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Acetaminophen Poisoning


The Manual's Editorial Staff

Reviewed/Revised Dec 2023
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Acetaminophen is an over-the-counter medicine used to lower fevers and lessen pain. It's sold under many brand names, such as Tylenol. It's also found in many cough and cold products.

Acetaminophen is usually safe, but too much can hurt you.

What is acetaminophen poisoning?

Acetaminophen poisoning is the result of taking too much acetaminophen.

  • Acetaminophen poisoning can happen when you take too much in a short time such as if you accidentally take several different medicines or products that have acetaminophen or if you intentionally take an overdose

  • Acetaminophen poisoning also can happen slowly if you take a high dose for a long time because you have severe chronic pain

  • Even regular doses of acetaminophen can be dangerous in certain situations such as if you have liver damage

  • Acetaminophen poisoning can seriously damage your liver and can result in liver failure

  • Acetaminophen poisoning may not cause symptoms until your liver has been damaged

  • Carefully read the labels of cough and cold products

  • Read the label of pain medicines and don't take more than the recommended dose

If you're taking care of a child with a cold or cough, be very careful you don't give the child too much acetaminophen. Many different types of medicines in all different forms (liquid, pill, chewable) have acetaminophen as an ingredient. Don’t give a child medicine with acetaminophen if the child has already taken a different medicine with acetaminophen.

If you think you or someone else may have acetaminophen poisoning, call for emergency medical assistance (911 in most areas of the United States) right away or call the poison control center for advice (1-800-222-1222 in the United States). The World Health Organization provides a world directory of poison centers.

What are the symptoms of acetaminophen poisoning?

There usually aren't symptoms right away.

If your overdose is very large, symptoms happen in stages:

  • First, you may throw up and otherwise feel sick

  • After 1 to 3 days, you may feel sick to your stomach, throw up, and have belly pain

  • After 3 to 4 days, you may throw up more, develop yellow skin and eyes (jaundice), and bleed under the skin, and from the nose or gums

  • After about 5 days, you either recover or your organs fail, which can kill you

If the poisoning is from taking smaller doses over time, the first symptoms may be of liver failure:

  • Yellow skin and eyes (jaundice)

  • Bleeding

How can doctors tell if I have acetaminophen poisoning?

Doctors will do blood tests to check for acetaminophen poisoning. They may also do tests to check how well your liver is working.

How do doctors treat acetaminophen poisoning?

Doctors will:

  • Give you activated charcoal to keep the acetaminophen out of your blood, if you took the acetaminophen within the last few hours

  • Give you an antidote (medicine that works against the acetaminophen) to protect your liver

If your liver is damaged, you may need to be treated for liver failure or even receive a liver transplant.

How can I prevent acetaminophen poisoning?

  • Take only the recommended dose

  • Read medicine labels carefully

  • Don't take a medicine that contains acetaminophen if you’ve already taken acetaminophen

  • If you have liver problems or drink alcohol, ask your doctor what medicine you should take for pain or fever

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