It's one of the most popular pain medicines in the U.S., but every year, 150 Americans die from accidentally taking too much acetaminophen, the drug found in Tylenol. The drug is linked to more deaths than any other over-the-counter pain reliever.
When you’re in pain, they make it stop, but how many pills do you pop for relief? Surveys show a quarter of Americans routinely takes more over-the-counter pain pills than they should.
"We’re a medicine-taking culture. We reach for a pill for all of our medical problems," said Dr. Alexander Kuo, gastroenterologist, UC San Diego Health System.
Kuo, however, said the popular drug acetaminophen, found in Tylenol, can be dangerous in high doses. It's the nation's leading cause of acute liver failure.
"The problem is when people abuse it, when they take more than is healthy for them," Kuo said.
For healthy people, the standard dose is no more than 4,000 milligrams in a 24-hour period, but if you have chronic liver disease, such as cirrhosis, it's less than 2,000 milligrams. People who drink alcohol should also be cautious since alcohol combined with acetaminophen can lower the threshold for liver damage.
The tricky part — acetaminophen is found in other meds like Nyquil, Excedrin, Sudafed, Robitussin, and Benadryl. So, you might be doubling your dose without knowing it.
"Suddenly, they’ve gone from a safe amount of Tylenol to an unsafe amount," Kuo said.
Acetaminophen overdose sends as many as 78,000 Americans to the emergency room every year, but toxicologist Richard Clark said pain medicines like ibuprofen and aspirin also carry risks.
"If you took the maximum daily dose of ibuprofen for a week or two, 30 percent of everybody is going to have microscopic hemorrhages of their stomach," said Clark, with the UC San Diego Health System.
So, only take them when you need them and always follow dosing instructions.
"Limited use is perfectly safe," Kuo said.
Countries like Great Britain, Switzerland and New Zealand have limited how much acetaminophen consumers can buy at one time or require it to be sold only by pharmacies.