There may be no symptoms for the first day. A feeling of sickness (nausea) and being sick (vomiting) may occur a few hours after taking the overdose. After 24 hours there may be pain under the ribs on the right side (where the liver is) and there may be yellowing of the whites of the eyes and the skin (jaundice).
Taking 1 or 2 extra tablets is unlikely to harm you. Do not take more than 8 tablets in 24 hours. Taking too much paracetamol can be dangerous and you may need treatment. Too much paracetamol can cause liver damage.
Paracetamol is a common painkiller that is normally safe. If you take more than the recommended amount (an overdose), it can harm the liver, and occasionally the kidneys.
As for Paracetamol of 500mg per tablet, it is generally recommended to take no more than 8 tablets (500mg) within 24 hours, and 24 to 30 tablets taken at one time can lead to overdose or even death.
However, repeatedly taking more than the recommended dose or overdosing on paracetamol can cause serious injury to the liver and even death. The recommended maximum dose of paracetamol for an adult (or child over 12 years) is 4g in any 24-hour period (equivalent to 8 x 500mg tablets).
There may be no symptoms for the first day. A feeling of sickness (nausea) and being sick (vomiting) may occur a few hours after taking the overdose. After 24 hours there may be pain under the ribs on the right side (where the liver is) and there may be yellowing of the whites of the eyes and the skin (jaundice).
Taking more than five medications is called polypharmacy. The risk of harmful effects, drug interactions and hospitalizations increase when you take more medications.
Untreated paracetamol poisoning may cause varying degrees of liver injury over the 2 to 4 days following ingestion, including fulminant hepatic failure. Rarely, massive overdose may initially present with coma and severe metabolic acidosis.
Abdominal (stomach) pain, nausea, vomiting (sickness). Yellow discoloration of the skin or whites of the eyes (jaundice). Severe headache, confusion or drowsiness. Passing no urine at all for the past eight hours.
Based on the dose of paracetamol ingested (mg/kg body weight): Less than 150 mg/kg - unlikely. More than 250 mg/kg - likely. More than 12 g total - potentially fatal.
While paracetamol is safe in normal doses, it is hepatotoxic and potentially fatal in overdose. Fortunately, N-acetylcysteine (NAC) is a safe and effective antidote which if used correctly prevents serious hepatic injury after paracetamol overdose.
Talk to a doctor at once if you take too much of this medicine even if you feel well. This is because too much paracetamol can cause delayed, serious liver damage.
Serious toxicity may occur in patients who have ingested > 150 mg/kg in any 24 hour period. Rarely, toxicity may occur for ingestions between 75-150 mg/kg. Doses consistently < 75 mg/kg in any 24 hour period are unlikely to be toxic.
The recommended paracetamol dosing for adults and children 12 years and over is 500 to 1000mg every four to six hours as necessary, with a maximum of 4000mg in any 24 hour period.
Paracetamol poisoning, when associated with exceptionally high plasma concentrations, can give rise to coma and metabolic acidosis in the absence of hepatic failure or other drugs. Although unusual, other such presentations may not have been recognized because a toxicology screen was not performed.
Recent data shows that each year in Australia, paracetamol overdose leads to around nine people per million hospitalised with liver injury and two deaths per million – or about 50 Australian lives lost.
Histological and ultrastructure alterations were also recorded in the neurons of paracetamol-treated rats. In conclusion, we found that an overdose of paracetamol is neurotoxic. The observed alterations point to the possibilities of higher brain impairments which is of strong public health concern.
People might accidentally overdose because they are in pain, and believe because paracetamol is so widely available, it must be safe. They take more than the recommended dose, or take multiple different paracetamol-containing products together, resulting in harm.
The more meds you take, the higher the risk of harmful drug interactions. Having multiple meds in your system can cause them to work differently than they're supposed to—and may even make them less effective.
A person's condition can deteriorate rapidly during an overdose, so seeking emergency help is always recommended — even if they do not appear to be severely overdosing. If you or someone you know is using a specific drug, you should be familiar with the overdose symptoms of that drug.
Just a few paracetamol tablets over the recommended dose can potentially cause fatal liver damage, and there may be no symptoms until it is too late for treatment to help. There is an antidote for paracetamol poisoning and it is most effective within eight hours of the overdose, so getting help early is essential.
Children who have ingested more than 150 mg/kg of paracetamol in any 24-hour period are at risk of serious toxicity. Toxicity rarely occurs with paracetamol doses between 75–150 mg/kg in any 24-hour period.
Paracetamol, also known as acetaminophen, is a widely used anti-pyretic that has known liver toxicity once above therapeutic levels in the blood[4].