PainSAFE
SAFEalert: Acetaminophen
Acetaminophen is one of the most widely used and prescribed medications available. Although it is commonly taken on its own – in both over-the-counter and prescription formulations – to relieve pain and reduce fever, it is also included as an active ingredient in many other medications and drugs. It is extremely important to be aware of the cumulative amount of acetaminophen you are ingesting as it may be extremely dangerous, and possibly fatal, to take too much.
If you are taking any medications with acetaminophen included in them, you must add up all of the acetaminophen you are ingesting daily (from each product) and make certain it is not over the recommended amount (no more than four grams or 4000 mg for adults during a 24-hour period). Most health care providers recommend you do not take more than two products containing acetaminophen at a time.
Keep reading to find out more about this powerful medication, and what you can do to keep you – and your family safe.
Acetaminophen (also known as Tylenol) is a drug used to relieve pain and reduce fever. It is the most commonly prescribed and used pain reliever and fever reducer in the world and is sold in both over-the-counter and prescription formulations. Because it is so popular, acetaminophen is also one of the medications most commonly associated with intentional or accidental poisoning. 1
Acetaminophen can provide relief for mild to moderate pain caused by a number of different conditions:
In addition to being the active ingredient in Tylenol, acetaminophen can be found in a large number of medications used to treat pain, colds and sinus conditions.
Many opioid medications contain acetaminophen. These combination drugs are only available by prescription. When your doctor writes a prescription, the pharmacist may label the bottle with the initials APAP, meaning that the product contains acetaminophen. On the lower part of the prescription will be two numbers separated by a slanted line. The second number (e.g., 325 or 500) refers to the amount of acetaminophen per tablet or capsule. Your doctor and/or pharmacist may or may not explain to you when the prescription is given how much acetaminophen you are being given per dose. It is up to you to calculate that and add it to any over-the-counter preparations you may be taking at the same time that contain acetaminophen.
Although this is not a complete list, acetaminophen is an active ingredient in the following medications:
The maximum allowable daily dose of acetaminophen is four grams (or 4000 mg) for adults. Always calculate your own dose – it’s important to make sure you don’t take more than you should and to double check that the dosing information your doctor or pharmacist gave you is correct.
An adult can take acetaminophen for up to three days for fever or 10 days for pain, you should stop using the medication and see a doctor if your symptoms do not improve or if you develop new symptoms.
For infants and children, the maximum daily dose is based on weight and age. Follow all directions on the product package carefully. Always calculate your child’s dose carefully. If you are uncertain about any of the information, talk to your child’s health care provider or pharmacist.
Acetaminophen poisoning can be very harmful to the liver. Nearly half of the cases of acute liver failure are now due to acetaminophen poisoning (up from 28% less than 10 years ago).2
The risk of liver damage from acetaminophen use increases with:
Signs of liver disease may include:
No, you should not drink alcohol while taking acetaminophen. The combination of these two substances can cause severe damage to your liver and can even kill you. Ask your health care provider before taking acetaminophen if you drink three or more alcoholic beverages every day or have had alcoholic liver disease or any other liver condition.
If you are experiencing side effects from your acetaminophen use, call your health care provider immediately. Certain side effects can be very dangerous and might be a sign of an allergic reaction or other serious medical condition. Seek health care immediately if you experience any of the following:
To reduce your risk of taking too much acetaminophen, always tell your health care provider and pharmacist about all prescription and over-the-counter medicines (including herbal remedies) you are already taking, and ask for advice before taking any more.
REMEMBER: Stop taking acetaminophen and call your health care provider if your symptoms get worse, you develop new or different symptoms, your pain worsens or lasts for more than 10 days or your fever worsens or lasts more than three days.
If you are taking any medications with acetaminophen included in them, you must add up all of the acetaminophen you are ingesting daily (from each product) and make certain it is not over the recommended amount (no more than four grams or 4000 mg for adults during a 24-hour period). Most health care providers recommend you do not take more than two products containing acetaminophen at a time.
Keep reading to find out more about this powerful medication, and what you can do to keep you – and your family safe.
What is Acetaminophen?
Acetaminophen (also known as Tylenol) is a drug used to relieve pain and reduce fever. It is the most commonly prescribed and used pain reliever and fever reducer in the world and is sold in both over-the-counter and prescription formulations. Because it is so popular, acetaminophen is also one of the medications most commonly associated with intentional or accidental poisoning. 1
What is Acetaminophen Used to Treat?
Acetaminophen can provide relief for mild to moderate pain caused by a number of different conditions:
- Arthritis
- Backache
- Cold
- Fever
- Headache
- Menstrual periods
- Muscle aches
- Osteoarthritis
- Reactions to vaccinations
- Sore throats
- Toothache
What Drugs Contain Acetaminophen?
