The Directions Are Smarter Than You

Written by Dr. Dave Hnida CBS4 Medical EditorThe makers of Tylenol have just changed the recommended dosage on its Extra Strength version of the product.

These big boys contain 500 mg of acetaminophen, and prior to the change the directions said you could take eight pills total each day– for a grand total of 4000 mg.

The problem is some people were taking acetaminophen in other products along with the Extra Strength version. And what they wound up with is liver failure.

In fact, the leading cause of liver failure is accidental acetaminophen overdose.

So, the thinking is: let’s cut the recommended max dose, and maybe fewer people will wind up needing a liver transplant.

The new recommended total dose for one day is 3000 mg, or the equivalent of six Extra Strength tablets or caps. (The regular adult tab contains 325 mg.)

It’s a good idea but it’ll only work if you do follow the directions AND make sure you’re not getting acetaminophen from other products. It’s not easy since more than 2000 medications (cough, cough, allergy, headache, and other products) contain some level of acetaminophen. Making matters worse, is your doctor may give you an Rx with acetaminophen in it, and you don’t realize it — then you take some OTC acetaminophen, and before you know it, you’ve blasted your dose through the roof.

So the advice — be a mathematician and add up those milligrams from all sources. Meaning, take some meds — and make sure you don’t go over that 3000mg total.

Hard to do, so perhaps the best advice is to not mix medicines unless you can do the math — or ask your doc or pharmacist.

After all, a liver is a good thing to have.

(and as you know, the follow directions rule applies to all medications!)

  • edward collins

    Hey Dave .. What about a much safer alternitive, medical marijuana. No liver damage, safe and effective, works for me, whats you opinion?

  • edward collins

    Acetaminophen overdose is the leading cause of liver failure in the US and the United Kingdom and the leading cause of calls to the Poison Control Centers across the US. It is estimated that acetaminophen poisoning calls exceed 100,000 per year. Studies indicate that acetaminophen overdose results in over 56,000 injuries, 2,500 hospitalizations, and an estimated 450 deaths per year.

    People at Tylenol Risk

    People consuming three or more servings of alcohol per day should take even less than the FDA’s proposed recommended dosage: more than two servings of alcohol per day can increase the risk of liver failure from acetaminophen. People who take Tylenol in high doses, or simply use it regularly are also at risk.

    People with decreased liver function, kidney disease, hepatitis, malnutrition, AIDS, chronic ethanol abuse, or anorexia nervosa may be at increased risk for liver failure and death when using Tylenol. For diabetics, acetaminophen may also affect the results of blood glucose (sugar) tests.

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