How Much Tylenol® is Too Much Tylenol®?

Cold and Cough season brings the need for pain relievers and fever reducers.  A long time standby remedy has been Tylenol® (Acetaminophen, APAP; N-Acetyl-P-Aminophenol).  This medication is marketed not only for its medicinal quality, but for NOT causing stomach upset and risks of stomach ulceration; this medicine is noted for being well tolerated.  With this quality, it seems obvious to choose Tylenol® over Ibuprofen (active ingredient in Motrin® and Advil®), but how much Tylenol® should one take?  This question does not stop here; the next question is how much am I taking when I take ___________?  The cumulative effect of multiple sources of APAP is still the same; too much APAP can cause serious side effects.  These mainly consist of hepatic effects (liver enzymes increase, liver damage).  In addition to too much APAP, too much alcohol consumption while using APAP containing products, can amplify these side effects.  The key to using this medicine, as with any medicine, is to take the minimum amount needed to alleviate symptoms.

The recommended maximum adult dosage (ages 12+) is 4 grams (4000 mg) total of Tylenol® spanned over 24 hours, while the children’s dosage (ages 6-11) is 2 grams (2000 mg) total dosage over 24 hours.  Each Regular Strength Tylenol® contains 325mg of acetaminophen; each Extra Strength Tylenol® contains 500mg of acetaminophen; and each Tylenol 8hr or Tylenol® Arthritis contains 650mg of acetaminophen.

These are the doses of Tylenol® for both adults and children.

Regular Strength Tylenol® 325mg: Adult (ages 12yr+) dosage is 1-2 tab(s) every 4-6 hours while symptoms last; NOT to exceed 12 total tabs per 24hr period;
and Children’s (ages 6-11yr) dosage is 1 tab every 4-6 hours while symptoms last; NOT to exceed 5 total tabs per 24hr period.

Extra Strength Tylenol® 500mg: Adult (ages 12yr+) dosage is 1-2 tab(s) every 4-6 hours while symptoms last; NOT to exceed 8 total tabs per 24hr period;
and Children (ages under 12yr) are NOT to use this product as it contains too much active ingredient and will provide more than the recommended dose (overdose) and may cause liver damage.

Tylenol® Arthritis 650mg: Adult (ages 12yr+) dosage is 1-2 tab(s) every 4-6 hours while symptoms last; NOT to exceed 8 total tabs per 24hr period;
and Children (ages under 12yr) are NOT to use this product as it contains too much active ingredient and will provide more than the recommended dose (overdose) and may cause liver damage.

Remember the cumulative total (24 hour period) dosage of Acetaminophen containing products is 4 grams (4000mg/24hrs).

Many medications utilize acetaminophen as an active ingredient; check to see what you may be taking for your symptoms, it may contain APAP.  Check with your primary care physician if you are taking multiple sources of acetaminophen, and verify that you are taking a safe dosage.

By:
Jeremy KW Spiewak, CPhT, MA RPhT, BA Chemistry, Doctor of Pharmacy Candidate at Massachusetts College of Pharmacy and Health Sciences

Edited By:
Maryann Mackowiak, RN, CPhT, MA RPhT
Aileen Lemoine, RPh, BS Pharmacy

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References:

Tylenol. Drug Facts and Comparisons® eAnswers [online]. 2010. Available through Wolters Kluwer Health, Inc. Accessed November 14, 2010

Additional Resources:

http://www.tylenol.com


Original Published:November 2010

Revised:November 2010