Dosages circled on a medicine bottle label.

When acetaminophen is used as directed, it is a safe and effective medicine that can help relieve pain or fever. However, when taken in large and unsafe doses, it can lead to an overdose. An acetaminophen overdose can result in serious problems, such as liver damage or death.

What are the causes?

This condition is caused by taking a dose of acetaminophen that is larger than what your health care provider or the manufacturer recommends for you.

What are the signs or symptoms?

Symptoms of this condition may not develop until hours or days after the overdose. Symptoms include:

  • Loss of appetite.

  • Nausea or vomiting.

  • Abdominal pain.

  • Tiredness (fatigue).

  • Sweating more than usual without cause (diaphoresis).

  • Urinating less than normal.

  • Skin or the white parts of your eyes turning yellow (jaundice).

Severe symptoms of this condition include:

  • Confusion.

  • Jerky movements that you cannot control (convulsions).

  • Coma.

How is this diagnosed?

This condition may be diagnosed based on:

  • Your symptoms.

  • Your medical history. Your health care provider may ask questions about how much acetaminophen you took.

  • A physical exam.

  • Tests, including:

    • Blood tests to check for liver problems.

    • Blood tests to check how much acetaminophen is in your blood.

    • Close monitoring of your blood pressure, pulse, temperature, and breathing.

How is this treated?

Treatment for this condition depends on your test results and when your overdose occurred. Treatment may include:

  • Medicine to reduce the toxic effects of acetaminophen on your liver (N-acetylcysteine, NAC).

  • Medicine to prevent acetaminophen in your stomach from being absorbed into your body (activated charcoal).

  • Medicines to treat your symptoms, such as medicines for nausea.

  • IV fluids.

  • Having multiple blood tests to monitor your liver function and the levels of acetaminophen in your blood.

  • A liver transplant, in severe cases.

Your health care provider may contact a poison control center to help determine what treatment is best for you.

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.

  • Avoid any medicines that contain acetaminophen for as long as told by your health care provider. To do this:

    • Check all medicine labels for the presence of acetaminophen. Acetaminophen is found in many over-the-counter and prescription medicines. These include medicines for cough, cold, flu, and pain.

    • Look for abbreviations or other names for acetaminophen, such as APAP, AC, or paracetamol.

  • When using acetaminophen, take only a safe amount. When acetaminophen is taken outside of the hospital:

    • The maximum dose for children depends on the child’s weight (weight-dependent dose). Read the medicine label or ask the health care provider what a safe maximum dose is for your child.

    • The maximum dose for adults is 3,000 to 4,000 mg a day. Ask your health care provider what dosage is safe for you.

General instructions

Three cups showing dark yellow, yellow, and pale yellow urine.

  • Drink enough fluid to keep your urine pale yellow.

  • Do not drink alcohol for as long as told by your health care provider.

  • Keep all follow-up visits. This is important. You may need follow-up blood tests to check your liver function.

Contact a health care provider if:

  • You cannot stop vomiting.

Get help right away if:

  • You become very confused or sleepy.

  • You vomit blood or material that looks like coffee grounds.

  • Your stool is bloody, black, or looks like tar.

  • You have severe abdominal pain.

  • You are not urinating.

  • You take more acetaminophen than was prescribed.

A severe overdose is an emergency. Get help right away. Call 911 or call your local poison control center (1-800-222-1222 in the U.S.).

  • Do not wait to see if the symptoms will go away.

  • Do not drive yourself to the hospital.

Summary

  • When acetaminophen is used as directed, it is a safe and effective medicine that can help relieve pain or fever. However, when taken in large and unsafe doses, it can lead to an overdose. This can result in serious problems, such as liver damage and death.

  • When this medicine is taken outside of the hospital, the maximum dosage is a total of 3,000 to 4,000 mg a day for adults. For children, the maximum dosage depends on the child’s weight.

  • Symptoms may not develop for hours or days after an overdose.

  • Contact a health care provider if you cannot stop vomiting. Get help right away if you become very confused or sleepy, see blood in your vomit or stool, have severe abdominal pain, are not urinating, or you take more acetaminophen than was prescribed.

This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.