Acetaminophen/paracetamol has a hard stop upper dose limit, above which it becomes extremely toxic.
That limit is 4g (8 “extra strength” (500mg) tablets) in 24 hours (about 2 tablets every 6 hours).
A single dose of 22 extra strength tablets can kill you.
Taking 12 or more tablets per day for more than a week can also kill you (this is about 3 tablets every 6 hours).
Symptoms of overdose take up to 24 hours to manifest, and are fairly difficult to distinguish from other problems. They include abdominal pain (especially right upper quadrant), nausea, malaise, and confusion.
The antidote (n-acetylcystine) must be given within 8hours of ingestion in order to be useful.
After 10 hours the only thing that will work is a liver transplant.
You might think “why would I ever accidentally take so much?”
Well, acetaminophen is in almost everything in the cold/flu/pain aisle. Migraine combos like Excedrin, cold and flu combos like NyQuil, basically anything that says “non-aspirin pain relief”, and anything that’s branded as a fever reducer. It’s all probably acetaminophen/paracetamol.
So the goal of this post is to get you to read the labels on your medications. Because taking taking Tylenol and NyQuil together for a week (like you might if you had the flu) could kill you.
I listened to some science podcast a while back all about how ridiculously dangerous acetaminophen is and how it should never have been approved. So in case you hadn’t heard.
The other thing about acetaminophen/ paracetamol you have to watch out for is that the dosages per pill vary wildly. I’ve seen as low as 250mg and as high as 1000mg per pill. That’s bonkers to me, given that it goes from “very safe” to “very deadly” with such a small margin of error. You really need to check the label carefully when you get a new bottle. If you’re used to the consistency of NSAID dosing, this might be something that wouldn’t even register as a concern.
I just want to voice- acetaminophen is not “ridiculously dangerous.” It’s actually really safe and effective. Problems arise when people aren’t following the label and aren’t thinking about dosage.
Extra strength excedrin has 250mg per cap.
Dayquil severe has 325 MG per cap.
Tylenol extra strength has 500mg per cap.
If you took 2 of each of these all at once, you’d be at 1400mg. You could do that twice in one day and still not hit that 4g mark. You would have to do that 3 times in a 24 hour period to be at risk, and getting NAC within 8 hours would still save you.
Now, please understand- high levels for days upon days can build up, and people who are very sick may not be reading medicine labels carefully. It’s important to know what the limits are and to check what is in medication. If you have chronic pain, you may need a different management plan completely.
But pain relief is a blessing. Learn to use it safely so that you can use it when you need it.
I think it’s funny how Nintendo introduced Sidon and had to deal with all of the gay subtext that came out of it and then conveniently had to give him a fiancé in TOTK, cause they couldn’t deal with literally everyone pairing him with Link
a little more information regarding the maui wildfires:
medical workers on the ground are describing finding hundreds of bodies. the current death toll in the media is, unfortunately, only a fraction of the reality
hospital workers are describing injuries and trauma as if survivors had come out of a warzone
thousands are still missing
an apartment complex for the elderly was lost. not everyone could get out. people were saying goodbye to loved ones over the phone
people who did get out of lahaina were leaving with ashes covering their faces and nothing but the clothes on their backs. people are losing everything.
hotels are still operating. hotels are still operating. they are not the ones offering shelters or housing or food. even bowling alleys are offering shelter, but hotels have the audacity to build on burial sites but not open their doors to local families who have lost everything.
Hey if you work for a major company that you fucking hate, but they also have a Diversity, Inclusion, Culture Department… check if they offer donation matching.
Your $10 donation can turn into $20
Your $50 donation can turn into $100
I completely forgot until an org put it at the bottom.