When you have an ache, pain, fever or cold, acetaminophen may seem like a miracle cure, easing the pain and symptoms to keep moving without having to skip a beat. However, as helpful as this medicine can be, too much of a good thing can be harmful. Show
About one-third of acetaminophen overdoses in the U.S. are accidental. "An acetaminophen overdose means that you've taken more than is safe in a 24-hour period," explained Geisinger pharmacist Stacey Grassi. "In general, the most acetaminophen that's safe to take is 4,000 milligrams or 4 grams in a 24-hour period." Although acetaminophen is a safe and effective medicine, taking too much of it, even if it's accidentally, can lead to acetaminophen poisoning, which can cause liver damage and/or liver failure. You may be asking, "How is it possible to accidentally take too much acetaminophen?" There are a few ways an unplanned acetaminophen overdose can occur. "Some people accidentally take more than the recommended dose if their pain or fever doesn't go away after taking the recommended amount," Grassi said. "Some people end up taking too much if they're taking acetaminophen too many days in a row." Similarly, an accidental overdose can happen if you're taking an extended-release form of acetaminophen - extended-release pills causes the medicine to stay in your body longer. "You're supposed to take extended-release medicines less often than you would with regular acetaminophen. You will have too much acetaminophen in your system if you take the extended-release variety too often," Grassi said. People can also accidentally overdose on acetaminophen simply because they don't know it's in multiple medicines they're taking. "If someone is suffering with a migraine and a cold, they may take something for their migraine and a different medicine for their cold symptoms and never realize they both contain acetaminophen," Grassi said. Many medicines - both prescription and over-the-counter - contain acetaminophen, including medicines for allergies, colds, the flu, and trouble sleeping. If you don't read the medicine's label or know how to read the label, you could be at risk of an acetaminophen overdose. Here's how you can avoid an accidental acetaminophen overdose. 1. Read the labels of all the medicines you take "If the medicine you're taking contains acetaminophen, it will be listed under the active ingredients section of the packaging," Grassi said. "It is also listed on the label as APAP, Acetaminoph, Acetaminop, Acetamin, or Acetam." You should also check the label carefully to check if the medicine contains regular acetaminophen or the extended-release form. 2. Take the correct dose While you're looking at the label, check to make sure you're taking the correct dose, especially if it's extended-release acetaminophen. "Never take more than the label says to take and wait the right amount of time between doses," Grassi advised. 3. Don't take more than one type of acetaminophen at a time Since many medicines contain it, make sure that the total dose you take doesn't exceed 4,000 milligrams or 4 grams in one day. "You shouldn't take medicines together that contain acetaminophen - the combined amount may be too much," Grassi said. Plus, the acetaminophen in one medicine can address all of the aches and pains you may be taking multiple medicines for. 4. Don't take it for too many days in a row "Don't take acetaminophen for more than 10 days to treat pain and don't take it for more than three days for a fever," Grassi said. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Acetaminophen (brand name Tylenol®) is a safe, effective pain reliever and fever reducer for children and adolescents. But giving your child more than the recommended dose can lead to acetaminophen toxicity, which can cause liver damage and even death if untreated. Among the signs of acetaminophen toxicity are nausea, vomiting, breathing problems, and abdominal pain. These need immediate medical attention.
