What happens if you take 4 paracetamol at once

Note: This information is about paracetamol use in adults. For information about giving paracetamol to babies and children, see paracetamol for children. Paracetamol is used to treat different types of pain including headache, migraine, period pain and aches and pains associated with colds and flu. It is the most commonly used pain relief medicine in New Zealand. Paracetamol is also used to treat fever but mild fever does not need to be treated unless it is causing discomfort. Read more about pain relief medication.

Paracetamol can be safely used by adults, including if you are pregnant, but there is a limit to the amount of paracetamol that you can safely take in a hour period.

Taking more than the daily limit is very harmful to your liver. For adults, the usual maximum dose is 4 grams per day. If the patient is unstable - such as having low blood pressure - or there is overwhelming liver failure, they will need to be treated on an intensive care unit.

The paracetamol levels will be sent off and once the result is back this is compared with a standard graph - patients who are above a certain line will need treatment. Those below the line may not require treatment. Treatment is with intravenous N-acetylcysteine NAC and is given to all who have high paracetamol levels.

If there is any doubt about the time of the overdose or there has been a 'staggered overdose', intravenous NAC is started without delay. NAC protects the liver and this may be the result of it restoring the glutathione levels. It may also help the liver to combat toxicity. A full treatment course consists of three consecutive bags of the medicine, mixed with intravenous fluid and given over approximately 24 hours.

During that period several blood tests may be taken to monitor the liver and kidneys. It is most effective when given within eight hours of taking the paracetamol overdose. If, however, there is ongoing damage from the paracetamol overdose then the NAC treatment may need to be prolonged. NAC is used in children and also in pregnant women. In pregnant women the paracetamol overdose can affect the liver of the fetus as well and NAC can help prevent this.

The main complication following a paracetamol overdose is liver failure. The patient may need to be referred to the specialist liver unit if the bloods confirm liver failure.

Other features which will help the healthcare professionals to decide if the patient needs to go to a specialist unit include: involvement of the brain, abnormal clotting, kidney impairment, low blood pressure hypotension , low blood sugar hypoglycaemia and high blood acid levels.

Urgent liver transplantation is the only treatment when overwhelming, irreversible liver failure occurs. Hawton K et al ; Impact of different pack sizes of paracetamol in the United Kingdom and Ireland on intentional overdoses: a comparative study. Biomed central Paracetamol overdose - revised single line treatment nomogram ; Medicines and Healthcare products Regulatory Agency, Sept Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.

Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.

For details see our conditions. The recommended adult dose of paracetamol is 1 gram, four times a day. Each tablet of paracetamol contains milligrams so this equates to two tablets four times a day with a maximum daily dose of 4 grams or eight tablets.

At least four to six hours should be left between doses. You should not take more than this recommended dose. Some overdoses are taken intentionally as an act of self-harm but many are accidental. Taking a few extra tablets each day over a number of days could push you into harmful toxic levels and result in liver damage and possibly death. If you have taken more than the recommended dose you should attend Accident and Emergency to be assessed as soon as possible.

Paracetamol is mainly cleared from the body by the liver. The liver can only cope with so much paracetamol at one time. A substance called glutathione is needed to neutralise the toxic break down components of paracetamol. If the glutathione runs out, then the toxic substances build up and damage liver cells.

An adult body can produce enough glutathione to safely clear 4 grams of paracetamol every 24 hours which is why it is the recommended dose. Taking more than this amount risks permanent and even fatal liver damage. There are other factors which determine how much paracetamol your body can safely deal with and these include:.

In these situations, the safe daily amount of paracetamol will be reduced, you may even be advised to avoid it altogether — check with your doctor. Any amount of paracetamol over the recommended dose could be classed as an overdose. Staggered overdoses, where people take more than the recommended dose over a period of hours or days can cause harm in the same way that sudden, large overdoses can. Sometimes people take a small amount over the recommended dose every day with no intention of harming themselves, just to help ease their pains.

This is called a therapeutic excess and can still be harmful. There may be no symptoms until liver damage is already established so the presentation to a doctor can be late and the condition irreversible. Paracetamol was first made available over the counter in the UK in Due to concern over the number of deaths from paracetamol overdoses, the Government placed restrictions on how much you could buy in one go. Reducing the amount to a maximum purchase of 8 grams 16 tablets made it harder to overdose.