Can You Never Take Tylenol Again If You've Overdosed In The Past?

In our latest question and answer, our pharmacist discusses whether or not Tylenol can ever be taken again after a prior overdose.

Question

A friend of mine intentionally overdosed on acetaminophen as a teenager but thankfully survived and has recovered. It's been about 20 years and they've been under the impression that they can never safely take acetaminophen again as a way to treat pain. Is this true?

Asked by Larry On Jan 14, 2023

Answered by
Medical Content Reviewed By HelloPharmacist Staff

Published Jan 16, 2023
Last updated Apr 24, 2024

Key points

  • Overdosing on Tylenol (acetaminophen) can cause both acute and permanent liver damage.
  • The extent of liver damage caused by an overdose of Tylenol depends on many factors, including how soon you are treated afterward.
  • With quick treatment, the majority of individuals will recover fully with no lasting liver damage, but other factors can put you more at risk for damage.
  • Previously overdosing on Tylenol does not preclude you from being able to take the drug again in the future, but you should see your doctor first before taking it so you can be evaluated and monitored.

Answer

Thanks for reaching out! There are many factors that come into play regarding the outcomes that can result from a Tylenol (acetaminophen) overdose, including the length of time between the overdose and the treatment (this is extremely important), the person's age, other drugs that someone may be taking, and overall health. Most people recover fully with no lasting effects if treatment is given in a timely manner, while others may have permanent liver damage.

As a general point, and not specifically for your friend as I don't know their medical situation, the majority of individuals recover from a Tylenol overdose with no lasting liver damage if they are treated quickly (generally 12 hours or so after an overdose).

Studies report that around 90% of individuals who have previously overdosed on Tylenol (acetaminophen) recover fully, with no lasting injury, if they are treated quickly. Therefore, having overdosed in the past does not definitively preclude someone from being able to take the drug again.

Nevertheless, it is important to be cautious about taking the medication again and you should certainly talk to your doctor again before doing so. They can check to make sure there is no pre-existing liver injury or other risk factors to be concerned about, and they can of course monitor you appropriately, including monitoring liver function if you do resume taking the drug again.

One study discussing acetaminophen (the drug contained in Tylenol) had this to say regarding the prognosis after an overdose:

More than 90% of patients with acetaminophen overdose recover completely, whether or not they develop acetaminophen hepatotoxicity. Overall survival for patients with acetaminophen hepatotoxicity is 78% to 80%, better than 80% if NAC [N-acetyl-cysteine] is given within 12 hours after ingestion, but only 48% if NAC is not administered.

J Clin Gastroenterol . 2009 Apr;43(4):342-9

It's so important to be cognizant of the risks of acetaminophen overdose as it is one of the most common drugs associated with accidental overdose. It is in hundreds of different products and can be relatively easy to accidentally take too much.

If you suspect an overdose, I highly recommend contacting Poison Control at 1-800-222-1222 or visiting Poison.org. 

Final Words

I hope this answer helped!

I'm sorry that I can't say definitively say whether or not your friend can safely take Tylenol again after a previous overdose, but, as mentioned, there are many factors at play.

However, I think I answered your primary concern regarding whether or not it is possible to take Tylenol again after a previous overdose, and the answer is yes, as long as there was no lasting damage to the liver and your doctor (or your friends in this case) evaluates you and provides guidance that it is safe.

References

  • Acetaminophen Toxicity: What Pharmacists Need to Know, U.S. Pharmacist
  • Acetaminophen hepatotoxicity and acute liver failure, PubMed
  • Acetaminophen Monograph, PubChem
  • Acetaminophen Poisoning, PubMed

About the Pharmacist

Dr. Brian Staiger, PharmD

Dr. Brian has been practicing pharmacy for over 13 years and has wide-ranging experiences in many different areas of the profession. From retail, clinical, program development, and administrative responsibilities, he's your knowledgeable and go-to source for all your pharmacy and medication-related questions! Dr. Brian Staiger also has herbalist training and educational certificates in the field of medical ethnobotany. Feel free to send him an email at [email protected]! You can also connect with Dr. Brian Staiger on LinkedIn.

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