It’s possible to overdose on acetaminophen if you take more than the recommended dose. In severe cases, it can cause liver failure. The recommended dose can vary by age and medication strength.
Tylenol is an over-the-counter medication used to treat mild to moderate pain and fever. It contains the active ingredient acetaminophen.
Acetaminophen is one of the most common drug ingredients. According to the Food and Drug Administration (FDA), it’s found in more than 600 prescription and non-prescription drugs.
Acetaminophen may be added to medications used to treat a wide variety of conditions, including the following:
- allergies
- arthritis
- backaches
- cold and flu
- headaches
- menstrual cramps
- migraines
- muscle aches
- toothache
In this article, we’ll look at what’s considered a safe dosage, the signs and symptoms that could indicate an overdose, and how to avoid taking too much.
It’s possible to overdose on acetaminophen. This can happen if you take more than the recommended dosage.
When you take a normal dose, it enters your gastrointestinal tract and is absorbed into your bloodstream. It starts to take effect in 45 minutes for most oral forms, or up to 2 hours for suppositories. Eventually, it’s broken down (metabolized) in your liver and excreted in your urine.
Taking too much Tylenol changes the way it’s metabolized in your liver, resulting in an increase in a metabolite (a by-product of metabolism) called N-acetyl-p-benzoquinone imine (NAPQI).
NAPQI is toxic. In the liver, it kills cells and causes irreversible tissue damage. In severe cases, it can cause liver failure. This triggers a chain of reactions that can lead to death.
According to a
Those who survive an acetaminophen overdose without needing a liver transplant may experience long-term liver damage.
Tylenol is relatively safe when you take the recommended dose.
In general, adults can take between 650 milligrams (mg) and 1,000 mg of acetaminophen every 4 to 6 hours. The FDA recommends that an adult shouldn’t take
Don’t take Tylenol for more than 10 days in a row unless you’ve been instructed to do so by your doctor.
The chart below contains more detailed dosage information for adults based on the type of product and the amount of acetaminophen per dose.
| Product | Acetaminophen | Directions | Maximum dosage | Maximum daily acetaminophen |
| Tylenol Regular Strength Tablets | 325 mg per tablet | Take 2 tablets every 4 to 6 hours. | 10 tablets in 24 hours | 3,250 mg |
| Tylenol Extra Strength Caplets | 500 mg per caplet | Take 2 caplets every 6 hours. | 6 caplets in 24 hours | 3,000 mg |
| Tylenol 8 HR Arthritis Pain (Extended Release) | 650 mg per extended-release caplet | Take 2 caplets every 8 hours. | 6 caplets in 24 hours | 3,900 mg |
For children, the dose varies according to weight. If your child is under the age of 2, ask your doctor for the correct dose.
In general, children can take around 7 mg of acetaminophen per pound of their body weight every 6 hours. Children shouldn’t take more than 27 mg of acetaminophen per pound of their weight in 24 hours.
Don’t give your child Tylenol for more than 5 days straight unless you’ve been instructed to do so by your child’s doctor.
Below, you’ll find more detailed dosage charts for children based on different products for infants and children.
Product: Infants’ and Children’s Tylenol Oral Suspension
Acetaminophen: 160 mg per 5 milliliters (mL)
| Age | Weight | Directions | Maximum dosage | Maximum daily acetaminophen |
| under 2 | under 24 lbs. (10.9 kg) | Ask a doctor. | ask a doctor | ask a doctor |
| 2–3 | 24–35 lbs. (10.8–15.9 kg) | Give 5 mL every 4 hours. | 5 doses in 24 hours | 800 mg |
| 4–5 | 36–47 lbs. (16.3–21.3 kg) | Give 7.5 mL every 4 hours. | 5 doses in 24 hours | 1,200 mg |
| 6–8 | 48–59 lbs. (21.8–26.8 kg) | Give 10 mL every 4 hours. | 5 doses in 24 hours | 1,600 mg |
| 9–10 | 60–71 lbs. (27.2–32.2 kg) | Give 12.5 mL every 4 hours. | 5 doses in 24 hours | 2,000 mg |
| 11 | 72–95 lbs. (32.7–43 kg) | Give 15 mL every 4 hours. | 5 doses in 24 hours | 2,400 mg |
Product: Children’s Tylenol Dissolve Packs
Acetaminophen: 160 mg per packet
| Age | Weight | Directions | Maximum dosage | Maximum daily acetaminophen |
| under 6 | under 48 lbs. (21.8 kg) | Do not use. | Do not use. | Do not use. |
| 6–8 | 48–59 lbs. (21.8–26.8 kg) | Give 2 packets every 4 hours. | 5 doses in 24 hours | 1,600 mg |
| 9–10 | 60–71 lbs. (27.2–32.2 kg) | Give 2 packets every 4 hours. | 5 doses in 24 hours | 1,600 mg |
| 11 | 72–95 lbs. (32.7–43 kg) | Give 3 packets every 4 hours. | 5 doses in 24 hours | 2,400 mg |
Product: Children’s Tylenol Chewables
Acetaminophen: 160 mg per chewable tablet
| Age | Weight | Directions | Maximum dosage | Maximum daily acetaminophen |
| 2–3 | 24–35 lbs. (10.8–15.9 kg) | Give 1 tablet every 4 hours. | 5 doses in 24 hours | 800 mg |
| 4–5 | 36–47 lbs. (16.3–21.3 kg) | Give 1.5 tablets every 4 hours. | 5 doses in 24 hours | 1,200 mg |
| 6–8 | 48–59 lbs. (21.8–26.8 kg) | Give 2 tablets every 4 hours. | 5 doses in 24 hours | 1,600 mg |
| 9–10 | 60–71 lbs. (27.2–32.2 kg) | Give 2.5 tablets every 4 hours. | 5 doses in 24 hours | 2,000 mg |
| 11 | 72–95 lbs. (32.7–43 kg) | Give 3 tablets every 4 hours. | 5 doses in 24 hours | 2,400 mg |
The signs and symptoms of a Tylenol overdose include:
- nausea
- vomiting
- loss of appetite
- pain in the upper right side of the abdomen
- high blood pressure
Call 911 or poison control (800-222-1222) right away if you suspect you, your child, or someone you know took too much Tylenol.
