We assume most of the painkillers and cold medications we stock in our medicine cabinets are safe and effective for us and for our kids. But public health officials are urging caution around one of the most common: the pain and fever medication acetaminophen, also known by brand names such as Tylenol and Tempra.

The main worry? Accidental overdosing. Because so many prescription and over-the-counter products contain acetaminophen—from headache tablets to cold meds and cough syrups— it’s easy to surpass the daily maximum dose if you use more than one product. And that’s bad news, especially for liver health. 

According to Health Canada, acetaminophen is the leading cause of serious liver injury in Canada. “Of the more than 250 cases of serious liver injury each year in Canada involving acetaminophen, over half involved accidental overdose,” reads a July press release.

Of particular concern is an overdose in children. Toronto’s Sick Kids Hospital, for instance, helps parents stay informed on the topic and reminds them to double-check measurements and not to give two doses of acetaminophen if one is missed.

While Health Canada added stronger warning requirements for the painkiller in 2009, they plan to go further in the future, possibly asking manufacturers to add a drug facts table on the product that will provide safety information. They'll also be asking for plainer language on labels, so that consumers can more easily identify products that contain acetaminophen and understand the liver risks.

Some options Health Canada is examining:

• Decreasing the maximum recommended daily dose of acetaminophen (which is currently four grams per day)
• Decreasing the unit dose for some products
• Requiring all children's products be supplied with a dosing device such as a syringe or cup to prevent the risk of dosing errors

Update your acetaminophen routine
In the meantime, if you use acetaminophen on a regular basis, here’s how Health Canada recommends staying safe:

• Always read the product label and follow the instructions. Know if the product contains acetaminophen, the amount to take, how frequently to take it, and when to stop. Never exceed the maximum daily dose.
• Avoid taking more than one acetaminophen product at a time. The drug is in many products, and you could accidentally take too much if you're using more than one medication at the same time.
• Talk to a health professional if you have any questions about acetaminophen.
• Talk to a health professional before taking acetaminophen if you have risk factors that increase your risk of liver damage, such as liver disease or drinking alcohol regularly, as the amount of acetaminophen you can safely take may be less than what is recommended on the label.

Read on for nine ways to get rid of a migraine and how your pain medication may alter your mood, too.