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Acetaminophen Overdose

WHAT YOU NEED TO KNOW:

What is an acetaminophen overdose?

Acetaminophen overdose means taking more than it is safe to take. It may also be called acetaminophen poisoning. Acetaminophen is called paracetamol in countries outside the United States. When used correctly, acetaminophen is a safe drug that decreases pain and fever. Many medicines contain acetaminophen, including some that you can buy without a prescription.

What causes an acetaminophen overdose?

The most acetaminophen that is safe for most people to take is 4,000 milligrams (4 grams) in a 24-hour period. An overdose means you have taken more than is safe in a 24-hour period. The following are ways an unplanned overdose may happen:

  • You take more than the recommended dose. You might accidentally take too much if your pain or fever did not go away after the recommended dose. You may also get too much if you take acetaminophen for too many days in a row.

  • You accidentally take more than one medicine at a time. Many medicines contain acetaminophen along with other drugs. These include medicines for colds, the flu, allergies, or trouble sleeping. You may have taken more than one medicine that contains acetaminophen, and the total was too much.

  • You take an extended-release form. When you take extended-release pills, the medicine stays in your body longer. You are supposed to take these medicines less often than you would take regular acetaminophen. If you take this medicine too often, you will have too much in your body at one time.

What are the signs and symptoms of an acetaminophen overdose?

You might not have any signs or symptoms at first. Early signs and symptoms may make you feel like you have the flu. Common signs and symptoms happen during each stage of an acetaminophen overdose. If the overdose is treated right away, you might have fewer or easier symptoms in the later stages.

  • First 24 hours:

    • Nausea, vomiting, stomach pain, and loss of appetite

    • Paleness

    • Tiredness

    • Sweating

  • 24 to 72 hours after the overdose, you may also have any of the following:

    • Pain in your upper right side

    • Dark urine

    • Urinating less often than usual

    • Skin and the whites of your eyes turn yellow

  • 72 to 96 hours after the overdose, you may also have any of the following:

    • Blood in your urine

    • Fever, lightheadedness, or fainting

    • Fast breathing or trouble breathing

    • Extreme weakness or tiredness

    • Feeling very hungry, or shaking

    • Blurred vision, a fast heartbeat, or headache that will not go away

    • Trouble staying awake

    • Confusion

    • Coma

How is an acetaminophen overdose diagnosed?

Tell your healthcare provider when you took the acetaminophen and how much you took. He may ask how long you have been taking acetaminophen. He may ask about other medicines you take and when you take them. He may ask if you have any medical problems, such as liver disease. He may ask if you drink alcohol and how much you drink. He will take your blood pressure and temperature. He may check your skin for color changes and your stomach for pain. You may also need any of the following:

  • Blood tests are used to check the amount of acetaminophen in your blood.

  • Liver function tests may show if your liver is working properly.

  • Prothrombin time (PT) and INR rates measure how long it takes for your blood to clot. If your liver is damaged, your blood may not clot properly. You could have serious bleeding problems.

How is an acetaminophen overdose treated?

Acetaminophen overdose is a serious problem. Treatment should be started as soon as possible. Treatment depends on how much time has passed since the overdose and if the overdose happened all at one time. You may be given activated charcoal medicine to soak up the acetaminophen that is still in your stomach. Activated charcoal will make you vomit. Gastric lavage may be needed to clean out your stomach to get rid of the acetaminophen. Gastric lavage is also called having your stomach pumped. You may be given antidote medicine to stop the effect of the overdose. You may also be given medicine to slow down the effects of acetaminophen.

How can an acetaminophen overdose be prevented?

  • Read labels carefully. Read the labels of all the medicines you take. If your medicine contains acetaminophen, it will be listed in the active ingredients section. Acetaminophen may be listed on the label as APAP, Acetaminoph, Acetaminop, Acetamin, or Acetam. Check carefully to see if the acetaminophen is a regular or extended-release form.

  • Do not take more than 1 type of acetaminophen at a time. Many combination medicines contain acetaminophen. Make sure the total dose of acetaminophen you take is not more than 4,000 milligrams (4 grams) in 1 day. Ask your healthcare provider if you are not sure how much you are taking. Check other medicines to see if they contain acetaminophen. Do not take these medicines together with acetaminophen. The combined amount of acetaminophen may be too much.

  • Take the correct dose. Make sure you take the right amount and wait the right number of hours between doses. Never take more than the label says to take. Do not take acetaminophen for more days than directed. If the medicine came with a device such as a spoon or dropper, use it to measure your medicine.

  • Do not take acetaminophen for too many days in a row. Do not take acetaminophen for more than 10 days to treat pain, unless your healthcare provider tells you to. Do not take acetaminophen for more than 3 days to treat a fever, unless your healthcare provider tells you to. Your pain or fever may need to be treated another way if it lasts longer than a few days.

What should I do if I think I took too much acetaminophen?

Immediately call the Poison Control Center at 1-800-222-1222 .

Where can I find more information?

  • 24-Hour Nationwide Poison Control Hotline
    National Capital Poison Center
    3201 New Mexico Avenue, Suite 310
    Washington , DC 20016
    Phone: 1- 800 - 222-1222
    Web Address: http://www.poison.org
  • US Food and Drug Administration
    10903 New Hampshire Avenue
    Silver Spring , MD 20993
    Phone: 1- 888 - 463-6332
    Web Address: http://www.fda.gov

When should I seek immediate care?

  • You or another person took too much acetaminophen.

  • You feel confused or more tired than usual, or you are sweating more than usual.

  • You have severe nausea and are vomiting.

  • You cannot have a bowel movement or urinate.

  • Your skin and the whites of your eyes turn yellow.

When should I contact my healthcare provider?

  • You have a fever.

  • You have taken too much acetaminophen by mistake, even if you do not have any signs or symptoms.

  • You have pain in the upper right side of your abdomen.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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