Are You Overdoing Acetaminophen?

Do recent Food and Drug Administration warnings have you wondering if it’s safe to take pain relievers? In May, the FDA issued stronger warnings and lower dosage limits for acetaminophen, taken to relieve pain or reduce fevers. That’s because research has shown that overuse of the drug — sold under brand names such as Tylenol®, Liquiprin® and Panadol® — can result in liver poisoning.

Using over-the-counter and prescription pain relievers containing acetaminophen is safe, but only if you follow directions, says Mandy Leonard, PharmD, BCPS, Assistant Director of Drug Information Services at Cleveland Clinic. 

Those tiny tablets add up

With so many people relying on pain relievers to manage joint pain, menstrual cramps and other aches, it’s no wonder that unintentional acetaminophen overdose results in more emergency room visits than any other medication on the market.

“Taking more than 4 grams per day may result in an unintentional overdose,” warns Dr. Leonard. “Since tablets typically contain 500 milligrams of acetominophen, most adults can safely take up to two tablets three to four times per day.”

However, she notes that:

• depending on your health status, even 4 grams daily of acetaminophen may be too much for you; check the warnings on the label
• the FDA is considering changing the recommended dose to less than 4 grams per day.

Don't mix and match

Reading labels is also critical because many other popular over-the-counter medications contain acetaminophen, including Pamprin®, Alka-Seltzer Plus® and Excedrin PM®. So taking one of those drugs for cramps, indigestion or to help you sleep while also taking Tylenol for a headache can be dangerous — and even fatal, Dr. Leonard warns. And watch for “APAP” as an active ingredient; it’s an abbreviation for acetaminophen.

Alcohol is also a concern — acetaminophen can be extremely harmful to your liver if you consume three of more drinks per day. And your risk for liver damage from accidental acetaminophen overdose is even greater if you are fasting or are malnourished.

Weigh other options

Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are popular alternatives to acetaminophen. Dr. Leonard cautions that each of these comes with its own set of risks, including ulcers. So before switching from acetaminophen to an NSAID, consult your doctor or pharmacist about which pain reliever best suits your needs.