How Much Paracetamol Is Safe in a Day?

Paracetamol is the pain medicine most people take for joint pain, and it is safe when used properly. The problem is that it is easy to take too much without knowing, because it is hidden inside many other medicines. Here is how to stay within safe limits.

The daily limit

For a healthy adult, the maximum is 4,000 mg per day from all sources. That means everything you take in 24 hours added together, not just one type of tablet.

Taking more than this can damage the liver. That is the main risk, and it is a serious one. Paracetamol overdose is one of the most common causes of sudden liver failure.

The safest approach is to take the lowest dose that controls your pain, and treat 4,000 mg as a ceiling you stay under, not a target.

Know how many milligrams are in your tablet

This is where most people go wrong. Paracetamol tablets come in different strengths, and the box does not always make it obvious.

Common strengths are 325 mg, 500 mg and 650 mg. In India the 650 mg tablet is very common. Many people take it without noticing that it is stronger than the 500 mg one.

Here is what the daily limit looks like in tablets.

Six tablets of 650 mg is 3,900 mg. That is almost the whole daily limit, and it is not a lot of tablets. Be extra careful with the 500 mg and 650 mg strengths.

The hidden paracetamol problem

This is the part people miss most often.

Paracetamol is not only sold on its own. It is mixed into many other medicines, especially cold and flu tablets, fever medicines, and some combination painkillers. You can take your usual paracetamol for your knee, then take a cold tablet in the evening, and go over the limit without realising it.

Before you take anything new, read the ingredients on the box. Look for the word paracetamol or acetaminophen. Both names mean the same medicine. Acetaminophen is the name used in the United States.

If you cannot tell, ask the pharmacist. Show them everything you are already taking.

Alcohol and paracetamol

Alcohol and paracetamol are both processed by the liver. Together they put more strain on it.

If you are taking paracetamol, men should stay under two standard drinks a day and women under one. If you drink more than that regularly, tell your doctor before taking paracetamol for any length of time.

If you drink heavily, the safe paracetamol dose for you is lower than 4,000 mg. Do not work it out yourself. Ask your doctor.

Simple rules to stay safe

• Check the strength on the box. 325, 500 or 650 mg makes a big difference.
• Add up everything you take in 24 hours, including cold and flu medicines.
• Leave at least 4 to 6 hours between doses.
• Take the lowest dose that works, not the highest you are allowed.
• Do not take two different paracetamol products at the same time.
• Keep to the alcohol limits above.
• Never take a double dose to catch up on a missed one.

If you take it every day for joint pain

Many people with knee or hip arthritis take paracetamol daily for months or years. That is common, and for a lot of people it is reasonable. But it should be a decision your doctor knows about, not something that just carries on.

Talk to your doctor if any of these apply to you.

• You have been taking it daily for more than a couple of weeks.
• You need it more often than you used to, or it is working less well.
• You have liver problems, or you drink alcohol regularly.
• You are underweight, or over 65.
• You take other regular medicines, including anything for epilepsy or tuberculosis.
• You are also taking a second painkiller such as an anti inflammatory.

If pain relief is needed every single day just to get through normal activity, that is worth looking into. The medicine is treating the symptom. Something is causing it. Read more about knee treatment options and hip treatment options.

Warning signs of liver trouble

Liver damage from paracetamol often has no symptoms at first. That is what makes it dangerous. Signs can appear a day or two after taking too much.

• Feeling sick or vomiting that does not settle.
• Pain in the upper right side of the stomach.
• Loss of appetite.
• Yellow colour in the eyes or skin.
• Dark urine.
• Feeling confused or very sleepy.

If you think you have taken too much paracetamol, go to a hospital straight away. Do not wait to feel unwell. Treatment works much better when it is given early, and waiting for symptoms wastes the time when it would help most. Take the boxes with you so the doctor can see exactly what was taken.

Frequently asked questions

How much paracetamol can I take in one day?

For a healthy adult the maximum is 4,000 mg in 24 hours, counting every source. That is about six 650 mg tablets or eight 500 mg tablets. Take the lowest dose that controls your pain rather than aiming for the maximum. If you have liver problems, drink alcohol regularly, are over 65 or are underweight, your safe limit is lower, so ask your doctor.

Is Dolo 650 the same as paracetamol?

Yes. Dolo 650 is a brand of paracetamol, and each tablet contains 650 mg. Crocin and several other brands are also paracetamol. Because they are the same medicine, taking two different brands together adds up and can take you over the limit.

What is the difference between paracetamol and acetaminophen?

They are the same medicine with two names. Paracetamol is the name used in India, the United Kingdom and most of the world. Acetaminophen is the name used in the United States. If a box lists either one, it counts towards your daily total.

Can I take paracetamol every day for arthritis pain?

Many people do, and for some it is a reasonable long term option. It should still be reviewed by a doctor rather than continuing indefinitely on its own. If you need it every day just to manage normal walking or sleeping, the underlying joint problem is worth assessing.

Can I drink alcohol while taking paracetamol?

In small amounts, usually yes. Men should stay under two standard drinks a day and women under one while taking paracetamol. If you drink more than that regularly, speak to your doctor first, because your safe dose is lower.

Can I take paracetamol with an anti inflammatory painkiller?

Sometimes doctors do prescribe both together, but you should not combine them on your own. Anti inflammatory medicines carry their own risks for the stomach and kidneys. Ask your doctor which combination is right for you and for how long.

In short

Paracetamol is a safe and useful medicine when it is taken properly. Check the strength on the box, add up everything you take in a day, remember that cold and flu medicines often contain it too, and stay well under 4,000 mg.

If you are taking it every day for knee or hip pain, it is worth finding out what is causing the pain. Call +91 6355 991 466 to arrange an assessment.

Trusted sources and further reading

This article is general information reviewed by Dr Dev Padia. For more on the conditions and treatments mentioned, see the pages below.

• Knee treatment options — when pain relief is not enough.
• Insurance and payment — how treatment is covered.
• NHS: Paracetamol for adults — dosage and safety.
• MedlinePlus: Acetaminophen — US National Library of Medicine.

The information on this website is for general guidance and does not replace a personal medical consultation. Please consult a qualified doctor about your own symptoms.