Can You Take Tylenol On An Empty Stomach?

What is the best way to take Tylenol? Is it on an empty stomach or should you eat a pudding cup or applesauce first? 

Tylenol — clinically known as acetaminophen, N-acetyl para-aminophenol (APAP), or paracetamol — is used widely to treat pain and reduce fevers (via National Library of Medicine). When Tylenol is used as directed, it can safely relieve mild and moderate pain caused by common conditions like backaches, headaches, arthritis, and menstrual cramps. Given Tylenol's widespread use, it's important to understand the impact taking it on an empty stomach may have on your body, if any.

According to The Mayo Clinic you don't need to take food with Tylenol, as a general rule. However, children taking oral granules or powder formulations should take Tylenol along with applesauce or other soft foods. 

It is important to note that when taking Tylenol with or without food there are other factors to consider — like absorption time and your existing health conditions. And even though you don't need to take Tylenol with food, it is recommended that you drink a full glass of water per dosing instructions (via GoodRx Health).

Tylenol has been proven to be gentler on the stomach than other pain relievers, such as ibuprofen and naproxen, and can be taken by individuals who have a history of a sensitive stomach or intestinal lining. According to an article published by Harvard Medical School, Tylenol is an important and frequently used painkiller for the elderly population.

Though it is frequently administered to patients with gastrointestinal ailments, there are patients who should avoid Tylenol due to the health risks it poses. Specifically, Tylenol has been shown to cause liver damage if used incorrectly, or with prolonged use (via The Mayo Clinic). According to WebMD, taking Tylenol for more than 10 days for pain, or three days for fever is considered prolonged and unsafe use. If pain or fever symptoms haven't subsided while taking Tylenol during this time, consult a healthcare provider.

Liver damage can occur within 24 hours, says leading liver disease specialist at UCI Health Ke-Qin Huin. In a 2018 interview with UCI health he shared that, "Severe liver damage could occur if people take more than four grams of acetaminophen in 24 hours. And that's very conservative, because if taken with alcohol, even two grams can cause problems." According to a 2010 report, patients with liver disease should not take Tylenol due to the severe and potentially fatal adverse effects that can occur. Given this information, anyone considering taking Tylenol should consult their healthcare provider to assess any potential health concerns or interactions with medications they are taking.

Knowing it's safe to take a medication on an empty stomach is one thing, but how does taking Tylenol on an empty stomach impact its effectiveness and bioavailability? And what is bioavailability and why should it play a role in deciding whether to take Tylenol with food? According the Merck Manual, bioavailability is the rate at which and the amount of a drug that enters the circulation system, which in turn dictates how quickly it begins working within the body. Bioavailability is impacted by formulation, dosage, and how a drug is manufactured — meaning that the bioavailability of Tylenol will vary between liquid, tablets, and so on. 

Taking Tylenol on an empty stomach reduces the time it takes to be absorbed by your body and begin working to alleviate your pain or fever. The time it takes to work will depend upon the formulation and route of administration. The oral disintegrating tablets and oral liquid Tylenol will both take 20 minutes to work if taken on an empty stomach. However oral and extended-release oral tablets will take between 30 to 45 minutes. When taken on a full stomach Tylenol can take twice as long to start alleviating pain symptoms, and as a general rule takes longer to reduce fever symptoms (via Drugs.com).

The bottom line? Tylenol is able to be absorbed more quickly when taken on an empty stomach, therefore allowing symptoms of pain to be reduced at a faster rate than if it were administered on a full stomach.