Acetaminophen (Tylenol): doses, the daily limit and liver safety
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- Tylenol Extra Strength caplets, 500 mg. Best for: Adults who want fewer pills per dose. See options on Amazon
- Tylenol Regular Strength tablets, 325 mg. Best for: Lower per-pill dose and children 6 to under 12. See options on Amazon
- Weekly pill organizer. Best for: Tracking doses to stay under the daily limit. See options on Amazon
Regular vs Extra Strength
| Product | Acetaminophen per pill | Adults and children 12 and over |
|---|---|---|
| Tylenol Regular Strength | 325 mg per tablet | 2 tablets every 4 to 6 hours; not more than 10 tablets in 24 hours |
| Tylenol Extra Strength | 500 mg per caplet | 2 caplets every 6 hours; not more than 6 caplets in 24 hours |
Details are from each product's DailyMed label; both say not to take more unless directed by a doctor and not to use for more than 10 days unless directed by a doctor. Regular Strength also lists doses for children 6 to under 12: 1 tablet every 4 to 6 hours, not more than 5 tablets in 24 hours.
What acetaminophen treats
The Tylenol labels list the purpose as pain reliever and fever reducer. They say it temporarily relieves minor aches and pains due to the common cold, headache, backache, minor pain of arthritis, toothache, muscular aches, and premenstrual and menstrual cramps, and temporarily reduces fever.
Unlike ibuprofen and naproxen, acetaminophen is not an NSAID, which is one reason people choose it when they need to avoid that class of medicines. For local muscle pain, see our lidocaine patches guide and muscle rub cream guide.
The 4,000 mg limit and hidden acetaminophen
The FDA says more than 600 medications contain acetaminophen, and that the maximum recommended adult dose is 4,000 milligrams per day for all medicines combined. Cold and flu products, sleep aids and prescription pain relievers often contain it.
- Check every Drug Facts label for acetaminophen, especially before using two or more products together.
- Do not take more than one OTC medicine containing acetaminophen, the FDA says.
- Read prescription labels carefully. The FDA notes abbreviations such as APAP, Acetaminoph, Acetaminop, Acetamin and Acetam may be used instead of the full name.
- Tell your pharmacist about all medicines and supplements you take.
Liver and skin warnings
The Tylenol label's liver warning says severe liver damage may occur if you take more than 4,000 mg in 24 hours, take it with other drugs containing acetaminophen, or have 3 or more alcoholic drinks every day while using it. Ask a doctor before use if you have liver disease, and ask a doctor or pharmacist if you take the blood thinner warfarin.
The label also carries an allergy alert: acetaminophen may cause severe skin reactions such as skin reddening, blisters or rash. If a skin reaction occurs, stop use and seek medical help right away.
Overdose: act fast
The FDA says symptoms of acetaminophen overdose may include nausea, vomiting, abdominal pain, confusion and jaundice, that some people have no symptoms, and that symptoms may take several days to appear. The Tylenol label says quick medical attention is critical for adults as well as children even if you do not notice any signs or symptoms.
In case of overdose, get medical help or contact a Poison Control Center right away at 1-800-222-1222.
Children and when to stop
For children, the FDA says to read the directions on the Drug Facts label to see whether the medicine is right for your child and how much to give, and never to guess on a dose; if the label does not list a dose for your child's age or weight, ask a health care professional. The Extra Strength label says ask a doctor for children under 12.
Stop use and ask a doctor if pain gets worse or lasts more than 10 days, fever gets worse or lasts more than 3 days, new symptoms occur, or redness or swelling is present. For checking fevers, see our digital thermometer guide.
What to look for when you buy
Tylenol Extra Strength caplets, 500 mg
Best for: Adults who want fewer pills per dose
Its label lists acetaminophen 500 mg; adults take 2 caplets every 6 hours, no more than 6 in 24 hours.
Watch out: Do not combine with other acetaminophen products.
See options on AmazonTylenol Regular Strength tablets, 325 mg
Best for: Lower per-pill dose and children 6 to under 12
Its label lists acetaminophen 325 mg with doses for ages 6 and up.
Watch out: Children 6 to under 12: not more than 5 tablets in 24 hours.
See options on AmazonWeekly pill organizer
Best for: Tracking doses to stay under the daily limit
The FDA lists 4,000 mg per day as the maximum recommended adult dose across all medicines.
Watch out: Count acetaminophen in cold and sleep products too.
See options on AmazonQuestions people ask
- What is the maximum amount of acetaminophen per day?
- The FDA lists 4,000 mg per day for adults, across all medicines you take.
- How often can I take Tylenol Extra Strength?
- Adults: 2 caplets every 6 hours, no more than 6 caplets in 24 hours, per the label.
- Can I drink alcohol with acetaminophen?
- The label warns of liver damage with 3 or more alcoholic drinks a day; ask a doctor.
- Is acetaminophen in other medicines?
- Yes. The FDA says more than 600 medications contain it, including cold and sleep products.
- What does APAP mean on a prescription?
- It is an abbreviation for acetaminophen, per the FDA.
Sources
- Don't Overuse Acetaminophen (fda.gov), U.S. Food and Drug Administration
- Tylenol Extra Strength (acetaminophen) caplet label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine
- Tylenol Regular Strength (acetaminophen) tablet label (dailymed.nlm.nih.gov), DailyMed, U.S. National Library of Medicine