Take care when taking acetaminophen

Acetaminophen reigns as one of the most popular painkillers ever, despite sometimes getting bad press. In very recent memory, it has faced ongoing concerns about liver damage, major recalls for contamination problems and disturbing links to childhood asthma. Yet sales consistently rebound. Why? It does the job for millions, who find it easier on their stomachs than other painkillers.

Still, we've just gotten another reminder of how vital it is to take acetaminophen precisely.

The new alarm: "staggered overdoses." Unlike classic overdoses (taking too many pills at once), staggered ones occur if you take even slightly too much acetaminophen over several days. The effect can be lethal. You should carefully follow dosing directions on the box. In hospital studies, 37 percent of staggered overdose cases died, versus 28 percent of classic overdoses. And survivors were more likely to have liver, brain and kidney problems.

While acetaminophen is quite safe when used correctly, it's also particularly easy to misuse during holidays because it combines very badly with alcohol. As we enter peak party season and peak cold-and-flu time, do not drink and take acetaminophen, whether for a hangover or a head cold.

That's smart advice for all drugs, but it's vital with acetaminophen (and remember, it's in many other medications, from Thera-Flu to Percocet).

Acknowledging the problem, Johnson & Johnson is reducing acetaminophen dosages in maximum-strength Tylenol and various other formulations. Still, it's up to you to take it safely.