In addition to being the active ingredient in Tylenol, acetaminophen can be found in a large number of medications used to treat pain, colds and sinus conditions.
Many opioid medications contain acetaminophen. These combination drugs are only available by prescription. When your doctor writes a prescription, the pharmacist may label the bottle with the initials APAP, meaning that the product contains acetaminophen. On the lower part of the prescription will be two numbers separated by a slanted line. The second number (e.g., 325 or 500) refers to the amount of acetaminophen per tablet or capsule. Your doctor and/or pharmacist may or may not explain to you when the prescription is given how much acetaminophen you are being given per dose. It is up to you to calculate that and add it to any over-the-counter preparations you may be taking at the same time that contain acetaminophen.
Although this is not a complete list, acetaminophen is an active ingredient in the following medications:
| Over-the-Counter Acetaminophen-only products | Over-the-Counter Acetaminophen Containing Products | Prescription Narcotic (opioid)/Acetaminophen Combination Products |
| Adenol | Actifed | Anexsia |
| Atasol | Anacin | Capital with codeine |
| Panadol | Benadryl | Darvocet |
| Paracetamol | Comtrex | Endocet |
| Pediatrix | Contac | Fioricet |
| Tempra | Coricidin | Lortab |
| Tylenol | Dimetapp | Magnacet |
| Execdrin | Maxidone | |
| Feverall | Mersyndol with codeien | |
| Goody's Powder | Norco | |
| Midol | Percocet | |
| NyQuil/DayQuil | Roxicet | |
| Pamprin | Talacen | |
| Robitussin | Tylenol with codeine (#2 or #3) | |
| Sinus Alka-Seltzer Plus | Tylox | |
| Sinutab | Ultracet | |
| Sudafed | Vicodin | |
| Tavist | Wygesic | |
| TheraFlu | Xodol | |
| Triaminic | Zydone | |
| Tylenol products, including Tylenol Cold formulations, Tylenol Allergy formulations, and Tylenol PM | ||
| Vanguish | ||
| Vicks | ||
| Women's Tylenol Menstrual Relief |
What's the Maximum Daily Dose of Acetaminophen?
The maximum allowable daily dose of acetaminophen is four grams (or 4000 mg) for adults. Always calculate your own dose – it’s important to make sure you don’t take more than you should and to double check that the dosing information your doctor or pharmacist gave you is correct.
An adult can take acetaminophen for up to three days for fever or 10 days for pain, you should stop using the medication and see a doctor if your symptoms do not improve or if you develop new symptoms.
For infants and children, the maximum daily dose is based on weight and age. Follow all directions on the product package carefully. Always calculate your child’s dose carefully. If you are uncertain about any of the information, talk to your child’s health care provider or pharmacist.
What’s the Connection Between Acetaminophen and Liver Damage?
Acetaminophen poisoning can be very harmful to the liver. Nearly half of the cases of acute liver failure are now due to acetaminophen poisoning (up from 28% less than 10 years ago).2
The risk of liver damage from acetaminophen use increases with:
- Large doses of acetaminophen
- Long-term use of acetaminophen
- The combination of acetaminophen with alcohol and/or other drugs that increase the risk of liver damage
What are the Signs of Liver Disease?
Signs of liver disease may include:
- Yellowing of the skin and/or eyes(jaundice)
- Excessive fatigue
- Gray-colored stools (bowel movements)
- Pain in the stomach, especially the upper portion
- Loss of appetite
- Weight loss
Can I Drink While Taking Acetaminophen?
No, you should not drink alcohol while taking acetaminophen. The combination of these two substances can cause severe damage to your liver and can even kill you. Ask your health care provider before taking acetaminophen if you drink three or more alcoholic beverages every day or have had alcoholic liver disease or any other liver condition.
What are the Most Serious Side Effects of Acetaminophen?
If you are experiencing side effects from your acetaminophen use, call your health care provider immediately. Certain side effects can be very dangerous and might be a sign of an allergic reaction or other serious medical condition. Seek health care immediately if you experience any of the following:
- Closing of the throat
- Difficulty breathing
- Difficulty swallowing
- Hives
- Hoarseness
- Itching
- Rash
- Swelling of the lips, tongue or face
To reduce your risk of taking too much acetaminophen, always tell your health care provider and pharmacist about all prescription and over-the-counter medicines (including herbal remedies) you are already taking, and ask for advice before taking any more.
REMEMBER: Stop taking acetaminophen and call your health care provider if your symptoms get worse, you develop new or different symptoms, your pain worsens or lasts for more than 10 days or your fever worsens or lasts more than three days.