Published February 5, 2013 (revised December 23, 2024)
Acetaminophen (brand name Tylenol) is well known as an over-the-counter (OTC) pain reliever and fever reducer. Acetaminophen is an ingredient that is also found in many OTC and prescription medicines, such as flu and cold medicines, for both adults and children.
Acetaminophen has received public attention as a cause of liver damage when more than the recommended amount is taken. In 2011, the Acetaminophen Awareness Coalition (AAC) was formed to educate people about the safe and effective use of acetaminophen. The Coalition is made up of leading healthcare organizations, healthcare providers, and consumer organizations. The US Food and Drug Administration (FDA), a member of the Coalition, issued a statement reminding consumers about the dangers of taking too much acetaminophen.
Some of the key points you should know about using acetaminophen safely include the following:
There is a large selection of both prescription and non-prescription medicines that contain acetaminophen in combination with other active ingredients. For example, many cold medicines contain acetaminophen to help reduce fever and pain, a decongestant to treat nasal stuffiness, and a cough suppressant. Combining two or more products containing acetaminophen can be harmful.
It is important to read the active ingredients on the Drug Facts label before taking the medicine.
OTC medicines: The FDA makes sure that labels on OTC medicines list all the active ingredients in the Drug Facts section of the label. Go to KnowYourDose to learn how to read an OTC label.
Prescription medicines: Because of limited space on prescription labels, sometime an abbreviation for acetaminophen, APAP, is used instead. APAP stands for N-acetyl-p-aminophenol, a chemical name for acetaminophen. So, if a prescription medicine contains acetaminophen, you may not see the word acetaminophen written out on the prescription label. For example, the pain reliever Percocet contains oxycodone (a powerful pain medicine) and acetaminophen. The prescription label for a generic brand of Percocet may list "oxycodone and APAP" on the label.
Familiarize yourself with the recommended daily dosage of acetaminophen. Taking too much can lead to severe liver damage.
Adults: The current maximum recommended adult dose is 4,000 milligrams per day. Depending on the medicine you are taking, each tablet or liquid dose of acetaminophen may vary. Carefully read the label to determine how much acetaminophen you are taking in each dose. Follow the dosing schedule as directed on the label. For example, do not take a dose sooner than recommended.
Children ages two years and up: The recommended dosage of acetaminophen for children two years and older depends on the child’s weight. OTC package labels will provide recommendations by both the age and weight of your child. However, to get the most accurate dose, it’s best to know your child’s current weight is. The maximum dosing should not exceed five doses in 24 hours.
Children ages two and younger: Currently, OTC products containing acetaminophen do not include dosing instructions for children less than two. Parents are instructed to call their physician for dosing instruction.
Be aware that the maximum amount of acetaminophen that can be safely ingested may not be the same for every person. If you have a history of liver disease, drink more than three alcoholic beverages per day, or take other medications that can affect the liver, ask your doctor what the safest dose of acetaminophen is for you.
Sometimes, your doctor may write or send your prescription to the pharmacy with instructions to take the medicine “as directed.” In these cases, you must remember what the doctor has told you about how to take the medicine correctly. The label on the prescription container will not help you remember because the directions will simply say, “Use as directed.”
When it comes to medicines, you may already know how essential it is to exactly follow the instructions provided by your healthcare provider or directions on over-the-counter (OTC) Drug Facts labels. But you may be overlooking some habits or beliefs that can keep you from getting the full benefit of your medicines or cause you to risk your health and safety. See if any of these common medicine missteps apply to you.
Confusion between the medicines Wakix (pitolisant) and Lasix (furosemide) was reported. Wakix is used to treat adults with narcolepsy (sleep disorder) for excessive daytime sleepiness. Lasix is a diuretic (or “water pill”) which increases the flow of urine to rid the body of excess fluid and salt. Using an online secure messaging system, a man was asking his doctor about a change in his dose of “Wakix” and whether he should get blood tests drawn. The man was also taking Lasix, and the dose had been changed several times over the years. The man had made several spelling errors when typing messages to his doctor. The doctor assumed the man had made a spelling error when typing “Wakix” and was instead talking about Lasix. Further questioning revealed the man actually was asking about Wakix.
On October 14, 2011, The New York Times published a story about a 13- month-old boy who died after swallowing pills from a prescription medicine bottle. His parents had given him the bottle to play with as a rattle, believing he could not open the child-resistant cap.
