Doctor's Notes on Tylenol Poisoning
Acetaminophen (brand name: Tylenol) is a common medication used as a pain reliever and fever reducer. Acetaminophen is generally safe and effective, but when taken in excess doses, it can cause serious damage to the liver and cause life-threatening illnesses. People taking maximum acetaminophen (Tylenol) doses may accidentally overdose if they also take other medicines that contain acetaminophen at the same time. Other drugs that contain acetaminophen include Actifed, Alka-Seltzer Plus, Benadryl, Butalbital, Darvocet, Excedrin, Fioricet, Lortab, Midrin, Norco, Percocet, Robitussin, Sinutab, Sudafed, TheraFlu, Unisom With Pain, Vick's Nyquil and DayQuil, Vicodin, and others. It is important to read all drug labels or ask a doctor or pharmacist to ensure you do not take excess acetaminophen.
Symptoms of acetaminophen (Tylenol) poisoning may not occur until up to 24 hours after taking a toxic dose of the drug. Symptoms of acetaminophen (Tylenol) poisoning may include
- nausea,
- vomiting,
- feeling unwell (malaise),
- not being able to eat or having a poor appetite,
- yellow eyes, and
- skin, or abdominal pain.
Acetaminophen overdose can damage the liver. In severe cases, a liver transplant may be necessary.
What is the Treatment for Acetaminophen Poisoning (Tylenol)?
Patients with a suspected acetaminophen overdose should seek medical care right away in a hospital emergency department. Patients with acetaminophen overdose do not have symptoms within the first 24 hours.
Overdose with acetaminophen is often self-reported by the patient. It is important to start treatment for acetaminophen overdose as soon as it is identified in order to prevent severe liver toxicity and potential death.
Initial treatment for acetaminophen overdose includes:
- symptomatic care for vomiting, dehydration, or abdominal pain.
- Intravenous fluids and nausea medications are often needed.
- The patient should have a blood test to assess the acetaminophen level in the blood.
- Based on this level, the amount possibly ingested, and the timing of the ingestion, a doctor can calculate the necessity of acute treatment for acetaminophen overdose.
Patients with acetaminophen overdose are treated with a specific antidote called N-acetylcysteine (NAC). This medication, if given before liver damage occurs, can block the toxic side effects of acetaminophen. The medication is given either by mouth (PO) or intravenously (IV).
Patients with delayed presentation and signs of liver damage should be managed in consultation with a regional poison control center (1-800-222-1222 in the United States) or a medical toxicologist.
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REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.