The maximum dosage of painkillers that one can safely ingest has been debated back and forth many a time, even by the medical community itself. As with all the first aid articles on this website, this article is not designed to offer professional medical advice, nor should it be seen as a replacement for asking a professional medical practitioner your questions. Rather, it stands to present aggregated facts in a concise manner so that a very general understanding of what overdosing on common painkillers would look like versus how much would be, under most conditions, considered likely to be safe.
As a general rule, always follow the directions on the label – those are there for a reason! With that said, the recommended maximum dosage on pill bottles is usually extremely conservative, and with use over time our bodies do build up a resistance to painkillers. Always keep an eye out for negative side effects regardless of the dosage you take. Some individuals have extremely adverse reactions to what are generally considered “safe” chemical compounds, and as a result it’s best to ere on the side of caution, even with very common pain meds.
Mandatory disclosures aside, pain is very real; and as someone who has had to deal with a chest drain in for three days, as well as having had his flesh ripped off (nerves and all) amongst many other injuries, I must admit that feeling less pain is an absolutely enormous benefit of modern medicine. I’d be the very last person to be judgmental over a person doing what they to alleviate their pain, safely.
The following are general guidelines for using near maximum dosage when it comes to safely using pain killers for the average adult. This advice is for adults only; do not try using these dosages on children. If you’d like to learn more about maximum dosages when it comes to children, always consult a pediatrician directly, as there are many variables to account for when it comes to a child’s health.
Aspirin (Acetylsalicylic Acid)
Recommended: 1-3 g orally in divided doses.
Maximum: 6500 mg in divided doses (example; for Rheumatic Fever).
Possible side effects:
- Upset stomach
- Heartburn
- Drowsiness
- Headaches
Cease & seek immediate medical assistance if;
- You have a fever lasting longer than 3 days
- Experience severe nausea, vomiting, and/or stomach pain
- Have pain or swelling lasting longer than 10 days
- Experience tinnitus (ringing in ear) or other hearing problems
- Begin coughing or vomiting blood that resembles ground coffee in appearance
Advil (Ibuprofen)
Recommended: 400-800 mg orally every 6-8 hrs (a very conservative dose in my opinion).
Maximum: 3200 mg a day in four 800 mg doses (example; for a torn ligament).
Possible side effects (list is extremely long so this is pretty basic, check out this link for an exhaustive list):
- Abdominal pain
- Diarrhea
- Constipation
- Excessive flatulence
- Bloating
- Nausea
- Trouble breathing (shortness of breath, rattling breathing, etc.)
- Vomiting
Cease & seek immediate medical assistance if;
- You experience seizures
- Severe abdominal pain (cramping & burning sensation)
- Severe and continuing nausea
- Swollen and/or painful glands
- You begin to vomit blood
- Experience the symptoms of Jaundice (yellowing eyes or skin)
- Experience drowsiness to the point of coma
- Feel muscle tremors
- You begin to not breathe
- Have an irregular or slow heartbeat
- Experience excessive sweating
- Fainting
- Hallucinations
- Dizziness when getting up from lying position
- Develop bluish skin and/or lips
Tylenol (Acetaminophen)
Recommended: 325-650 mg every 4-6 hours
Maximum: 4000 mg maximum daily dose as long as you weigh more than 50 kg (risk of liver failure is still possible – consult a medical professional for recommendations). If you weigh under 50 kg, do not exceed 1000 mg.
Possible side effects:
- Diarrhea
- Loss or reduced appetite
- Increased sweating
- Nausea
- Stomach cramps and/or pain
- Tender upper abdomen or swelling to the stomach area
Cease & seek immediate medical assistance if;
- Unusual bleeding or bruising begins
- Symptoms of Jaundice (yellowing eyes or skin) appear
- You experience sores, ulcers, and/or white spots on lips or mouth
- You have black or bloody stool
- Red spots appear on your skin
- Skin rash, hives, or general irritation
- There is a decrease in your usual output of urine
- You begin feeling acute, sharp pain in your lower back or side
- You have a fever or sore throat after taking Tylenol
So that’s what we know in terms of maximum dosages and possible side effects. I would say that, in the short term, most circumstances would result in no long term effect just for going above the prescribed dosage of Advil, Tylenol, or Aspirin that’s written on the bottle.
Realistically, though, if you are under levels of pain that require excessive amounts of over the counter painkillers just to function, don’t be ashamed and go straight to your physician to discuss options that are better suited, both for pain management and for your body. Those over the counter pain meds may not be working for you as well as they should. It’s 2014, and in this day and age, no one should be living in pain; consult a healthcare professional and they should have some suggestions for a medical regimen that will be much more ideally suited for you.
If we’re talking pure SHTF scenario, however, and it’s impossible to visit a medical professional for advice, as stated, in most circumstances, it appears you can safely exceed the recommended dosage on the bottle. Just be careful not to ever exceed the maximum recommended dosages listed in this article, and you should, under most circumstances, be safe.
