Acetaminophen: How much is too much?

Pat Lester
Nursing Program Coordinator, Unit 7-1 Orthopaedics/Neurosurgery

We use acetaminophen to relieve headaches, backaches, arthritis pain, cold symptoms and fever.  But do you know how much is too much? The following scenarios show how someone like me might take acetaminophen throughout the day.

I have been meaning to make an appointment for this darn knee. It’s so achy and stiff that I take a few Tylenol, and walk out to the car and drive to work. The car is covered in pollen, and I swear I can see clouds of it in the air. Oh boy, my eyes are starting to itch already. I dig through my bag in search of my Sudafed Sinus. There it is. I wonder briefly if it’s ok to wash it down with coffee. Well, it’s all I have. Today promises to be another busy day.

A few hours later, I have walked several miles on the unit; I have pushed and lifted what feels like a ton at least. My feet are sore and my back aches. One of my co-workers has some Excedrin Back and Body that she swears by. I take a few to get through the rest of my 12-hour shift.

Home at last! I eat some leftovers and watch a few episodes of my favorite reality show, and then it’s bedtime. I stare at the ceiling thinking I shouldn’t have had that last cup of coffee. I’m exhausted but can’t sleep and that stupid knee is aching again. Sighing, I head to the bathroom for some Goody’s PM. Tomorrow I am making that appointment!

So how much acetaminophen is too much? According to MedlinePlus, the average adult should take a maximum of 4,000 milligrams (mg) of acetaminophen in 24 hours. That’s two tablets (650 mg) every four hours. Sounds easy enough to stay below the limit, doesn’t it? But did you know that acetaminophen is an ingredient in many different products? For example, Alka-Seltzer Cold, Midol PMS, Nyquil Cold and Flu, Sominex Pain and Triaminic Cold and Fever all have acetaminophen as a main ingredient. Pain medications like Norco, Percocet and Ultracet combine another pain reliever with acetaminophen. You can see from the scenario above how easy it can be to exceed the daily limit.

When pain strikes, be sure to read the labels of all medications you are taking to stay below the daily limit! Ask your doctor or pharmacist if you have questions about acetaminophen or other medications.

Visit MedlinePlus, a service of the U.S. National Library of Medicine and National Institutes of Health, for a list of medications that contain acetaminophen.

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