Quick summary

• If you may have taken too much paracetamol, always go to hospital straight away.
• Adults can take two 500mg tablets, 4 times in 24 hours. You must always wait 4 hours between doses.
• Most people who take too much paracetamol will make a full recovery if they get medical help.

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How much paracetamol is dangerous?

Most cases of acute liver failure are caused by a deliberate overdose. But it can also happen by accident.

Many medicines contain paracetamol. Including a lot of cold and flu medicines that you can buy from a pharmacy. You can accidentally take too much paracetamol if you mix different medicines.

Always read the label on medicines that you buy and check if they have paracetamol in them. If you are not sure, ask the pharmacist. Your pharmacist can also tell you which medicines it is safe to take together.

The NHS states: Adults can take two 500mg tablets, 4 times in 24 hours. You must always wait 4 hours between doses. Do not take more than 8 tablets in 24 hours.

If you take more than this, you should go to the hospital to be checked.

If you weigh less than 8 stone (50 kg), talk to your doctor or pharmacist about safe paracetamol dosage.

If you are in pain, and the recommended dose of paracetamol is not helping, talk to your doctor. They may be able to suggest or prescribe other pain medicines to help you. Or you could ask if there are specialist pain services in your area to which you could be referred.

If you already have a liver condition, talk to your doctor about which pain medicines are best for you. And how much you can take.

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Symptoms of acute liver failure caused by paracetamol overdose

If you think you have taken too much paracetamol, get help straight away. Do not wait to see if you get symptoms.

The symptoms of acute liver failure caused by a paracetamol overdose include:

• A yellow colour in your eyes or skin (jaundice)
• Low blood sugar
• Sweating
• Trembling
• Being irritable
• Being more clumsy or less coordinated than usual
• Feeling sick (nausea)
• Being sick (vomiting)
• Feeling very tired (fatigue)
• Pain in your tummy

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Symptoms of acute liver failure caused by paracetamol overdose

If you think you have taken too much paracetamol, get help straight away. Do not wait to see if you get symptoms.

The symptoms of acute liver failure caused by a paracetamol overdose include:

• A yellow colour in your eyes or skin (jaundice)
• Low blood sugar
• Sweating
• Trembling
• Being irritable
• Being more clumsy or less coordinated than usual
• Feeling sick (nausea)
• Being sick (vomiting)
• Feeling very tired (fatigue)

Pain in your tummy

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Treatment for paracetamol overdose

With medical help, most people will get better after a paracetamol overdose. The sooner you start treatment, the less chance there is of any lasting damage to your liver.

To help doctors decide on the best treatment, you should tell them:

• How much paracetamol you have taken.
• When you took the paracetamol.
• Any other medicines you have taken. Including:
  • prescription medicines
  • medicines from your pharmacy
  • recreational drugs
  • supplements
  • any natural, herbal or alternative medicines

If you can, take the packets of all the medicines you have taken to the hospital with you. Or you could take a picture of all the labels on your phone. This will help the doctors to work out the best treatment for you.

Doctors might also do a blood test to see how your liver is doing and how much paracetamol is in your blood.

If you need treatment, you will be given a drug called acetylcysteine. You might also hear the name Parvolex. This will be given to you as a drip. It will take about 24 hours to have the full dose.

You might also be given activated charcoal. This can help to stop the paracetamol from getting to your blood and other parts of your body.

If you are already very poorly when you get help, you might need more intense treatments. Liver failure can have an impact on your whole body. So you might need to go to an intensive care unit.

While you are in hospital, you might be asked to talk to a member of the mental health team. In some places, this will happen even if the overdose was accidental, as part of the routine checks. If you think you need some help with your mental health, ask the mental health team what is available in your area. And how best to access it.

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Life after acute liver failure caused by a paracetamol overdose

Most people will make a full recovery from acute liver failure caused by a paracetamol overdose. But it can still be worrying to know that your liver was so poorly.

Your liver has an amazing ability to repair itself. But this can take time. You might feel very tired for a few weeks or months. This is normal, but it can make it hard to do all your usual activities for a while.

Support for you

If you are struggling with your mental health, you can talk to the Samaritans by calling 116 123.

The helpline is free and open all day every day. You can get in touch about anything that’s troubling you, no matter how large or small the issue feels. You can also find other ways to contact them on their website.

The Samaritans also provide information if you are worried about a loved one’s mental health.

We have more information on looking after your mental health and other organisations offering support here.

Liver UK is here for anyone who has a liver condition. We can also support families and loved ones. You can find out more using the link below.

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