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Tylenol is a North American brand of drugs for relieving pain, reducing fever, and relieving the symptoms of allergies, cold, cough, and flu. The active ingredient of its original, flagship product, acetaminophen (called "paracetamol" outside of North America), is marketed for headaches, fever, muscle and body pain, arthritis, and joint pain. Like the words "acetaminophen" and "paracetamol", the brand name is derived from the chemical name for the compound, N-acetyl-para-aminophenol (APAP). It is available over the counter without prescription, has few side effects, and reacts with very few medications. However, it can cause liver, kidney, other organ damage, and have fatal interactions with alcohol. The active substance of Tylenol, acetaminophen, was first used in medicine in 1894. Acetaminophen only gained widespread use after 1948, when scientists concluded that another popular drug, acetanilide, was toxic and that the same therapeutic effect could be safely achieved with acetaminophen, which was already known to be a metabolite of acetanilide. James Roth, a U.S. gastroenterologist, advocated paracetamol as a safer alternative to aspirin, which was shown to have some negative effects. Roth was also principal consultant to McNeil Laboratories. In 1953 McNeil Laboratories introduced Algoson, a preparation containing paracetamol together with sodium butabarbital, a sedative. In 1955 McNeil Laboratories introduced Tylenol Elixir for children, which contained paracetamol as its sole active ingredient. It was originally marketed mainly towards children, but soon came to dominate the North American pain-killer market. There are a number of different varieties of Tylenol available today including extra-strength (with 500&_160;milligrams of acetaminophen), children's doses, longer-lasting, and sleep aiding (in combination with diphenhydramine). In 2005 Tylenol Ultra was introduced in Canada, with 500&_160;mg of acetaminophen and 65&_160;mg of caffeine; caffeine has vasoconstricting effects, for which there is some disputed evidence for additional effectiveness.[1][2] The patent on paracetamol has expired, and the continued successes of Tylenol brand preparations are largely due to marketing, the backing of Johnson & Johnson, and new patented delivery mechanisms such as quick-release and extended-release forms of the medication. On September 29, 1982, a "Tylenol scare" began when the first of seven individuals died in metropolitan Chicago, after ingesting Extra Strength Tylenol that had been deliberately contaminated with cyanide. The crime was never solved and Tylenol sales temporarily collapsed, but the brand was rebuilt and recovered in a few years. At the request of later Chairman, Joseph Chiesa, new product consultant Calle & Company rescued the brand with the invention of the first inherently tamper-proof [enrobed] capsule, Tylenol Gelcaps, recapturing the 92% of capsule segment sales lost after the cyanide incident. The scare led to the introduction of tamper-evident packaging and "gelcaps" across the over-the-counter drug (OTC) and prescription drug industry.
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