Can You Overdose on Tylenol?

Facts About Taking Too Much Acetaminophen

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Tylenol, the most popular brand name for the over-the-counter pain reliever acetaminophen, seems pretty safe. But before you pop more pills than directed, be aware that large doses of acetaminophen can lead to liver and kidney damage and can even be fatal in some cases.

That said, don't throw your bottle of pain relievers in the trash. But you must take precautions that you never take more than a total of 4 grams of acetaminophen in a 24-hour period, and that you account for doses from all sources.

Boxes of Tylenol
Scott Olson / Getty Images

Causes and Statistics

Since the pain reliever is included as an active ingredient in many different over-the-counter (OTC) products, including headache relief, cold and flu products, and cough reducers, you can ingest more than you realize pretty easily. Many people equate "over-the-counter" with "harmless," and that's just not true with regards to acetaminophen.

Acetaminophen is the leading cause of acute liver failure in the United States, according to a report published in the British Medical Journal. The same report notes that acetaminophen overdose accounts for 82,000 emergency room visits and 26,000 hospitalizations each year.

Liver failure induced by acetaminophen is most commonly seen in people who are depressed, in chronic pain, misuse alcohol or narcotics, or take several acetaminophen preparations at once. Around 45% of these cases are intentional suicide attempts.

Oklahoma Case Demonstrates Challenges

One such case occurred in Oklahoma when 17-year-old Kellie Lynn McWilliams, who was having a migraine attack, took approximately 20 acetaminophen capsules, each of which contained 500 milligrams (half a gram).

Her dose translated to ingesting 10 grams of acetaminophen. The maximum recommended within 24 hours is 4 grams, and anything more than 7 grams is considered a severe overdose.

When Kellie became ill, repeatedly vomiting, she was admitted to the hospital. She even told her mother, "I thought it was OK. It's just Tylenol, Ma." But the side effects of the overdose caused kidney and liver damage resulting in organ failure, which ultimately led to her death.

How to Avoid Accidental Overdose

When you're in the midst of pain from a headache or a migraine, your thinking isn't always clear, and that makes it much easier to overdose on pain relievers accidentally.

It is important to never take more than 4 grams of Tylenol within 24 hours. If you have an underlying liver impairment or drinking problem, even this may be too much. Speak with your healthcare provider to determine the right dose for you.

Here are some do's and don't for avoiding such a problem.

  • Ask someone to keep track of what medications you take at what time to be sure you're not exceeding the recommended dosage.

  • Consider putting the maximum amount you can take in a day in a separate pill bottle to avoid taking more than you should.

  • Keep a notepad next to your medications and jot down the times you take a dose, what you take, and how much.

  • Don't forget to include Tylenol from other potential sources (for example, common opioids and OTC cold and flu products) when calculating your total daily Tylenol dose.

  • Don't take more if the maximum dosage of medication doesn't give you relief. Contact your healthcare provider or go to the emergency room.

Alternatives to Tylenol

While taking Tylenol for a headache is a reasonable approach, you may want to consider a non-medication therapy first. For instance, if you are sleep deprived or hungry, taking a nap or eating a nutritious snack may soothe your headache.

If you find that you are taking Tylenol or another medication frequently, it's good to be aware that you may be at risk for developing a medication overuse headache—a rebound headache that forms as a result of taking headache medication too much (typically more than 10 to 15 days per month, depending on the specific drug).

A Word From Verywell

The take-home message here is to always read the labels and heed the dosage instructions when taking medications, and this goes for over-the-counter and prescription medications.

While Tylenol is generally a safe and effective pain reliever for mild headaches (and other aches and pains), it can be fatal in large doses. This doesn't mean you should avoid it, instead, use it sensibly and properly.

Headaches Healthcare Provider Discussion Guide

Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.

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Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Rubin JB, Hameed B, Gottfried M, Lee WM, Sarkar M; Acute Liver Failure Study Group. Acetaminophen-induced acute liver failure is more common and more severe in womenClin Gastroenterol Hepatol. 2018;16(6):936-946. doi:10.1016/j.cgh.2017.11.042

  2. Tanne, J. Paracetamol causes most liver failure in UK and US. BMJ. 2006;332(7542):62-8. doi:10.1136/bmj.332.7542.628-a 

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