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Tylenol overdosage

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Hi. I took about 9000mg of Tylenol on Monday in a moment of panic and passed out, but have since been okay -- just some mild nausea and fatigue (except for vomiting after having had a few drinks on Christmas). Is there still a reason to go to the ER, or am I probably out of the woods on the liver front?

Thanks for your help.

Category: Family Physician-GP

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Category: HIV- AIDS Specialist
 22 Doctors Online


Thank you for choosing DoctorSpring.

I have discussed your concern with our Toxicology Specialist Dr.Vivek Verma.

Yes, you should visit ER/Medical care. Although 9000mg of Tylenol is most likely under the critical toxic dosage for you (I assume you weigh more than 60Kgs). However even this dose can cause a liver damage and even now the damage could be going on. Most likely you are on a recovery phase. This means your liver should be recovering.

However there is still a small chance that the liver damage is still persisting or getting worse . This has to be ruled out by few simple blood tests (ALT, Liver Function Panel, PT, INR). It is prudent to under go these tests to be safe.

Meanwhile stay in touch with friends and family. Consider getting in touch with the socail and mental help service in your country. You SHOULD NOT take alcohol or OTC medications for 1 month (or until the liver function is clear).

Hope this helps
Feel free to ask followups

Patient replied :

Thanks so much for your helpful response. I really do appreciate it. Yeah, I'm over 60kgs (about 150lbs). I just wasn't sure how much I could judge the situation based on my current symptoms, which are only very mild, except for when I was drinking (drank a few times since the OD, once to excess but otherwise just 1 or 2 beers). I'd had reservations about going to the ER given the potential for the visit getting dragged out since it's hard to make a claim that 9000mg was accidental (I let my psychiatrist know, but he's 3000 miles away for the next 2.5 weeks and medication changes won't be immediate). Is it a bad idea to take any pain meds at all (as prescribed)? I ask because I've got a badly sprained knee on top of everything else. Thanks again for letting me know that it's still a good idea to get checked out.

No, You SHOULD NOT take pain meds at all. You can try ointments or analgesic sprays. Especially since you are not planning an ER visit alcohol and pain medications (all medications as a matter of fact ) should be avoided at any cost.

Tylenol toxic effects can be delayed in certain individuals. Moreover certain individuals can have slow metabolism for acetaminophen resulting in disproportionate severe toxicity.

I still recommend ER visit. Or if possible you just get a LFT (Liver Function Test ) done and update me the results.

Hope this helps
Feel free to ask followups
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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