It’s critical to seek medical assistance as soon as possible. Early treatment
Treatment for a Tylenol or acetaminophen overdose depends on how much was taken and how much time has passed.
If less than an hour has passed since the Tylenol was ingested, activated charcoal may be used to absorb the remaining acetaminophen from the gastrointestinal tract.
When liver damage is likely, a drug calledN-acetyl cysteine (NAC) may be given orally or intravenously. NAC prevents liver damage caused by the metabolite NAPQI.
Keep in mind, though, that NAC can’t reverse liver damage that has already occurred.
When used as directed, Tylenol is safe for most people. However, you should speak to your healthcare provider before using Tylenol if you have any of the following conditions:
Tylenol may pose some risks to people who are pregnant or breastfeeding. Be sure to speak to your healthcare provider before taking a Tylenol product.
Tylenol can interact with other medications. It’s important to talk to your doctor or pharmacist before taking Tylenol if you’re also taking any of the following medications:
- anticonvulsant medications, particularly carbamazepine and phenytoin
- blood thinners, particularly warfarin and acenocoumarol
- cancer drugs, particularly imatinib (Gleevec) and pixantrone
- other drugs that contain acetaminophen
- the antiretroviral drug zidovudine
- the diabetes drug lixisenatide
- the tuberculosis antibiotic isoniazid
Overuse of acetaminophen probably happens more often than you think. This is due to acetaminophen being a common ingredient in many types of over-the-counter and prescription drugs.
Acetaminophen overdoses are responsible for approximately
Here are some ways to ensure that you’re taking a safe level of acetaminophen:
- Check product labels. Tylenol is one of many drugs that contain acetaminophen. Carefully check the labels of any drugs you’re taking. Acetaminophen will usually be listed under “active ingredients.” It may be written as APAP or acetam.
- Don’t take more than one product at a time that contains acetaminophen. Taking Tylenol together with other medications, like cold, flu, allergy, or menstrual cramp products, may result in a higher intake of acetaminophen than you realize.
- Be careful when giving Tylenol to children. You shouldn’t give Tylenol to children unless it’s necessary for pain or fever. Don’t give Tylenol with any other products that contain acetaminophen.
- Carefully follow the dosing instructions indicated on the label. Don’t take more than the recommended dose. For children, weight is the most effective way to determine how much to give. If you’re not sure, ask a pharmacist for help figuring out the dose.
- If the maximum dose doesn’t feel like it’s working, don’t take more. Talk to your doctor instead. Your doctor will evaluate whether another drug can help with your symptoms.
If you suspect someone is at risk of using Tylenol to harm themselves or has used Tylenol to harm themselves:
- Call 911 or seek emergency medical attention. Remain with them until help arrives.
- Remove any additional medication.
- Listen without judging or admonishing them.
If you or someone you know is considering suicide, reach out to the Suicide Prevention Lifeline at 800-273-8255 or text HOME to 741741 for help and support.
Tylenol is safe when it’s used according to the directions on the label. Taking too much Tylenol can cause permanent liver damage, liver failure, and, in some cases, death.
Acetaminophen is the active ingredient in Tylenol. Acetaminophen is a common ingredient in many types of over-the-counter and prescription drugs. It’s important to read drug labels carefully as you don’t want to take more than one drug containing acetaminophen at a time.
If you’re not sure if Tylenol is right for you or what’s considered a safe dose for you or your child, reach out to a healthcare professional or pharmacist for advice.