What is the recommended dose of Tylenol (acetaminophen) for headache relief?

Tylenol Dosing for Headache

For headache relief, the recommended dose of Tylenol (acetaminophen) is 1000 mg (two 500 mg tablets or three 325 mg tablets) every 6 hours as needed, not exceeding 3000-4000 mg per day. 1, 2

Dosing Guidelines

• Standard adult dose: 1000 mg per dose
• Frequency: Every 6 hours as needed
• Maximum daily dose:
  • 3000 mg according to recent voluntary manufacturer changes 3
  • 4000 mg according to traditional FDA guidelines 1, 3

Effectiveness for Different Headache Types

For Tension Headaches

• Acetaminophen 1000 mg is effective for acute tension-type headaches 4
• For moderate to severe tension headaches, 1000 mg provides better relief than 500-650 mg doses 4

For Migraine Headaches

• Acetaminophen 1000 mg alone can be effective for mild to moderate migraines 5
• For moderate to severe migraines, acetaminophen may be combined with an NSAID or a triptan for better efficacy 2
• The number needed to treat (NNT) for pain-free at 2 hours is 12, and for headache relief at 1-2 hours is approximately 5 5

Treatment Algorithm

1. For mild headache:

   • Start with acetaminophen 1000 mg
   • Alternative: NSAID (ibuprofen 400-800 mg or naproxen sodium 275-550 mg) 1, 2

2. For moderate to severe headache or inadequate response to acetaminophen alone:

   • Consider adding an NSAID if not contraindicated 1, 2
   • For migraines, consider adding a triptan if first-line treatment is inadequate 1, 2

3. For headache with significant nausea/vomiting:

   • Consider adding an antiemetic like metoclopramide 10 mg 1, 5

Important Considerations

• Timing: Take at the onset of headache for best results 2
• Safety: Acetaminophen has a favorable safety profile compared to NSAIDs, with similar adverse event rates to placebo 5, 4
• Medication overuse: Avoid using acetaminophen for headaches more than 15 days per month to prevent medication overuse headache 2
• Liver concerns: Use with caution in patients with liver disease or alcohol use 1

When to Consider Alternative Treatments

• If acetaminophen alone fails to provide adequate relief after 2-3 headache episodes
• For severe migraines, combination therapy with NSAIDs or triptans may be more effective 1, 2
• For recurrent or frequent headaches, preventive therapy should be considered 2

Remember that acetaminophen 1000 mg is as effective as aspirin 650 mg for tension headaches, with potentially fewer gastrointestinal side effects 6.