What is acetaminophen and acetaminophen toxicity in children?Acetaminophen (brand name Tylenol®) is a common over-the-counter (OTC) pain reliever and fever reducer for both children and adults. With the right dose, acetaminophen is very safe. Children are often prescribed acetaminophen for pain and fever reduction rather than aspirin because of the risk of Reye’s syndrome. But if a person of any age takes more than the recommended dose of acetaminophen the result can be acetaminophen toxicity. This is a dangerous situation. The liver can’t process excessive doses of the medication. If a child takes too much acetaminophen (or takes the recommended amount for too long) toxins can build up in their body. This toxicity can cause vomiting, liver damage and death. It’s important to deal with the situation quickly. What is the correct dose of acetaminophen for children?Every child’s dosage may be different. Among other factors, your child’s dosage depends on
You and your healthcare provider will determine the right dose for your child. Remember that any other prescription and OTC medications (such as cold medicines) also contain acetaminophen. Be sure to read the label of cold, sinus and other OTC medicines carefully to see how much acetaminophen (if any) it contains. Always note your child’s dosage when you give them acetaminophen. How common is acetaminophen toxicity in children?Acetaminophen overdoses and toxicity are common. Anyone can have an adverse reaction to an overdose of acetaminophen. Every year in the United States, about 50,000 emergency room visits are due to Tylenol overdose or acetaminophen toxicity. Acetaminophen poisoning is a common cause of liver damage (hepatotoxicity). Certain groups of people are more vulnerable to liver damage than others. Children and adolescents who already have liver disease or hepatitis A, B, or C are more likely to have severe symptoms after taking too much acetaminophen. Their livers struggle to process the medication, which can lead to liver failure. How does a child get acetaminophen toxicity?The liver acts as a filter for the body. It processes drugs and detoxifies substances in your system. Your child’s liver can stop working if it processes (metabolizes) too much of a medicine or has to metabolize it for too long. Acetaminophen toxicity occurs when your child:
What are the symptoms of acetaminophen toxicity in children?Symptoms of acetaminophen overdose don’t appear right away. There may be no symptoms at all for up to 24 hours following an overdose. It’s important to note the time your child takes their acetaminophen, and in what form (liquid, tablet, capsule, time-release capsule/tablet) it was taken. Some symptoms of acetaminophen toxicity are:
If you notice any of these symptoms in your child and you suspect an acetaminophen overdose, call an emergency number or go to the nearest emergency room right away. Call your local emergency number (such as 911), or your local poison control center, which can be reached through the national toll-free poison help hotline (1-800-222-1222). How is acetaminophen toxicity in children diagnosed?Your provider will examine your child and ask you about recent medications as far as how much was ingested, the approximate time it was taken, and the type of formulation (liquid, tablet, time-release capsule/tablet). To confirm a diagnosis of an acetaminophen overdose, blood tests are taken. These blood tests check:
What do I do if my child has acetaminophen toxicity?If your child has symptoms of an acetaminophen overdose after taking the medication, or you suspect an accidental overdose, seek emergency medical treatment immediately. Call local emergency (911) or your local poison control center, which can be reached through the national toll-free poison help hotline (1-800-222-1222). What are the treatments for acetaminophen toxicity?Treatment depends on when your child took the unsafe dose of acetaminophen. Based on when the overdose occurred, treatment may include:
What are the complications associated with acetaminophen toxicity?An acetaminophen overdose is a life-threatening emergency. If it isn’t treated soon after the overdose, it can lead to:
What can I do to help relieve symptoms of acetaminophen toxicity in children?If you believe your child has taken more than the recommended dose of acetaminophen, call 911 or your local poison control center, which can be reached through the national toll-free poison help hotline (1-800-222-1222). Get treatment as soon as possible after your child took the medication. How can you prevent acetaminophen toxicity in children?To prevent an acetaminophen overdose, follow dosage instructions carefully. Talk to your child’s provider about the right dose based on your child’s weight and age. Don’t give more than one product that contains acetaminophen at the same time. Other ways to prevent acetaminophen toxicity include:
What is the outlook for children who have acetaminophen toxicity?The prognosis depends on how much acetaminophen the child took and how soon treatment started after the overdose. Children who receive fast treatment after acetaminophen poisoning have a much higher chance of recovering without long-term health problems, such as liver damage. When should I call a healthcare provider about acetaminophen toxicity?Acetaminophen toxicity is a life-threatening emergency. If you believe your child has taken an unsafe dose of acetaminophen, you should call 911, go to the emergency room or immediately call a poison control center. If you don’t know the number, it can be reached through the national toll-free poison help hotline (1-800-222-1222). Share Facebook Twitter LinkedIn Email Print Last reviewed by a Cleveland Clinic medical professional on 04/13/2020. References
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Can Tylenol be earlier than 4 hours?If your child holds the first dose down for longer than 20 minutes before spitting up, you should wait 4 hours or more before giving your child another dose. Give acetaminophen every 4 to 6 hours as needed, but never give your child more than five doses in 24 hours.
Can you give Tylenol 2 hours apart?Doses of acetaminophen (e.g., Tylenol, Tempra) should be given at least four hours apart.
Can I take Tylenol again after an hour?Healthy adults can take 650 mg every four hours or 1000 mg every six hours. Don't exceed the maximum dose of 4000 mg in 24 hours.
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Accidentally gave Tylenol an hour early
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