How many tablets does it take to overdose on paracetamol?
The recommended adult single dose of paracetamol is two standard 500 mg tablets. Research shows that the common threshold for liver damage to occur from a single paracetamol overdose is 15 gms (30 tablets) although standard hospital guidelines allow an extra safety margin and assume liver damage could occur at a single overdose of 24 standard tablets or 150 mg/kg body weight, whichever is the smaller. The overdose threshold may be lowered in a person taking certain prescription medicines, or a person who is an alcoholic or is seriously undernourished. If the overdose is spread over a period of time the threshold may be higher, as the initial paracetamol dose is effectively metabolised. (The recommended maximum dose in a 24 hour period is 4g or 8 tablets). There are often no symptoms in the first 24 hours following overdose, although there may be mild nausea and vomiting. In a large overdose liver function deteriorates leading to jaundice, confusion, and loss of consciousness. Death is