Tylenol (acetaminophen) is a popular painkilling medication that can cause life-threatening liver damage or liver failure. The first Tylenol overdose symptoms are typically nausea, vomiting, and abdominal pain. If you or someone you know has taken too much Tylenol, it is essential to seek medical attention immediately.

Tylenol and Liver Toxicity

The primary side effect of Tylenol (acetaminophen) overdose is liver damage. Following an overdose, the liver is incapable of metabolizing the drug and cells in the liver are destroyed. The symptoms of a Tylenol overdose vary depending on how much medication was ingested. Mild overdoses can cause liver damage without producing symptoms. Severe overdoses can cause acute liver failure, coma, and death within 48 hours.

Phase I (0-24 Hours): Symptoms of Tylenol Overdose

The first symptoms of a Tylenol overdose begin shortly after the drug is ingested and they last for 12 to 24 hours. Symptoms include:

  • Stomach or abdominal pain
  • Nausea, vomiting
  • Sweating
  • Loss of appetite
  • Pale color

Phase II (18-48 Hours): Symptoms of Tylenol Overdose

After Tylenol overdose, symptoms may resolve and the patient may feel better. This is actually the period when liver damage occurs. At approximately 12 hours after the overdose, blood tests may reveal elevated liver enzyme levels. This indicates that cells in the liver have been damaged. Symptoms include:

  • Abdominal pain (upper-right hand side)
  • Blood tests show rising levels of liver enzymes, bilirubin, and more
  • Liver becomes swollen and tender

Phase III (3-5 Days): Symptoms of Tylenol Overdose

In rare cases, patients who accidentally overdose on Tylenol develop severe liver damage and necrosis (tissue death). If liver failure occurs, the only treatment is an organ transplant. Symptoms include:

  • Loss of appetite
  • Nausea
  • Malaise (generally feeling unwell)
  • Abdominal pain
  • Jaundice (yellowing of the skin or whites of the eyes)
  • Blood clotting problems
  • Bleeding
  • Confusion
  • Low blood-sugar
  • Cerebral edema (fluid in the brain)
  • Kidney damage
  • Heart failure (cardiomyopathy)
  • Death


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