Johns Hopkins Health Alerts | Healthy Living After 50 | Acetaminophen for Pain Relief

• The recommended daily maximum dosage of acetaminophen is 4,000 milligrams (4 grams) daily and overdosing is easier than with other pain relievers

Acetaminophen is the active ingredient in more than 400 over-the-counter (OTC) and prescription products—including Tylenol and other analgesics (pain relievers), cough medicines, and sleep aids. Acetaminophen is the recommended drug of choice for most minor aches and pains, and when used correctly, is one of the safest and most effective drugs on the market.

Yet a recent major study found that overdoses of acetaminophen accounted for nearly 40 percent of patients hospitalized for acute liver failure— far more than any other cause of liver impairment, and a great concern because liver damage can occur quite rapidly and may be severe. Some people recover completely, but others die unless they receive a liver transplant.

Overdosing on acetaminophen is easier than with other pain relievers. The recommended daily maximum dosage of acetaminophen is 4,000 milligrams (4 grams) daily. Exceeding this ceiling by only 20 percent for even one day can result in liver injury and rapidly deteriorating liver function in healthy people; the kidneys can also be affected.

Four mistakes account for most overdoses of acetaminophen:

• Acetaminophen is in so many products that many people exceed the recommended dose by inadvertently taking two of them together.

• Thinking that “more is better,” many people purposely take more than the recommended dose or take the next dose too soon after the previous one.

• Many people combine acetaminophen with alcohol. Alcohol increases production of the enzyme that makes acetaminophen toxic to the liver. If you drink alcohol and take acetaminophen you can overdose even at recommended doses.

• Many people in chronic pain continue taking acetaminophen for much longer than the recommended time period.

Be sure to avoid these mistakes by carefully following label directions. Also keep in mind that many formulations of acetaminophen are sold in different strengths, but the maximum daily amount remains the same—4,000 mg. If you need an OTC pain reliever for a longer time than indicated on the label, talk to your doctor; there are often safer and more effective alternatives.

Johns Hopkins Health Alerts | Healthy Living After 50 | Acetaminophen for Pain Relief