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Helping you stay healthy is our goal! January 2006 Could you be taking too much Tylenol (acetaminophen)? The drug acetaminophen, best known under the brand name Tylenol, is one of the most popular pain relievers. However, did you know that acetaminophen could be poisonous if not taken appropriately? It’s true. A recent study tracked patients with acute liver failure, and found that in nearly half of the cases studied, the liver failure was the result of acetaminophen poisoning – of which, 25 percent were accidental. In fact, the study concluded that cases of acetaminophen poisoning are on the rise; the proportion of acute liver failure due to acetaminophen poisonings went from 28 percent in 1998 to 51 percent in 2003. Individuals use acetaminophen as a pain reliever. However, many people do not realize that acetaminophen is also found in the products they may be taking to treat other symptoms like a cold or the flu. For example, NyQuil, TheraFlu, AlkaSeltzer Plus Cold Medicine, Tylenol Cold and Flu Severe, Excedrin, and Midol (Teen Formula) all contain acetaminophen. Additionally, acetaminophen can also be found in some prescription drugs; the commonly prescribed narcotics Vicodin (hydrocodone/acetaminophen) and Percocet (oxycodone/acetaminophen) are just two examples. How can you avoid acetaminophen poisoning? • Know the maximum daily dose: The recommended maximum daily dose of acetaminophen for adults is 4 grams, or 4,000 milligrams. • Read the label: Make sure you know if the product you’re taking contains acetaminophen and know how much it contains. When reading the label, look for “APAP,” as it’s the abbreviation for acetaminophen. • Be aware of the total acetaminophen dose when taking multiple medications: Remember that acetaminophen can be found in both over-the-counter and prescription medications. • Be cautious when drinking alcohol: If you consume three or more drinks every day, consult a doctor before taking acetaminophen. Additionally, those who drink heavily on the weekends should also be cautious. • Talk with your doctor or pharmacist: If you’re not sure how much acetaminophen to take – ask. The chart below gives you an idea of how much acetaminophen is in some of the over-the-counter medications currently available. Medication Tylenol Extra Strength Tylenol Arthritis Strength Midol (Teen Formula) NyQuil (Cold and Flu) Tylenol (Cold and Flu Severe) Dosage 1 tablet 1 tablet 1 tablet 1 adult dose 1 adult dose Amount of Acetaminophen 500 milligrams 650 milligrams 500 milligrams 500 milligrams 1,000 milligrams Maximum Dose for 24 hr. Period 8 tablets 6 tablets 8 tablets 8 doses 4 doses Most people can safely take the recommended four-gram daily maximum for adults – which is equal to eight tablets of Tylenol Extra Strength (over a 24-hour period). However, after taking eight grams in one day, individuals whose liver may be stressed by a virus, medication, alcohol or other factors, could experience complications. It’s important to remember that when given in precise, appropriate doses, acetaminophen is safer for children and teenagers than aspirin. Additionally, when it comes to adults, low doses of acetaminophen are less likely than aspirin, ibuprofen or naproxen to harm the stomach, aggravate bleeding or harm the kidneys.