Tylenol, or acetaminophen, is one of the most commonly used over-the-counter medicines. It is used as an anti-inflammatory, as a pain reliever and as a fever reducer. Despite being over-the-counter, taking too much Tylenol can have serious consequences, including permanent liver damage and death. The side effects of taking too much Tylenol depend on the time after the ingestion.
Early Phase
Within hours of taking too much Tylenol, a person might feel dizzy with nausea and vomiting. Patients can have sweating and a generalized feeling of being sick, or malaise. Patients also might appear pale. If the ingestion is caught at this point, treatment with a medicine called acetylcysteine can prevent subsequent liver damage.
Middle phase
About a day after taking too much Tylenol, the initial symptoms might resolve and a patient may feel like she is back to normal. Sometimes she will have abdominal pain, particularly in the right upper quadrant of the abdomen, where the liver is located. The liver is the organ most severely affected by Tylenol overdoses. At this point, patients exhibit changes in their liver function, with elevated liver enzymes, reflecting early liver damage. Other abnormalities include jaundice, due to increased bilirubin, another substance that the liver metabolizes; and decreased ability of the body to clot off blood, another function in which the liver plays an important role.
Late Phase
Three to four days after the initial overdose, the liver has suffered its maximum damage. At this point, patients again experience nausea and vomiting, and show signs of fulminant liver failure, with pain, pronounced jaundice, easy bruising and bleeding. The kidney also becomes affected. After this patient either resolve their dysfunction, or progress to coma and death, if untreated. Most patients would need a liver transplant to survive.
References
- Comprehensive Pediatric Hospital Medicine, Lisa Zaoutis and Vincent Chiang, 2007
- Medline Plus
- The Merck Manuals
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