Potential toxicity should be assessed and a toxicologist consulted when: >200 mg/kg (or 10 g) ingested over a 24 hour period. >150 mg/kg/day (or 6 g) ingested over a 48 hour period. >100 mg/kg/day ingested over a 72 hour period.
This refers to excessive ingestion of paracetamol over a period longer than one hour, usually in the context of self-harm. Serious toxicity may occur in patients who have ingested > 150 mg/kg in any 24 hour period. Rarely, toxicity may occur for ingestions between 75-150 mg/kg.
Paracetamol is a common painkiller that is normally safe. If you take more than the recommended amount (an overdose), it can harm the liver, and occasionally the kidneys. The medical team will assess you.
Adult dosing of paracetamol
The recommended paracetamol dosing for adults and children 12 years and over is 500 to 1000mg every four to six hours as necessary, with a maximum of 4000mg in any 24 hour period.
If you take too much
Taking 1 or 2 extra tablets is unlikely to harm you. Do not take more than 8 tablets in 24 hours. Taking too much paracetamol can be dangerous and you may need treatment. Too much paracetamol can cause liver damage.
The lowest amount of Paracetamol to cause death was found by one study to be 10g. As for Paracetamol of 500mg per tablet, it is generally recommended to take no more than 8 tablets (500mg) within 24 hours, and 24 to 30 tablets taken at one time can lead to overdose or even death.
If you take too much Paracetamol your liver may not be able to metabolise it efficiently and this could make you extremely unwell. Paracetamol overdose can lead to liver failure in some people and this is why you need to take careful note of this advice.
Just a few paracetamol tablets over the recommended dose can potentially cause fatal liver damage, and there may be no symptoms until it is too late for treatment to help. There is an antidote for paracetamol poisoning and it is most effective within eight hours of the overdose, so getting help early is essential.
From 1 February 2025, new restrictions on paracetamol will: reduce the maximum size of packs available for general sale (e.g. supermarkets and convenience stores) from 20 to 16 tablets or capsules.
Taking 1 or 2 extra tablets is unlikely to harm you. Do not take more than 8 tablets in 24 hours. Taking too much paracetamol can be dangerous and you may need treatment. Too much paracetamol can cause liver damage.
While paracetamol is safe in normal doses, it is hepatotoxic and potentially fatal in overdose. Fortunately, N-acetylcysteine (NAC) is a safe and effective antidote which if used correctly prevents serious hepatic injury after paracetamol overdose.
Taking more, especially 7,000 mg or more, can lead to a severe overdose problems. If you have liver or kidney disease, you should discuss the use of this drug with your health care provider.
If levels exceed the above paracetamol can cause liver damage (hepatotoxicity) if you take larger doses than recommended. Adults must not take more than 4000 mg in a 24-hour period.
For most people, it is safe to take 4,000 mg (4 g) of acetaminophen within a 24-hour period. Accidental overdose may occur when a person takes too much acetaminophen because the pain or fever does not diminish after the recommended dose, or when a person takes too many different medications containing acetaminophen.
NSAID overdoses
It is possible to accidentally exceed the recommended dosage for NSAIDs such as diclofenac, ibuprofen and combined formula painkillers like paracetamol, aspirin and caffeine. This is why you should always read the label before using any medication to avoid accidental pill overdoses.
Paracetamol overdose is one of the leading causes of acute liver failure. Adults can usually take one or two 500mg tablets every 4-6 hours, but shouldn't take more than 4g (eight 500mg tablets) in the space of 24 hours.
However, taking too many prescription medications can be risky. Taking more than five medications is called polypharmacy. The risk of harmful effects, drug interactions and hospitalizations increase when you take more medications.
Intravenous acetylcysteine is the antidote to treat paracetamol overdose and is virtually 100% effective in preventing liver damage when given within 8 hours of the overdose.
For example, an overdose of acetaminophen (Tylenol) can destroy half of a person's liver cells in less than a week. Barring complications, the liver can repair itself completely and, within a month, the patient will show no signs of damage.
Liver failure can happen if you take too much paracetamol and don't get help. This can lead to death. Symptoms of paracetamol overdose are: abdominal pain, nausea, vomiting.
If you develop any of the following symptoms, you must seek medical advice immediately. Abdominal (stomach) pain, nausea, vomiting (sickness). Yellow discoloration of the skin or whites of the eyes (jaundice). Severe headache, confusion or drowsiness.
Summary. Paracetamol overdose may occur after excessive ingestion of paracetamol or paracetamol-containing medication as an acute or staggered overdose, or therapeutic excess. Patients are often asymptomatic or have only mild gastrointestinal symptoms at initial presentation.
Acetylcysteine has long been recognized as an effective antidote, via oral or intravenous administration, minimizing the risk and severity of acute liver injury if administered sufficiently early after a paracetamol overdose.
Adults, the elderly and children 16 years and over (above 55 kg body weight): Take 500 mg to 1000 mg at a time, up to 3000 mg per 24 hours. The maximum daily dose of Paracetamol must not exceed 3000 mg.