Tylenol: the good, the bad and the ugly

Back in 2010, I had a terrible tooth ache, and had to wait a couple of weeks to see a dentist. Meanwhile, I was popping as much as 8-9 tabs of 500mg Tylenol a day all in a bid to numb the pain. After 5 days of taking the tabs, I got really sick and was rushed to the ER when I started vomiting.

When I told the ER nurse how much Tylenol I was on, her eyes got huge, and a blood work was initiated ASAP; thank God it came back normal. Of cos, I was chewed out really good by the nurse and doctor for being so foolish, for months, I was worried that my liver was messed up.

Acetaminophen (Paracetamol, Panadol) is a commonly used over the counter pain reliever and fever reducer.

It is safe when used as directed. But, when too much is taken (overdose) it can cause liver and kidney damage.For the average healthy adult, the generally recommended maximum daily dose is no more than 4,000mg from all sources.

But in some people, doses close to the 4,000 mg daily limit for adults could still be toxic to the liver. It’s safest to take only what you need, and to not exceed 3,000 mg a day whenever possible, especially, when used always.

Now, the scary thing is that accidentally taking too much is all too easy because it’s found as an ingredient in more than 600 OTC and prescription medications, including allergy aids, cough and cold remedies, fever reducers, pain relievers, and sleep aids.

So, most people accidentally exceed the recommended dose when taking multiple products at the same time, often without realizing they contain acetaminophen or by not reading and following the dosing instructions. See image below as example: 

How to stay within limits

  • Talk to If your healthcare provider or pharmacist if you ever have concerns about how much acetaminophen you can tolerate based on your age, body size, and health status
  • When you reach for an over-the-counter cough, cold, or flu product, take a look at the label. Does it contain acetaminophen?
  • Know the mg in your pills, each pill may contain 325, 500, or 650 milligrams of the drug. Be extra cautious when taking 500 or 650 milligram pills
  • Stick to recommended doses, don’t be tempted to add a little extra to the recommended dose. A small-bodied person should stay on the low end of the recommended dose range (3,000 mg)
  • Drinking alcohol causes the liver to convert more of the acetaminophen you take into toxic byproducts. Men, do not have more than two standard drinks per day when taking acetaminophen. Women, do not have more than one drink per day
  • Ask your healthcare provider or pharmacist if any of your prescription medications could interact badly with acetaminophen
  • Experts recommend that it should not be used in children UNDER 6 YEARS

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