What is the maximum recommended dose of Tylenol (acetaminophen) for adults?

Maximum Recommended Dose of Tylenol (Acetaminophen) for Adults

The maximum recommended daily dose of acetaminophen (Tylenol) for adults is 4000 mg (4 grams) per day, with a maximum single dose of 1000 mg (1 gram). 1, 2

Standard Dosing Guidelines

• The maximum single dose of acetaminophen for adults is 1000 mg (1 gram) 1
• The maximum daily dose should not exceed 4000 mg (4 grams) in a 24-hour period 1, 3
• Typical dosing is 650-1000 mg every 4-6 hours as needed 3
• For extended-release or arthritis formulations, dosing is typically 1300 mg (two 650 mg tablets) every 8 hours, not exceeding 3900 mg daily 2

Special Population Considerations

• For elderly patients (≥60 years), the maximum daily dose should be reduced to 3000 mg or less per day to minimize risk of hepatotoxicity 4
• Patients with hepatic impairment should use lower doses and extend dosing intervals 4
• Patients with renal impairment may require dose adjustments, though acetaminophen is generally preferred over NSAIDs in this population 4

Safety Warnings

• Exceeding the maximum recommended dose can lead to severe hepatotoxicity, liver failure, and potentially death 2
• Liver damage may occur if you take:
  • More than the maximum daily amount (4000 mg) 2
  • Acetaminophen with other drugs containing acetaminophen 2
  • 3 or more alcoholic drinks everyday while using this product 2

Avoiding Accidental Overdose

• Be vigilant about the total acetaminophen intake, especially when using combination products containing acetaminophen 4
• The FDA has limited acetaminophen content in prescription combination products to 325 mg per dosage unit to reduce the risk of liver injury 1, 5
• Up to half of acetaminophen overdoses are unintentional, largely related to opioid-acetaminophen combinations and attempts to achieve better symptom relief 6

Recent Dosing Changes

• Some manufacturers have voluntarily reduced their recommended maximum daily dose to 3000-3250 mg, though the FDA-approved maximum remains 4000 mg 7
• The FDA has considered (but not mandated) reducing the maximum daily dose from 4000 mg to 3250 mg 5

Warning Signs of Toxicity

• Early signs of acetaminophen toxicity include nausea, vomiting, and abdominal pain 1
• Severe skin reactions (reddening, blisters, rash) may indicate an allergic reaction and require immediate medical attention 2
• Elevated liver enzymes (AST/ALT) may indicate developing hepatotoxicity 1

While some manufacturers have voluntarily lowered their recommended maximum daily dose, the FDA-approved maximum daily dose remains 4000 mg (4 grams) for adults, with appropriate adjustments for special populations such as the elderly or those with liver impairment.