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.
If the high amount of Paracetamol is ingested, then the liver may begin to deteriorate, which can lead to jaundice (yellowing of the skin), confusion, and fainting/loss of consciousness. In most instances of death by Paracetamol overdose, liver failure is the primary cause.
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.
However, repeatedly taking more than the recommended dose or overdosing on paracetamol can cause serious injury to the liver and even death. The recommended maximum dose of paracetamol for an adult (or child over 12 years) is 4g in any 24-hour period (equivalent to 8 x 500mg tablets).
Taking more than five medications is called polypharmacy. The risk of harmful effects, drug interactions and hospitalizations increase when you take more medications.
The threshold for potential paracetamol-induced hepatic injury in adults is >10g or >200 mg/kg (whichever is less) within 24 hours. So, 10g is the toxic dose for all those heavier than 50kg.
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.
There may be no symptoms for the first day. A feeling of sickness (nausea) and being sick (vomiting) may occur a few hours after taking the overdose. After 24 hours there may be pain under the ribs on the right side (where the liver is) and there may be yellowing of the whites of the eyes and the skin (jaundice).
Abdominal (stomach) pain, nausea, vomiting (sickness). Yellow discoloration of the skin or whites of the eyes (jaundice). Severe headache, confusion or drowsiness. Passing no urine at all for the past eight hours.
HEPATOTOXICITY RISK FACTORS
While acute liver injury can occur when used at or below the recommended daily maximum dose (4000 mg)[4], paracetamol toxicity is often the result of ingestion of paracetamol over this maximum dose.
Ibuprofen, aspirin and other NSAIDs (non-steroidal anti-inflammatory drugs) can irritate the stomach lining, so it is best to take them with food, or a glass of milk. Paracetamol doesn't irritate the stomach lining so it won't matter if you haven't eaten.
Emergency healthcare team will assess the person who has overdosed based on their condition. The emergency team will: Do a full assessment – which may include blood tests, observation and psychological review. Do a physical examination.
Adults can usually take 1 or 2 tablets (500mg) every 4-6 hours, but shouldn't take more than 4g (8 x 500mg tablets) in the space of 24 hours.
Paracetamol can also be used to treat fever (high temperature). It's dangerous to take more than the recommended dose of paracetamol. Paracetamol overdose can damage your liver and cause death. Always follow the directions on the packet when using 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.
Active ingredient: each Panadol 500 mg Film Coated Tablet contains paracetamol (500 mg). Panadol products contain paracetamol; do not take them with other medicines that also contain paracetamol. Paracetamol is in many medicines to treat pain, fever, symptoms of cold and flu, and sleep medicines.
Paracetamol poisoning, when associated with exceptionally high plasma concentrations, can give rise to coma and metabolic acidosis in the absence of hepatic failure or other drugs.
You should not take more than 8 normal strength tablets in 24 hours (4,000mg). 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.
A large overdose can cause a person to stop breathing and die if not treated right away. The person may need to be admitted to the hospital to continue treatment. Depending on the drug, or drugs taken, multiple organs may be affected, This may affect the person's outcome and chances of survival.
It is important to remember that not all overdoses are fatal or life threatening, however medical advice should always be sought if overdose is suspected or has occurred. An overdose is a medical emergency that requires immediate medical attention.
If you think you've taken too much of any OTC pain reliever, call your doctor or seek medical help right away. Signs and symptoms may not be noticeable right away. Symptoms of an overdose include: Nausea or vomiting.
If your child is sick (vomits) after taking a dose of paracetamol tablets or syrup, do not give them the same dose again. Wait until it's time for their next dose, or ask a pharmacist or your child's doctor for advice.
Rash, itching, sweating, hives, red patches on skin, angioedema with symptoms like swollen face, lips, throat or tongue. Dizziness, generally feeling unwell (malaise), fever, sedation, interactions with medicines. Overdose and poisoning.