Acetaminophen: how much is safe?

Managing pain with acetaminophen: what you need to know

Acetaminophen is found in more than 600 different medicines—both prescription and over-the-counter (OTC) pain relievers, fever reducers, and sleep aids as well as cough, cold, and allergy medicines. In fact, it is the most common “drug ingredient” in America–with over 50 million Americans using a medication that contains acetaminophen each week. Acetaminophen is safe and effective when it is used according to the label directions, but there is a limit to how much you can take in one day. Taking too much acetaminophen can be harmful and can cause liver damage.

According to the FDA, most cases of liver damage from taking acetaminophen happen when:

  • More than the prescribed dose of a medicine was taken in a day
  • More than one medicine containing acetaminophen was taken at the same time
  • Excessive alcohol was consumed while taking acetaminophen

Follow these tips to take acetaminophen safely

  1. Always read and follow the drug label: Always read the label before taking any medicine. Never take more acetaminophen than the label says. Taking too much can lead to liver damage and other side effects.
  2. Know if your medicines contain acetaminophen: You need to know if acetaminophen is in the medicines you take so you can avoid taking too much. Here’s how to find out:
    • If you are taking an over-the-counter medicine, check the front of the package and the “active ingredient” section of the Drug Facts label for the word “acetaminophen.”
    • For prescription medicine, look for the word “acetaminophen” or a shorter version such as “APAP” or “acetam” on the label.
    • See this list of medications that contain acetaminophen.
  3. Never take two medicines that contain acetaminophen at the same time: Don’t take two or more medicines that contain acetaminophen at the same time. Acetaminophen overdose can cause liver damage.
    • Learn about the different sections of the OTC label
    • Learn about the different sections of the labels that accompany prescription medicines
  4. Ask your healthcare provider if you have questions about dosing. Acetaminophen dosing for children, adults and the elderly may vary by weight and sensitivity in certain conditions, and can change as we age and face different health conditions.
    • Be sure to talk to your healthcare provider before taking acetaminophen if you drink three or more alcoholic drinks a day or if you have liver disease. You may be at greater risk for liver damage. Also, it is also important to talk to your healthcare provider before taking medicines containing acetaminophen if you are pregnant or breastfeeding, or if you take warfarin.
  5. Make sure to keep acetaminophen–and all medications in your household—out of the reach and sight of young children and grandchildren.

More information and resources about acetaminophen safe use

NCPIE has developed a number of educational toolkits that contain resources, brochures and handouts. These community education toolkits were developed by project advisory teams with expertise in advocacy, outreach, health communications and safe use of medicines. Acetaminophen Safe Use for Older Adults—a resource for adults, caregivers and healthcare professionals. Older adults use more medicines than any other age group in the U.S., increasing the risk of drug interactions. This educational toolkit provides information on how and why medicines can affect us differently as we age and what can be done easily and safely to reduce medicine risks. Be Acetaminophen-Savvy on Campus, an acetaminophen safe use college resource guide—to equip peer educators and campus leaders with practical, relevant informational resources and programming ideas to help ensure that college students become acetaminophen-savvy. Be Acetaminophen-Savvy, an acetaminophen safe use toolkit for teens and teen influencers such as parents, teachers, coaches, community and school-based healthcare providers to help ensure that teens are informed about how to take acetaminophen-containing products safely and appropriately.

A leader in acetaminophen safe use education, NCPIE is a founding member of the Acetaminophen Awareness Coalition, a Coalition of health, healthcare providers, and consumer organizations that educate consumers and healthcare providers about how to use medicines containing acetaminophen appropriately and to help change the behaviors that can lead to an unintentional acetaminophen overdose. Learn more at