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.
Make Sure You Get the Right Mix… Ask Questions if Your Medicine Is a Powder
Some medicines, including many prescribed for children, come in a powder form. Water must be added to the powder so the medicine can be easily measured and taken. The ratio of water to powder must be precise, so that the prescribed amount of the final liquid mixture provides the correct dose of medicine per milliliter (mL). It is best for the pharmacist to add water right before the medicine is picked up. Once mixed, the medicine often needs to be refrigerated to stay potent. But if the pharmacist forgets to add the water, or if the wrong amount of water is added at home, a serious dosing error can occur.
Do you use an inhaler? If so, always replace its cap after use. The importance of replacing caps on inhalers was recently illustrated when a woman accidentally inhaled a small earring while using her asthma medicine. She got her uncapped inhaler from her purse. As she inhaled the medicine, she felt a painful scratch in her throat and started coughing blood. She was taken to the emergency department, where the earring was removed from her lung. If the inhaler's cap had been in place, the loose earring in her purse would not have gotten into the inhaler.
Liquid in Fish Oil Capsules Interacts with Foam Cups
A nurse caring for a patient who was unable to swallow Lovaza (omega-3 fatty acids), punched holes in the large, soft gelatin capsule, squeezed the oily yellow liquid contents into a disposable foam (Styrofoam) cup, and diluted it with cranberry juice. Later, as the patient raised the cup to drink the juice, the cup began to leak.
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