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Pharmacy and Medications

Sleeping problems

07/18/2003

Question:

Is it bad for me to take tylenol pm before I go to sleep on a regular basis? I have insomnia whenever I`m anxious about anything, and tylenol pm really helps me have a good night`s sleep, without feeling groggy in the morning. Now that I know it works, I`ve been taking it about 3-4 nights a week for the last couple of weeks. What if I keep this up? What will happen to me?

Answer:

Tylenol PM is a safe over-the-counter (OTC) sleep aid, which contains diphenhydramine 25mg (Benadryl) and acetaminophen 500mg (Tylenol). Diphenhydramine is an antihistamine, whose most common side effect is drowsiness. Products containing diphenhydramine alone are also available OTC, and may provide an effective and less expensive alternative to the combination products. OTC sleep aids are meant for short-term use (for 2-3 days). Typically they begin to lose effectiveness when used for longer periods. Persistent difficulty sleeping can have many causes and should probably be evaluated by a physician. Proper sleep hygiene can help minimize the need for sleep aids. It is important to incorporate the following common sense items into you routine. Try to eliminated naps during the day. Try to go to bed at the same time every night and make sure the bed is comfortable. Use the bedroom for sleep, not as an office or TV room. Avoid eating large meals before bed, avoid caffeine after noon, and avoid alcohol or nicotine later in the evening. Do not exercise shortly before bedtime; instead engage in relaxing activities during this time. If you have good sleep hygiene and still have trouble sleeping for more than 2 weeks, you should see your doctor. If you are taking prescription medicines, ask your doctor or pharmacist before using any OTC medicines. Patients with glaucoma, breathing problems such as emphysema, chronic bronchitis, or asthma, or trouble urinating due to enlarged prostate should not use diphenhydramine. Tylenol PM may cause some drowsiness the following morning - avoid driving until you know how you respond to this medication. Taking too much acetaminophen can cause liver damage. Daily doses in excess of 3-4 grams of acetaminophen have been associated with of liver toxicity. Moderate alcohol use could increase this risk. If you consume 3 or more alcoholic drinks daily, ask your doctor whether you should take Tylenol PM. Acetaminophen is an ingredient in many over-the-counter products. Read the ingredient list of any other OTC medicines you intend to take to avoid an inadvertent overdose of acetaminophen. Difficulty sleeping can have many causes. For occasional difficulty getting to sleep or staying asleep the entire night, Tylenol PM is a reasonable choice. Don’t take Tylenol PM for more than 2 weeks. Try to change your sleep hygiene first. If that does not work, see your doctor to make sure you don’t have any medical conditions that are contributing to your sleep difficulties.

 

This response was prepared in part by Vitaly Bernadsky, a Pharm.D. student at the University of Cincinnati.

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Response by:

Robert James Goetz, PharmD, DABAT
Assistant Professor of Pharmacy Practice
College of Medicine
University of Cincinnati