Acetaminophen is the most common drug ingredient in the United States and is found in more than 600 different prescriptions and over-the-counter medicines, including pain relievers, fever reducers, and sleep aids as well as cough, cold, and allergy medicines. Over 50 million Americans use a medicine that contains acetaminophen each week. It is safe and effective when used as directed, but taking more than directed is an overdose and can lead to liver damage. The U.S. Food and Drug Administration (FDA) recommends taking no more than 4,000 milligrams (mg) of acetaminophen in a 24-hour period.
Here are four important steps to follow when taking any over-the-counter or prescription medicines:
- Always read and follow the labels on your medicines. Never take more medicine than the label says.
- Know if your medicine contains acetaminophen. It is important to check the active ingredients listed on the labels of all your medicines to see if they contain acetaminophen.
- On over-the-counter medicine labels, the word “acetaminophen” is written on the front of the package or bottle, and is highlighted or in bold type in the active ingredient section of the Drug Facts label.
- On prescription medicine labels, acetaminophen is sometimes listed as “APAP,” “acetam,” or other shortened versions of the word.
- In other countries, acetaminophen may be called paracetamol. There is no therapeutic or chemical difference between acetaminophen and paracetamol.
- Never take more than one medicine that contains acetaminophen at the same time.
- Always ask your healthcare provider or pharmacist if you have any questions about your medicines.
If you drink three or more alcoholic drinks a day or if you have liver disease, talk to your healthcare provider before taking acetaminophen as you may be at greater risk for liver damage. It is also important to talk to your healthcare provider before taking medicines containing acetaminophen if you are pregnant or breastfeeding, or if you take blood thinners.
It is advised that you stop taking acetaminophen and talk with your healthcare provider if:
- You still feel pain after 10 days for an adult or 5 days for children;
- You still have a fever after 3 days; or
- Your symptoms get worse, or you feel new symptoms.
In rare cases, acetaminophen may cause an allergic reaction. Seek medical assistance immediately if you experience difficulty breathing or swallowing, swelling of your face, lips, throat, or tongue, hives, severe itching, or peeling or blistering skin. This can happen even if you used this medicine many times in the past.
If you suspect you have taken more than the recommended dosage of acetaminophen, contact your poison control center (1-800-222-2222) or get medical help right away. Symptoms of overdose can include yellowing of your skin or the whites of your eyes, nausea or vomiting, loss of appetite, fatigue, and unusual bruising or bleeding.
There have been concerns surrounding over-the-counter pain relievers during the COVID-19 pandemic. Some sources have said to avoid ibuprofen or aspirin to treat symptoms of the disease. Instead, patients have been urged to take acetaminophen, noting that use of non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen could worsen the illness caused by the new coronavirus. Health experts caution that more evidence is needed, and to consult a healthcare provider if you are concerned about taking NSAIDs in conjunction with coronavirus infection.