sciencedirect.com/science/article/pii/S0022519320304148?casa_token=uwMPMw5eZp0AAAAA:8TqY0m2nRG5np3MVKcJ-0UamUncfQzCh4EtMdaeqVvGgpQFsPvxhZEj_yfob8gqdKdvS7Ya0L9g
4. https://archivepp.com/storage/models/article/ZXSoLEjL8DcjcMdASHlJa1yDPFBhOgx4lYpLIaytaxD39KzaUDoXDmNpg95c/evaluation-of-recent-updates-regarding-acetaminophen-induced-acute-liver-failure.pdf
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225146/