Beware of overusing Acetaminophen

INDIANA– You have flu symptoms, so you’ve been getting some relief by taking a cough and flu medicine every few hours. Late in the day, you have a headache and think about grabbing a couple of acetaminophen tablets (Tylenol, paracetamol, and panadol) to treat the pain. Stop right there.

You might not realize that more than 600 medications – both prescription and nonprescription (or over-the-counter, OTC) – contain acetaminophen to help relieve pain and reduce fever. Acetaminophen, alone or in combination, is commonly used to reduce fever and relieve pain from headaches, muscle aches, menstrual periods, sore throats, toothaches, and backaches.

Be cautious not to exceed the daily limit of acetaminophen when using a single medicine or combination of medicines containing this drug. Taken carefully and correctly, these medicines can be safe and effective. However, taking too much acetaminophen can lead to overdose and severe liver damage.

Symptoms of acetaminophen overdose may include nausea, vomiting, abdominal pain, confusion, and jaundice (yellow skin and eyes). Some people may have no symptoms after an overdose. Symptoms may take several days to appear. And even when they become apparent, these signs may initially mimic flu or cold symptoms. Severe cases may require liver transplantation and can cause death.

If you have questions about acetaminophen or any medication, contact the U.S. Food and Drug Administration’s Division of Drug Information at 1-855-543-3784 and 1-301-796-3400 or druginfo@fda.hhs.gov.

Acetaminophen Is in Many Products

Each year in the U.S., people catch 1 billion colds and as many as 12% of people get the flu. Moreover, 7 in 10 people use nonprescription medicines to treat cold, cough, and flu symptoms. Acetaminophen is often an ingredient in many medications used to treat these symptoms.

Acetaminophen is used in many commonly prescribed medications in combination with pain relievers such as codeine, oxycodone, and hydrocodone.

The current maximum recommended adult dose of acetaminophen is 4,000 milligrams per day for all medicines you might be taking. To avoid exceeding that dose:

  • Be aware of the number of milligrams of acetaminophen in all your medicines.
  • Don’t take more than one OTC medicine containing acetaminophen.
  • Don’t take a prescription and an OTC medicine containing acetaminophen unless advised to do so by your health care professional.
  • When your health care professional prescribes a drug, ask if it contains acetaminophen, and inform them of all other medicines (prescription and nonprescription) and supplements you take.

When deciding which OTC product to buy, read the Drug Facts label to see if the ingredients include acetaminophen, especially before using two or more products simultaneously. (The ingredients for prescription drugs are listed on the container label.)

The word “acetaminophen” is not always spelled out in full on the container’s prescription label. Abbreviations – such as APAP, Acetaminoph, Acetaminop, Acetamin and Acetam – may be used instead.

Rely on Health Care Experts

Make a habit of telling your pharmacist what other medications and supplements you’re taking and asking if taking acetaminophen in addition to them is safe.

When a treatment is intended for children, read the directions section of the Drug Facts label to see if the medicine is right for your child and how much to give. Never guess on a dose. If the dose for your child’s weight or age is not listed on the label and you can’t tell how much to give, ask a healthcare professional what to do.

If you still have pain and fever after treatment, don’t take more than directed. Instead, discuss this with your healthcare professional. To avoid harm, talk with your health care professional if you have a history of liver disease or drink three or more alcoholic beverages a day.

Have a Question? Contact FDA’s Drug Information Pharmacists.

When in doubt, reach out to our pharmacists and ask.

  • By email: druginfo@fda.hhs.gov
  • By phone: 1-855-543-3784 and 1-301-796-3400