More First Aid Resources
When it comes to first aid, you need two important things to help you on your quest to keep yourself and those around you safe & healthy: knowledge and (to a lesser extent) supplies. To tackle the prior, take a look through our list of the top 22 emergency & survival first aid books and grab those that you think will best help you gain the knowledge you’ll need. For the latter, take a look at our Ultimate First Aid Supplies List to see if there’s anything you should be adding to your at-home first aid supplies stockpile, or if there’s something you’ve forgotten to add to one of your first aid kits.
Do you know how to tell if a cut is infected, whether to use Advil, Tylenol, or Aspirin, and how to quickly assess and address emergency situations? Did you know you can superglue cuts and that Imodium is an excellent tool for survival?
Have some time to kill? If you’d like, you can also quickly browse through all the first aid articles we have on this blog, to see if there’s anything valuable you’ve yet to learn on the topics we’ve written about.
Do you foresee any problem with taking daily 880 mg of Aleve for arthritic pain? (Two tabs morning and evening)
I appreciate the questions and answers in this community.
Ray
Hi Ray, sadly I cannot give my personal opinion these days as it puts me in a precarious position regarding liability. Aleve (Naproxin) is heavily used and consequently, there is plenty of detailed information regarding risks and how to spot potential issues- check out https://www.drugs.com/aleve.html and look at side-effects. All I can do is recommend you speak to your GP and work on a treatment plan that works for you, and your unique requirements.
Maximum allowed dosage is always very conservative because it has to be limited to a “one size fits all” approach. As we know, we are all different in terms of size and our ability to manage pain and symptoms. Something to think about.
Comments:
People repeatedly ask the same questions about medications, so I make the following personal observations:
Assume shtf. If you haven’t made that assumption, then pick up the telephone and talk to your doctor or pharmacist. If shtf, you are probably going to run out of pain medication fairly fast anyway.
Store your medicines in a cool place. If you have a small refrigerator (I do) and the garage space, you are covered.
The opium based pain medications will last indefinitely.
If your pain medications get “too old”, they simply become ineffective and should not adversely affect you.
Most dentists have shifted to ibuprofen because it is as effective as the other pain medications previously prescribed after dental work. 4 200 tablets = prescription strength. So save some money and buy over the counter.
Naprosin (and the generic equivalent) is a muscle relaxant as well as a pain medication.
If you are older, taking too much aspirin or daily small tablets may be too much – I was taken off the daily small tablet.
When there is extreme pain, even morphine does not work. Only tying the patient down (been there in a major metropolitan hospital) is the other alternative.
Becoming an addict concern addressed. Although each person is different, I observe this. If you are terminal or in horrendous pain, don’t worry about becoming addicted. Not all people become addicted. Having had some serious surgeries, most people will just stop taking the pain medications. And, there will be a few days as the body adjusts to the pain medication being withdrawn.
I also make the following comment. Once, I was assigned to a medical clinic with 4 doctors. They had no pain medication at the clinic. In fact, on that day, the clinic was out of liquid nitrogen (a substance used many times a day in a clinic). Don’t rely upon your doctor or your pharmacy to have what you need. Having an advance supply of appropriate medications is just a form of insurance and the money you spend is a premium. So, eventually, if the sun shines, you will throw out some super expired medications.
As usual BDC, your comment is informative and succinctly put. A great cautionary tale right there about expecting the clinic to have the meds on hand. 100% agree about a medicine stockpile being a glorified insurance policy. I dread the day essential med supplies become scarce and the reality of the situation sinks in with most people.
I have read a lot of first hand accounts of such a situation happening during the Balkan wars and its grim. The lengths people will go to, to protect themselves and their family is expected but what people will do to profit/take advantage of the situation is shocking and makes you question this “shared humanity” we are all supposed to have.
Thanks for dropping by as always BDC, thought provoking as always.
I think it would be unusual to find a doctors office that keeps narcotics on hand. Most of the larger medical groups no longer accept samples from drug companies to prevent any conflict of interest; perceived or real. I have not heard of medical supplies becoming scarce; although antibiotics are becoming ineffective due to overprescribing. This should scare everyone especially those against vaccine. I see the future where we no longer treat some infections, but prevent them through vaccines.
Would it be safe to take 650 mg of Tylenol at 4 pm, 400 mg of ibuprofen at 530 pm, and one tramadol at 8 pm?
Thats a complicated question that is heavily dependent on your current physical well being, liver function, size and weight etc. Without a full medical profile its hard to ascertain- thats why we have conservative recommended limits on the back of bottles- its to be on the side of caution.
An adult would be fine (as in, it won’t send you to hospital) taking such doses with no serious side effects as long as its not a habit. The issue with meds is that they build up in your body overtime.
For prolonged use I would advise against it without seeking confirmation from your GP who would be far more comfortable deciding what you can and can’t handle.
Long term use is what concerned me as well. Tramadol use to contain acetaminophen, and I read that taking it with Ibuprofen can have a boosting effect for pain relief. This regimen was prescribed by an MD, so I feel comfortable administering it. Thanks for your reply.
Thomas Xavier, thank you, thank you, and once again thank you so much for the wealth of such helpful information.
