Are You Taking Too Much Tylenol Without Knowing It?

Katie Mui
Katie Mui is on the Research Team at GoodRx.
Posted on

Pretty much everyone experiences pain at some point in their lives. Sometimes it’s just a headache or a minor injury or brief illness — but for many, pain involves more chronic issues such as arthritis or back pain.

Many medications can help manage pain, with the best known being over the counter pain relievers like Motrin (ibuprofen), Aleve (naproxen), or Tylenol (acetaminophen). These drugs (except Tylenol) — known as NSAIDs, short for nonsteroidal anti-inflammatory drugs — work remarkably well for a variety of conditions.

So whats the problem? They work so well that these products get tossed into many other medications, both over-the-counter or prescription-only formulations. That makes it surprisingly easy to take too much without even knowing it. Here’s a quick guide to pain relievers by our friends at Iodine.

The Problem

Tylenol (acetaminophen) is a common pain relief agent in the U.S. and can also be used to help reduce fevers. As such, it is often combined in multiple products for a cough and cold and not just pain products.

Unintentionally taking too much Tylenol/acetaminophen happens far more often than you think because the average person doesn’t know what the drugs they’re taking have in them. It’s an all too common mistake, as seen in this sample case, where someone may be taking Tylenol Extra Strength for pain, but now with a cold is also taking Dayquil:

The Cause

Acetaminophen is broken down via the liver. Overall, when taking the recommended doses on the bottle, the liver does its job just fine for the majority of the population. The issue is when taking too much of acetaminophen, you can overload the liver, leading to liver failure and possibly death.

The other issue is mixing acetaminophen with alcohol. Because alcohol is broken down by the liver as well, these two will interact and overtax the liver in a short period of time. Acetaminophen will also build up in the liver which can lead to problems even if you didn’t take that much at once.

What can you do?

It’s wise to always check if the medication you’re taking or giving to someone has acetaminophen in it. Generally, if it’s used for pain, cough, cold, or allergies, there’s a good chance it contains acetaminophen.

The FDA suggests 4000 mg (or 4 grams) of acetaminophen is the maximum safe amount to ingest in a 24 hour period. Acetaminophen is often seen in common combination doses of 500 mg or 325 mg. For example, in Dayquil, each dose has 325mg of acetaminophen. Percocet and Vicodin are also combination pain drugs, with each having 5 mg of opioids and 325mg of acetaminophen.   

And alcohol and acetaminophen? The FDA warns against combining acetaminophen with 3 or more alcoholic drinks a day. So if you are out drinking heavily and reaching for Tylenol before you go to bed to keep that headache away in the morning, don’t do it!


Thanks to pharmacist Timothy Aungst and for help with this post.

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