Duration Health — Question Bank: Question #3

The common medication that's also a deadly poison

You develop a fever and take acetaminophen (generic for Tylenol®). Which of the following is true?
(A) Acetaminophen is not dangerous, even in overdose
(B) Acceptable amounts of acetaminophen use is up to 6 grams per day
(C) Patients with active liver disease can use acetaminophen freely

Acetaminophen (Tylenol) is a common over-the-counter medication used for pain relief and fever reduction. However, despite it being a common household medication, acetaminophen overdose is extremely dangerous and life-threatening.

Acetaminophen overdose is the most common cause of acute liver failure in the U.S. The use of more than 3-4 grams (3,000-4,000 milligrams, or 6-8 extra strength Tylenol) of acetaminophen per day can result in liver failure and death. Additionally, patients with active liver disease or who drink alcohol regularly with acetaminophen use are at increased risk of liver failure and death.

We provide a range of doses here because experts disagree on the safe maximum dose. The most often cited daily maximum is 4 grams (4,000 mg), but current recommendations from Tylenol brand producer of acetaminophen are a maximum of 3 grams (3,000 mg) per day. (See this link and this research paper.)

Doses discussed here are for adults only. Pediatric doses are calculated by weight.

Why are the other answers incorrect?

A) Acetaminophen is not dangerous, even in overdose
Acetaminophen overdose is life-threatening and can cause acute liver failure.

B) Acceptable amounts of acetaminophen use is up to 6 grams per day
This is incorrect! Use of more than 3-4 grams per day is considered dangerous.

C) Patients with active liver disease can use acetaminophen freely
Patients with active liver disease are at increased risk for acute liver failure with acetaminophen use.

D) Drinking alcohol regularly while using acetaminophen poses no risk
Alcohol use alongside acetaminophen use also increases the risk of acute liver failure.

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