Tylenol Extra Strength dosage, forms, and strengths

Tylenol Extra Strength is a brand-name over-the-counter pain reliever and fever reducer. The active ingredient, acetaminophen, works by blocking pain signals in the nervous system and reduces fever by affecting the brain’s regulation of body temperature. However, Tylenol Extra Strength only relieves symptoms. It does not treat or cure any underlying medical condition causing these symptoms. 

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Tylenol Extra Strength dosage, forms, and strengths

Tylenol Extra Strength products come in single doses of 500 milligrams (mg) per tablet, caplet, or powder pack. 

Tylenol Extra Strength dosage for adults

• Standard dosage for adults and children 12 years and older: Two tablets, caplets, or powders (1,000 mg) taken every six hours

• Maximum dosage for adults: Six tablets, caplets, or powders (3,000 mg) every 24 hours

Tylenol Extra Strength dosage for aches and pain

For adults and adolescents 12 years or older, Tylenol Extra Strength is used as an analgesic to temporarily relieve minor aches and pain caused by the common cold, headache, backache, arthritis, toothache, muscle aches, or premenstrual/menstrual cramps. If aches and pains get worse or last longer than 10 days, discontinue the use of Tylenol Extra Strength and consult a healthcare professional.

• Adults and adolescents (12 years and older): Two tablets, caplets, or powders (1,000 mg) taken every six hours

• Renally impaired patients—dose frequency adjustment: 

  • Creatinine clearance of 10-50 ml/min: One to two tablets, caplets, or powders (500–1,000 mg) taken every six to eight hours

  • Creatinine clearance less than 10 ml/min: One to two tablets, caplets, or powders (500–1,000 mg) taken every eight hours

  • Dialysis patients: One to two tablets, caplets, or powders (500–1,000 mg) taken every eight hours, no supplement

• Hepatically impaired patients—dosage decrease adjustment: Consider decreasing the dose

Tylenol Extra Strength dosage for fever

For adults and adolescents 12 years or older, Tylenol Extra Strength can be used to reduce fever. If, however, the fever rises above 103˚ or lasts for longer than three days, discontinue the use of Tylenol Extra Strength and talk to a healthcare provider.

• Adults and adolescents (12 years and older): Two tablets, caplets, or powders (1,000 mg) taken every six hours

• Renally impaired patients—dose frequency adjustment: 

  • Creatinine clearance of 10-50 ml/min: One to two tablets, caplets, or powders (500–1,000 mg) taken every six to eight hours

  • Creatinine clearance less than 10 ml/min: One to two tablets, caplets, or powders (500–1,000 mg) taken every eight hours

  • Dialysis patients: One to two tablets, caplets, or powders (500–1,000 mg) taken every eight hours, no supplement

• Hepatically impaired patients—dosage decrease adjustment: Consider decreasing the dose

Tylenol Extra Strength dosage for children

Tylenol Extra Strength should not be given to children younger than 12 years of age. Instead, parents can turn to Tylenol products specifically formulated to provide doses appropriate for younger children. Tylenol Regular Strength can be given to children as young as 6 years of age. Younger children, infants, and newborns should be given lower-dose products such as Children’s Tylenol and Infants’ Tylenol. These products are available as easily administered oral suspensions that allow for more precise dosing based on a child’s weight.

Tylenol Extra Strength dosage for pets

Veterinarians only very rarely prescribe acetaminophen to pets because of its toxicity. Even a small dose can poison some animals. If a pet or animal is in pain or has a fever, veterinarians typically prescribe other medications more suitable for animals such as NSAIDs, gabapentin, or opioids. Do not give an animal Tylenol Extra Strength for any reason except under the direction of a veterinarian. Pets that accidentally consume Tylenol will require emergency veterinary treatment.

How to take Tylenol Extra Strength

Tylenol Extra Strength is taken by mouth as a caplet, tablet, or dissolving powder.

• Read the instructions and warnings printed on the package or package insert.

• Do not take more than instructed.

• Tylenol can be taken with food or on an empty stomach.

Tablets or caplets

• Take two tablets or caplets with a full glass of water every six hours while symptoms last.

Powders

• Take two powders every six hours while symptoms last.

• Tear or cut open the powder packet and pour the powder directly on the tongue.

Tylenol Extra Strength dosage FAQs

Tylenol Extra Strength vs. Tylenol 8 HR: What’s the difference in doses?

Tylenol Extra Strength contains a high dose (500 mg) of immediate-release acetaminophen. Tylenol 8 HR, primarily intended for the relief of muscle aches or arthritis pain, contains a higher dose (650 mg) of acetaminophen in an extended-release format. People taking Tylenol 8 HR will take two caplets every eight hours as opposed to two caplets, tablets, or powders taken every six hours for Tylenol Extra Strength. However, the maximum daily dose for both Tylenol Extra Strength and Tylenol 8 HR is six tablets or caplets.

