It’s easier than you think!
The other day I watched in horror as a friend with mild cold symptoms swallowed two extra-strength Tylenol (acetaminophen) tablets with a large swig of NyQuil.
If he had followed with a double whisky, I would have suspected a suicide attempt.
“What are you doing?!” I shrieked, and grabbed both bottles from him. “You just swallowed a massive dose of acetaminophen!”
“Really?” he replied, without much interest. “Hmm.”
Does anyone read the labels on over-the-counter (OTC) medications?
“Look!” I stabbed a finger at the warning label on the back of the NyQuil bottle.
Liver warning: This product contains acetaminophen. Severe liver damage may occur if . . .
And there followed a long list of dos and don’ts related to acetaminophen. Since 2009, the Food and Drug Administration has required this warning an all products containing acetaminophen because of the high number of accidental overdoses.
Why the fuss? Because too much acetaminophen can seriously—even fatally—damage your liver.
Warning: Liver failure may occur
Acetaminophen overdose is the most common cause of acute (sudden) liver failure, and the second most common cause (after hepatitis) of liver failure requiring a transplant.
According to the Food and Drug Administration (FDA), cases of severe liver injury with acetaminophen have occurred in patients who:
- took more than the prescribed dose of an acetaminophen-containing product in a 24-hour period;
- took more than one acetaminophen-containing product at the same time; or
- drank alcohol while taking acetaminophen products.
The recommended daily maximum dose of acetaminophen is 3 grams or 3,000 mg/day.
An extra-strength acetaminophen tablet is 500 mg. So a single dose is 1,000 mg—that’s already one-third the daily limit!
Follow dosing instructions
It’s difficult to find, but I prefer to take only the regular-strength, or 325 mg, acetaminophen tablets.
When shopping for pain relievers or cold/flu medications at the drug store, read the label carefully to see how much acetaminophen is in each dose. And then follow the dosing instructions carefully.
Especially for young children! If you’re unsure, talk to your pediatrician.
Related post: Kids’ health—Avoid medication errors
Women, too, can be at higher risk of an overdose because most dosing instructions are determined by the weight of an average male. Liver failure has been known to occur in doses as small as 2.5 grams
Although my friend is an average-sized male, I figured he ingested at least 2 grams of acetaminophen in that single dose. If he followed the dosing directions for both medications over the course of a day (or just took some whenever he felt like it), he could ingest 8 grams, or more than twice the maximum safe amount. Scary.
Avoid combination products containing acetaminophen
Another reason it’s easy to take too much is because there are LOTS of combination over-the-counter (OTC) products that also contain acetaminophen.
You need to be your own watchdog. Read the labels!
I really dislike combination products like NyQuil for two reasons. One, you typically pay for the inclusion of a drug or drugs you don’t need—this topic is worth its own post. Two, most importantly, it’s not immediately clear on the packaging exactly what drug or drugs you are buying.
Acetaminophen is a wonderful addition to your home medicine cabinet. It works well to relieve the minor aches, pains and fever associated with headaches, colds or the flu, and it doesn’t cause stomach upset like ibuprofen.
But buy it as a single drug, not in combination with other less useful medications. Buy generic and, if possible, buy the regular-strength 325 mg tablets rather than the extra-strength 500 mg. That will give you a little extra cushion of safety.
Be safe. Stay healthy. Read the labels.