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==Longer Term NSAID usage==
Using NSAIDs for longer periods of time can lead so some serious problems. A running friend had a bleeding ulcer from using Ibuprofen, which is a known <ref name="IbuprophenSideEffects"/> side effect. The likelihood of a bleeding or perforated ulcer goes up with time, from 1% after 3-6 months, to 2-4% after 12 months. (Taking a Ibuprofen/Famotidine combination has been shown<ref name="Famotidine"/> to reduce the incidence gastric ulcers from 35% to 14% in longer term users.) Acetaminophen does not have the same risk of ulcers, but it is linked to liver damage, especially in those who drink alcohol. Acetaminophen is the leading cause of acute liver failure<ref name="AcetaAcuteLiver"/>. There are concerns that even the standard dose can cause changes in liver function. <ref name="AcetaNormalDoseLiver"/>
==Tangent - Is Acetaminophen really an NSAID?==
There are differing opinions around the classification of Acetaminophen as an NSAID with some resources<ref name="NotAnNsaid"/> stating it is not an NSAID. While Acetaminophen has limited anti-inflammatory properties, it shares the same mechanism of action with most NSAIDs of inhibiting the COX enzyme and the inhibition of prostaglandin synthesis. It is therefore reasonable and useful to classify Acetaminophen as an NSAID.
==References==
<references>
<ref name="AcetaNormalDoseLiver">FDA May Restrict Acetaminophen http://www.webmd.com/pain-management/news/20090701/fda-may-restrict-acetaminophen</ref>
<ref name="VitaminI">Urban Dictionary: Vitamin I http://www.urbandictionary.com/define.php?term=Vitamin%20I</ref>
<ref name="NotAnNsaid">ACETAMINOPHEN (PARACETAMOL) http://www.chemicalland21.com/lifescience/phar/ACETAMINOPHEN.htm</ref>
</references>
