Can You Overdose on Tylenol?

Acetaminophen can be dangerous and even fatal in large doses

Boxes of Tylenol.
Boxes of Tylenol. Scott Olson/Getty Images

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 panic and don't throw your bottle of pain relievers in the trash. It takes a lot of Tylenol to harm you.

Since the pain reliever is included as an active ingredient in many different over-the-counter 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 in this case.

In fact, an analysis by the investigative journalism website ProPublica reported that between 300 and nearly 1,000 people a year die from acetaminophen overdose. Although some of these deaths resulted from suicide, where the person took the medication intentionally, the majority were accidental overdoses.

Teen With Migraine Dies of Tylenol Overdose

One such case occurred in Oklahoma, when 17-year-old Kellie Lynn McWilliams, who was suffering from a migraine attack, took approximately 20 acetaminophen capsules, each of which contained 500 mg. That 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 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.

Here are some suggestions for avoiding such a problem:

  • If someone is with you, put them in charge of your medications. Let them keep track of what you take at what time and be sure that you're not exceeding the recommended dosage.
  • Wash and keep some small empty medication bottles. When you know you're getting a headache and migraine and are going to need medications, put the maximum amount you can take that day in an empty bottle. Then put the rest away where you will not accidentally pick it up and use it.
  • Keep a notepad next to your medications and jot down the times you take a dose, what you take, and how much.
  • If the maximum dosage of medication doesn't give you relief, do not take more. Contact your doctor or go to the emergency room.
  • When calculating your total daily Tylenol dose, be sure to include Tylenol from other potential sources (for example, common opioids often contain acetaminophen, as do many over-the-counter cold and flu products). It's important to never consume more than 4 grams of Tylenol within 24 hours, and this maximum dosage may be lower if you have other underlying health conditions. Speak with your doctor for your precise dosing information.

Other Options Besides Tylenol for Headache Relief

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. Along the same page, if you find that you are taking Tylenol or another medication frequent, 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.

Sources:

Budnitz DS et al. Emergency Department Visits for Overdoses of Acetaminophen-Containing Products. American Journal of Preventive Medicine. 2011 Jun;40(6):585-92.

U.S. National Library of Medicine and the National Institutes of Health. Acetaminophen

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