Find Information About:

Drugs & Supplements

Get information and reviews on prescription drugs, over-the-counter medications, vitamins, and supplements. Search by name or medical condition.

Pill Identifier

Pill Identifier

Having trouble identifying your pills?

Enter the shape, color, or imprint of your prescription or OTC drug. Our pill identification tool will display pictures that you can compare to your pill.

Get Started
My Medicine

My Medicine

Save your medicine, check interactions, sign up for FDA alerts, create family profiles and more.

Get Started

WebMD Health Experts and Community

Talk to health experts and other people like you in WebMD's Communities. It's a safe forum where you can create or participate in support groups and discussions about health topics that interest you.

  • Second Opinion

    Second Opinion

    Read expert perspectives on popular health topics.

  • Community


    Connect with people like you, and get expert guidance on living a healthy life.

Got a health question? Get answers provided by leading organizations, doctors, and experts.

Get Answers

Sign up to receive WebMD's award-winning content delivered to your inbox.

Sign Up

Pain Management Health Center

Font Size

Tylenol Safety Debated -- Again

Recommended Dose Safe, but Overdose Danger Debatable
WebMD Health News

July 23, 2004 -- Is acetaminophen -- best known as Tylenol -- safe enough for over-the-counter sales to continue?

Yes, most experts say. But every year, acetaminophen overdose is linked to 458 deaths from acute liver failure. Acetaminophen poisoning is implicated in half of all U.S. liver failures.

Yet tens of millions of Americans use Tylenol regularly. The FDA says the drug's benefits far outweigh its risks. Not so, argues liver disease expert William M. Lee, MD, professor of internal medicine at the University of Southwestern Medical Center in Dallas.

"It still must be asked: Is this amount of injury and death really acceptable for an over-the-counter pain reliever?" Lee writes in the July issue of Hepatology.

Unintentional Overdose

Lee warns that unintentional acetaminophen overdoses are often taken for several reasons:

  • People take several products, unaware that each one contains the maximum safe dose of acetaminophen.
  • People abusing narcotics often don't realize that the drug is paired with acetaminophen. As their tolerance for the narcotic increases, they take larger doses -- and get huge doses of acetaminophen.
  • People in pain take more and more pain reliever to get relief, far exceeding the recommended dose.
  • Chronic alcoholics are more sensitive to acetaminophen toxicity.

The largest recommended dose of acetaminophen comes in Tylenol Extra Strength products. The label instructs users to take two 500 mg pills -- a dose of 1 gram. The label warns people not to take more than 4 grams -- eight pills -- in a single 24 hour period.

Lee notes that most unintentional overdoses occur with 34 grams, taken, on average, over the course of three days.

That's a lot of pills, says Frank A. Anania, MD, director of hepatology at Emory University School of Medicine in Atlanta.

"Yes, this drug can be dangerous if people take 8 to 10 grams in a day. But that is 16 extra-strength tablets," Anania tells WebMD. "But even if you take eight pills every day for three days, that's only 12 grams. So that is a lot of Tylenol in these 'unintentional overdoses.' This brings up the question of whether the safety issue is one that can truly be addressed by more regulation of this drug."

Today on WebMD

pain in brain and nerves
Top causes and how to find relief.
knee exercise
8 exercises for less knee pain.
acupuncture needles in woman's back
How it helps arthritis, migraines, and dental pain.
chronic pain
Get personalized tips to reduce discomfort.
illustration of nerves in hand
lumbar spine
Woman opening window
Man holding handful of pills
Woman shopping for vegetables
Sore feet with high heel shoes
acupuncture needles in woman's back
man with a migraine