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Acetaminophen and Liver Injury: Q & A for Consumers

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Acetaminophen is generally safe when taken as directed. To lower your risk of liver damage make sure you do the following:

  • Follow dosing directions and never take more than directed; even a small amount more than directed can cause liver damage.
  • Don’t take acetaminophen for more days than directed.
  • Don’t take more than one medicine that contains acetaminophen at a time. For example, your risk of liver damage goes up if you take a medicine that contains acetaminophen to treat a headache, and while that medicine is still working in your body, you take another medicine that contains acetaminophen to treat a cold.

Q: How can I tell which medicines contain acetaminophen?

A: Medicines have ingredients listed on their labels. On OTC medicines, check the “Drug Facts” label under the section called Active Ingredients. If your medicine contains acetaminophen, it will be listed in this section. On prescription medicine containers, the label will say “acetaminophen” or “APAP.”

Q: When should I talk to a doctor before taking acetaminophen?

A: Talk to your doctor before taking acetaminophen if you

  • drink alcohol (three or more drinks every day)
  • have liver disease

Under these conditions, taking acetaminophen puts you at greater risk of getting liver damage, even when taking acetaminophen at the recommended dose.

If you take the blood thinner warfarin, you should also talk to your doctor before taking acetaminophen because taking warfarin and acetaminophen together may raise your risk of bleeding.

Q: How can I safely take acetaminophen?

A: Follow this advice to take acetaminophen safely:

  • Read all the information given to you by your doctor and follow directions.
  • Read the information on the OTC “Drug Facts” label or on the prescription label and follow directions.
  • Be sure you understand the following:
    - the dose, which is how much acetaminophen you can take at one time
    - how many hours you must wait before taking another dose of acetaminophen
    - how many doses of acetaminophen you can take safely each day
    - when to stop taking acetaminophen and ask a doctor for help
  • Never take more than directed, even if your pain or fever isn’t any better. Taking more acetaminophen than directed can put you at risk for liver damage.
  • Never take more than one medicine that contains acetaminophen. Check the active ingredients of all your medicines to make sure you are taking no more than one medicine containing acetaminophen at a time.