What if you are not able to take Acetaminophen and you have a fever due to COVID-19?
Anika H. Ahmed, MD
During the pandemic of COVID-19, the first analgesic to disappear off the shelves in major pharmacies and grocery stores was Tylenol. Acetaminophen, popularly available as Tylenol, Nyquil, Alka-Seltzer Plus, Sudafed and many more, is the most common pain and fever-reducing medication, widely recommended to COVID-19 patients to stay comfortable. Acetaminophen works on the part of the brain that perceives pain and controls body temperature. In fact, it has been labelled as the first line of treatment in COVID-19, as symptoms of fever and generalized aches and pain begin. It gives relief from a fever and generalized body aches within minutes and keeps a patient comfortable for four to six hours. Dosage can be repeated as needed every four to six hours and the maximum dose is 4 grams/day. However, it is commonly used in combination with Diphenhydramine (an antihistamine) in flu medications. Many are restricted from the use of Acetaminophen due to serious allergic reactions like difficulty in breathing, hives, swelling of the face, lips, mouth, or throat. Many are unable to take Acetaminophen due to allergic skin reactions leading to rashes. An overdose of Acetaminophen can lead to liver and kidney complications.
Anyone with an established allergic reaction to Acetaminophen should avoid it completely, as the resulting allergic reaction can be life-threatening. In instances when individuals are unable to take Acetaminophen, they are dependent instead mainly on non-steroidal anti-inflammatory drugs (NSAID). Many physicians are not comfortable using NSAID as the first line of analgesic and antipyretics in COVID-19 patients. Presently scientists and researchers are working “round the clock” to follow patterns of clinical symptoms seen in COVID-19 patients, both with the use of Acetaminophen and the NSAID. Much work still needs to be done. For all practical purposes, doctors managing COVID-19 patients are using Ibuprofen (commonly known as Advil or Aleve) for patients who are unable to take Acetaminophen.
The pattern of clinical symptoms in COVID-19 is changing across the globe on a daily basis. A lot of research, clinical trials, and footwork clinically needs to be done before any drug can be labelled as first line or second line of therapy. This is why it is important for all COVID-19 patients, including those who cannot take Acetaminophen, to connect with their doctor on a telemedicine platform following the onset of symptoms for proper advice regarding substitute medications, their dosages, and other supportive therapy.