Acetaminophen overdose
Tylenol overdose; Paracetamol overdoseAcetaminophen (most common brand name Tylenol) is a pain medicine. Acetaminophen overdose occurs when someone takes more than the recommended amount of this medicine.
Acetaminophen overdose is one of the most common poisonings. People often think that this medicine is very safe. However, it can be deadly if taken in large doses.
This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with overdoses, call the local emergency number (such as 911), or the local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.
Where Found
Acetaminophen is found in a variety of over-the-counter and prescription pain relievers.
Tylenol is a brand name for acetaminophen. Other medicines that contain acetaminophen include:
- Anacin-3
- Panadol
- Percocet
- Various cold and flu medicines
Note: This list is not all inclusive.
Common dosage forms and strengths:
- Suppository: 120 mg, 125 mg, 325 mg, 650 mg
- Chewable tablets: 80 mg
- Junior tablets: 160 mg
- Regular strength: 325 mg
- Extra strength: 500 mg
- Liquid: 160 mg/teaspoon (5 milliliters)
- Drops: 100 mg/mL, 120 mg/2.5 mL
Adults should not take more than 3,000 mg of single-ingredient acetaminophen a day. You should take less if you are 65 or more years old. Taking more, especially 7,000 mg or more, can lead to a severe overdose problem. If you have liver or kidney disease, you should discuss the use of this medicine with your health care provider.
Symptoms
Symptoms may include:
- Abdominal pain, upset stomach
- Appetite loss
- Coma
Coma
Decreased alertness is a state of reduced awareness and is often a serious condition. A coma is the most severe state of decreased alertness from whi...
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Seizures
A seizure is the physical changes in behavior that occurs during an episode of specific types of abnormal electrical activity in the brain. The term ...
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- Irritability
- Yellow skin and whites of the eyes (jaundice)
- Nausea, vomiting
Nausea, vomiting
Nausea is feeling an urge to vomit. It is often called "being sick to your stomach. "Vomiting or throwing-up forces the contents of the stomach up t...
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Note: Symptoms may not occur until 12 or more hours after the acetaminophen was swallowed.
Home Care
There is no home treatment. Seek medical help right away.
Before Calling Emergency
The following information is helpful for emergency assistance:
- Person's age, weight, and condition
- Name of the product (ingredients and strength, if known)
- Time it was swallowed
- Amount swallowed
However, DO NOT delay calling for help if this information is not immediately available.
Poison Control
The local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.
Poison control center
For a POISON EMERGENCY call:1-800-222-1222ANYWHERE IN THE UNITED STATESThis national hotline number will let you talk to experts in poisoning. This ...
Read Article Now Book Mark ArticleThis is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.
If you go to the emergency room, take the container with you, if possible.
What to Expect at the Emergency Room
The provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure. Blood tests will be done to check how much acetaminophen is in the blood. The person may receive:
- Activated charcoal
- Airway support, including oxygen, breathing tube through the mouth (intubation), and ventilator (breathing machine)
- Blood and urine tests
- Chest x-ray
- CT scan
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
Read Article Now Book Mark Article - ECG (electrocardiogram, or heart tracing)
Electrocardiogram
An electrocardiogram (ECG) is a test that records the electrical activity of the heart.
Read Article Now Book Mark Article - Fluids through the vein (intravenous or IV)
- Laxative
- Medicines to treat symptoms, including an antidote, n-acetylcysteine (NAC), to counteract the effects of the acetaminophen
People with liver disease are more likely to develop serious complications of acetaminophen overdose. Overdose may be either acute (sudden or short-term) or chronic (long-term), depending on the doses taken, and symptoms may therefore vary.
Outlook (Prognosis)
If treatment is received within 8 hours of the overdose, there is a very good chance of recovery.
However, without rapid treatment, a very large overdose of acetaminophen can lead to liver failure and death in a few days.
References
Aronson JK. Paracetamol (acetaminophen) and combinations. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:474-493.
Bluth MH, Pincus MR, Abraham NZ. Toxicology and therapeutic drug monitoring. In: McPherson RA, Pincus MR, eds. Henry's Clinical Diagnosis and Management by Laboratory Methods. 24th ed. Philadelphia, PA: Elsevier; 2022:chap 24.
Ganetsky M. Acetaminophen. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 138.
Nelson LS, Calello DP. Acute poisoning. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 96.
Nikolaides, JK, Thompson TM. Opioids. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 151.
Theobald JL, Corcoran JN. Poisoning. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. Nelson Textbook of Pediatrics. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 94.
Review Date: 1/8/2025
Reviewed By: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.