How much is too much over-the-counter pain medication?

In this Dec. 12, 2007 file photo, Tylenol drugs are shown in the drug department at Costco in Mountain View, Calif.
In this Dec. 12, 2007 file photo, Tylenol drugs are shown in the drug department at Costco in Mountain View, Calif. | Paul Sakuma

As you get older, it’s natural to develop aches and pains. But health experts say it’s important not to become reliant on pain killers like Tylenol or Ibuprofen to deal with your discomfort.

Overall, pain killers “shouldn’t be used for more than a few days in a row, and the specified maximum daily dose shouldn’t be exceeded,” according to a study from the National Library of Medicine.

The appropriate dosage depends on the type of pain relief medication you’re using, as well as on your existing conditions or current state.

Acetaminophen (Tylenol)

According to Medline Plus, Acetaminophen alleviates pain from “headaches, muscle aches, menstrual periods, colds and sore throats, toothaches, backaches, reactions to vaccinations and to reduce fever.” It’s also used for osteoarthritis pain relief.

Per Harvard Health, acetaminophen does not reduce inflammation like aspirin. But it also doesn’t irritate the stomach or intestinal lining like other common pain relievers.

How much you can safely take

These guidelines come from Harvard Health.

325 milligrams

500 milligrams

650 milligrams extended release

Number of pills

1 or 2

1 or 2

1 or 2

Frequency

Every 4 to 6 hours

Every 4 to 6 hours

Every 8 hours

Safest maximum dose for adults weighing 150 pounds

8 pills

6 pills

4 pills

Do not take more than this in a 24-hour period

12 pills (3900 milligrams)

8 pills (4000 milligrams)

6 pills (3900 milligrams)

Symptoms of Acetaminophen poisoning

Per Merck Manual, overdose develops in four stages. (Organ functioning can be determined using blood tests.)

  1. After a few hours of overdosing: The individual may vomit or have no symptoms.

  2. After one to three days: Individual suffers from nausea, vomiting, abdominal pain and poor liver functioning.

  3. After three to four days: Vomiting, poor liver functioning, jaundice and bleeding occurs. If severe, the individual might have pancreatitis and the beginning of kidney failure.

  4. After five days: Recovery or death if the liver and other organs fail.

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs treat pain, fever and inflammation. Common NSAIDS include aspirin, naproxen sodium (Aleve) and ibuprofen (Advil, Motrin), per the National Library of Medicine.

NSAIDs can lead to unwanted side effects such as dizziness, high blood pressure and stomach irritation, according to Better Health.

How much you can safely take

This information comes from Get Relief Responsibly.

Ibuprofen (200 milligrams per pill)

  • Dose and frequency: one pill every four to six hours.

  • Daily limit: 10 pills in 24 hours or 1,200 milligrams.

Naproxen sodium (220 milligrams per pill)

  • Dose and frequency: one pill every eight to 12 hours

  • Daily limit: two pills in an eight to 12 hour period and three pills in 24 hours. Stay under 660 milligrams.

Aspirin regular strength (325 milligrams per pill)

  • Dose and frequency: one or two pills every four hours and three pills every six hours.

  • Daily limit: 12 pills in 24 hours. No more than 4,000 milligrams.

Aspirin extra strength (500 milligrams per pill)

  • Dose and frequency: one or two pills every four to six hours.

  • Daily limit: Eight pills in 24 hours. No more than 4,000 milligrams.

Symptoms of NSAIDs poisoning

According to a study published in the National Library of Medicine, signs and symptoms of NSAIDs overdose include:

  • Nausea.

  • Vomiting.

  • Headache.

  • Drowsiness.

  • Blurred vision.

  • Dizziness.

  • Possible seizure if taking mefenamic acid.

What to do in the event of overdose?

According to the National Institute on Drug Abuse, you should seek immediate medical assistance by calling 911 if you or someone you know seems to have overdosed. If the individual has stopped breathing or their breathing is weak, CPR should be initiated.

If you or someone you care about is struggling with mental health challenges or experiencing thoughts of suicide, you can each out to the Suicide and Crisis Lifeline at 988 or seek assistance from a medical professional.

What can affect pain reliever safety?

Different conditions can affect how much or what type of pain medication you should use. Consider talking to your doctor if you have, do or worry about any of the following, per WebMD:

  • Age and weight: The less you weigh, the less you should take. Typically, children and teens should not take aspirin. Read the bottle label to learn more.

  • Alcohol use: Do not drink near or around the time during use. Read the label for specifics.

  • Stomachs: The more NSAIDs you take, the more irritation in your gut and stomach occur. Take a low dose with food if you are worried.

  • High blood pressure: Some medications raise blood pressure. Acetaminophen might be best.

  • Kidney disease or similar problems: Kidney damage may occur with NSAIDs.

  • Liver problems: Avoid NSAIDs and take acetaminophen in small doses.

  • Pregnancy: NSAIDs are not recommended.

  • Other medications you are taking: Some drug interactions are life threatening. Tell your doctor what other supplements and medications you are taking.

Over-the-counter pain medications can be addictive. Find help in your local area or call the SAMHSA National Helpline at 1-800-662-4357.