Summary: Extra Strength Tylenol labels will now contain warnings to not exceed 3,000 mg (3 grams) per day rather than the old 4,000 mg (4 gram) recommendation. This new recommendation arose from the fact that many consumers take other OTC products that contain additional Tylenol that consumers often don’t take into account. Raising their risk of exceeding the 4 grams per day limit.
Dear Curtis: In the past I was taking Lortab 5/500 mg. On my pharmacy label it always said not to exceed 4 grams per day of Tylenol. But now I’m hearing that it’s bad to take over 3 grams of Tylenol per day. Why did this change? Have I been doing something dangerous to my body this whole time?
I have to admit that, even as a pharmacist, when the new dosing recommendations for Tylenol® (acetaminophen is the generic name) came out even I was a little confused by what it all meant.
So let me try to clear the air.
It’s A Preventative Measure
I don’t know about you but once in a while I like to go golfing. One of the rules with golfing is that you have to take the wind into account. If you have a 100 yard shot and you have a club that you can hit 100 yards then you’re perfect. But, if you have a strong wind at your back then you’ll need to take preventative measures like using a smaller club, or take less of a backswing. If you don’t the wind will cause you to overshoot your target.
Like my golfing analogy, the new dosing recommendations were put in place to prevent side effects. Not because 4,000 mg a day is now suddenly a dangerous dose.
First of all, the reduction in total daily acetaminophen dosage was strictly directed at Extra Strength Tylenol. At least for the time being. Extra Strength Tylenol (acetaminophen) comes in 500mg tablets. Regular strength Tylenol comes in 325mg tablets.
Secondly, there will be a labeling change advising patients that you should indeed not exceed 3,000 mg (3 grams) of Tylenol a day. But, while it’s easy and understandable to think that you were doing something “dangerous” to your body it is really a response to the how much confusion there is out there surrounding Tylenol and the thousands of products that it’s contained in. In short, while consumers worry about taking different medications with Tylenol one of the most dangerous things you can do is take extra Tylenol with what you are already taking.
A Common Example
For example, you were taking Lortab. Which contains Tylenol. You were probably fine with taking up to 4,000 mgs (4 grams) a day. But where the problem comes in is let’s say you got a sinus infection or cold. So you went out and bought one of the dozens of cough and cold preparations that also contain Tylenol.
Too few patients realize that so many other over-the-counter products contain Tylenol. Either because they don’t read the label or because they didn’t sit down and run the math of how much Tylenol they are taking. So, a typical consumer may end up taking hundreds, or even thousands, of milligrams of extra Tylenol a day in other over-the-counter products without knowing it.
In your case, you may unknowingly get up to 5 or 6 grams a day and that’s when you start seeing liver problems from Tylenol. Especially when it’s being done on a consistent and long term basis.
At the end of the day it’s up to consumers like yourself to make sure that you read the ingredients and labels on all over-the-counter products you take. But, because that doesn’t happen the manufacturers and the FDA decided that to be a little more proactive it would make sense to lower the maximum dosage on just Tylenol-containing products.