For the last 3 days I’ve been in so much abdominal muscle pain I’ve barely able to eat. I’ve been in so much pain at times I’ve become nauseated. For the pain I’ve been taking a total of 5000mg ibuprofen, 1500mg acetaminophen, 1300mg aspirin, and 880mg of naproxen sodium tablets a day. It has definitely helped me and I haven’t experienced any adverse reactions whatsoever. My doctor is aware and said that though it is a high dose, it is fine medically (I just need to be mindful stomach pain with taking the 5000mg ibuprofen a day for another 3 days until my appointment to see her in order to get a RX for something stronger (that is if the pain is still present in 3 more days) But I haven’t been able to speak with her since adding the other medications. So my question is, basically if it’s okay?
The current amounts and the mixing? [By the way I am a 30 year old male that weighs about 165lbs.]
For your weight, I personally see no problems but as per my usual disclaimer- I do not have all the facts concerning your health and medical history and as such I can’t say if its “safe”. Admittedly, no drug is truly safe. When it comes to medicating, its always going to be a compromise.
For short term usage, people have been prescribed much higher dosage with tolerable adverse effects- but please always record what you take (keep track) and see your Doc asap- your digestive tract is a sensitive organ and prolonged abuse without medical oversight could be devastating. Please be attentive to signs of nausea, vomiting or diarrhoea as well as muscle spams.
Really sorry about the late response, I for some reason did not get notified about this comment or I would have answered it ASAP. I assume everything went well?
Thank you for sharing your wisdom. I have ME/CFS and it is hard to manage pain. I also have Cervical Radiculopathy (pinched nerve in neck). The pain is near impossible to manage. It is the most intense pain I’ve known. I tend to take the label limit of acetaminophen and ibu.
Eek, I am so sorry for what you go through. With such pain, I would expect the doctors to prescribe something more hardcore!
I, too have a ruptured disc in the neck area which I have been told is inoperable. I see a pain doctor who prescribes Oxycontin 60 tabs at a time to take 2 a day. I sometimes go for 3 months without getting a new prescription but recently have had my 7th stress fracture (upper back). The pain was unrelenting and so severe I had to go to the DR. The Oxy sure does the job most of the time and I encourage you to find a pain doctor.
IBUPROFEN (Advil) is NOT KIDNEY-FRIENDLY!!! Be aware of the potential for (more) damage, and possible renal failure if you already have issues. Just felt that needed to be stressed, much as Tylenol is known for not being liver-friendly.
Well worth mentioning Gin! I sometimes wonder how many disclaimers I should add to each article but realize that if I went full tilt/over the top, 50% of the article would be warnings- hence my use for a single broad one at the beginning.
Very informative, thanks!
Good info. Normally I only have to deal with a sinus headache every few days. When it hits, or I feel it coming on I normally take four 200mg ibuprofen liquigels or tablets and that takes care of it.
I tweeted this for the people I talk to that have fibromyalgia. It is very good information. I’m wondering about use of these long term. I try my best not to take prescription pain medication. That said I’ve been taking a lot of ibuprofen and acetaminophen for the past 10 years. Not more than the recommended amount though. Or at least not often.
Thanks for the compliment Mylinda! For long term use you will need analysis from a medical practitioner- everyone responds slightly differently. I will say (anecdotal experience) my grandmother-in-law has been popping Tylenol more or less everyday for the past few years (to relieve knee pain) and it doesn’t seem to have had much of a negative effect – just maybe doesn’t help as much as it used to.
Great article. Unfortunately the abuse of prescription medication is making it very hard for people who have to be on it to be able to lead a productive life.
Very true Linda, pain and its management is a multi faceted problem that needs to be addressed with support both medically and socially. The fact that therapy is still taboo amongst our fighting men and women as a perceived “weakness” and the medicinal use of THC for chronic pain, especially for G.I disorders is deplorable and ultimately leads to substance abuse as a way of dealing with these issues.
I think its about time we as a society have an honest discourse regarding how we both view and treat pain & their sufferers..
This is an informative and great post. However, I would have liked more info regarding a SHTF situation, ie: effective/storage length, stockpiling, more or less stored together, etc.
Thanks for all the great info!
Be Well–The Lady Kay
Great suggestion Lady Kay! I will definitely write an article about effective storage of meds.
Be careful of all pain medication. Especially prescription meds they can lead to addiction that you don’t want to have to deal with coming off them. Always best to try and endure the pain as long as you can. You’ll be happy that you did.
I agree that a lot of people underestimate the addictive risk of prescription opiates, its clear that rx abuse is a serious problem that society needs to address just as much as the garbage on the street. Especially when it concerns the young as they might think just because its in pill form it becomes magically safer.
As always use your (and your doctor’s) best judgement, if your pain is intolerable (affects your life to the point of destructive behaviour) then seek pain management regimen. The worst thing anyone can do is let it deteriorate to the point of alienating everyone around you. I have know a few people in my life, one that stubbornly tried to tough out severe nerve damage of the spine and resisted opiates and in the process pushed their friends and family away from them through taking it out them.
Prescription meds should not be your first stop solution to everything but at the same time you shouldn’t feel any shame for seeking help.
Balance, like much in life, is the key.