How long does it take Tylenol Extra Strength to work?

It takes Tylenol Extra Strength caplets or tablets about 45 minutes to start working. Pain relief and fever reduction peak in about 90 minutes. Tylenol Extra Strength dissolving tablets, however, typically start working about 20 minutes after taking a dose. 

Although Tylenol Extra Strength can be taken with or without food, some foods will interfere with the body’s ability to absorb the drug, making it less effective at pain relief or fever reduction. In particular, avoid eating cruciferous vegetables, such as broccoli, cabbage, Brussel’s sprouts, and cauliflower, when taking a dose of Tylenol Extra Strength. 

How long does Tylenol Extra Strength stay in your system?

Taken as directed, Tylenol Extra Strength should relieve pain and fever for about four to six hours. With a half-life of two to four hours, the levels of Tylenol Extra Strength in the blood are nearly undetectable in about eight hours. 

What happens if I miss a dose of Tylenol Extra Strength?

As a symptom medication, any missed dose of Tylenol Extra Strength can be taken when remembered, provided symptoms are still present. However, always make sure that at least six hours go by between doses. If you take a missed dose, don’t take the next dose until six hours after the missed dose was taken. Never take a larger dose of Extra Strength Tylenol to make up for a missed dose.

How long can you take Tylenol Extra Strength?

Tylenol Extra Strength should not be taken for longer than 10 days for pain relief or longer than three days for reducing fever. If aches, pains, or fever do not resolve in that time, talk to a doctor or other healthcare professional rather than continuing to take acetaminophen.

How do I stop taking Tylenol Extra Strength?

Taken at the recommended dose for the recommended number of days, Extra Strength Tylenol can be stopped at any time. 

For all adults, Tylenol Extra Strength should not be taken continuously for more than 10 days straight unless directed by a doctor. If the fever lasts more than three days or gets worse, it’s also time to discontinue the medication and get medical help. Any allergic skin reaction, such as redness, blisters, or swelling, is also a warning to stop taking the medicine and get medical help.

If you stop taking Tylenol Extra Strength and are still experiencing symptoms, other drugs that can help relieve pain and reduce fever include NSAIDs such as aspirin, Motrin (ibuprofen), Advil (ibuprofen), or Aleve (naproxen).

What is the maximum dosage for Tylenol Extra Strength?

McNeil Consumer Healthcare, the manufacturer of Tylenol, has set the maximum dosage of Tylenol Extra Strength at 3,000 mg of acetaminophen per day, or six caplets, tablets, or powders per day. This is lower than the FDA’s maximum dose of 4,000 mg of acetaminophen per day. This is because acetaminophen is a common ingredient in over-the-counter cold, flu, and allergy remedies, so there’s a risk that combining other OTC medications with Tylenol Extra Strength could accidentally result in an acetaminophen overdose. Doses of 4,000 mg per day should only be taken under the direction of a physician or other healthcare professional.

Can you overdose on Tylenol Extra Strength?

Acetaminophen overdose is one of the leading causes of drug poisoning in the United States. When the body breaks down acetaminophen, some of it is converted into poison. An overdose of acetaminophen can seriously damage the liver and even prove lethal.

While some people overdose on acetaminophen by taking too many pills, acetaminophen overdose is commonly due to combining drugs like Tylenol Extra Strength with other OTC drugs containing acetaminophen. Cold, flu, allergy, and other commonly purchased over-the-counter medications often contain acetaminophen as one of the ingredients.

What interacts with Tylenol Extra Strength?

Certain drug interactions with Tylenol Extra Strength can cause problems. In particular, don’t combine acetaminophen with topical anesthetics containing lidocaine or benzocaine. It’s also a good idea to avoid drinking alcohol regularly while taking acetaminophen. Regular alcohol use may increase the toxicity of acetaminophen by speeding up the body’s breakdown of acetaminophen and possibly poisoning the liver. Like alcohol, some prescription drugs may also speed up the body’s metabolism of acetaminophen, increasing the risk of liver damage. A doctor or other healthcare professional will know these drugs and can provide medical advice about taking them with Tylenol Extra Strength. Finally, people taking warfarin, a blood thinner, should avoid Tylenol Extra Strength. The combination increases the risk of bleeding problems.

Above all else, anyone taking Tylenol Extra Strength should be extra careful not to take other drugs containing acetaminophen. It's a common ingredient in many over-the-counter combination drugs for flu, cold, or allergies, as well as some prescription drugs. Acetaminophen poisoning is usually caused by unknowingly taking more than one medicine containing acetaminophen, so check the ingredient lists carefully before taking other medications.  

Resources:

• Acetaminophen compound summary

• Acetaminophen patient guide

• Acetaminophen

• Tylenol Extra Strength

• Tylenol products

• Tylenol for Healthcare Professionals