(HealthDay News) — During cold/flu season (CFS) there is an increase in acetaminophen use and overdosing, according to a study published online March 7 in the British Journal of Clinical Pharmacology.

Saul Shiffman, PhD, from Pinney Associates in Pittsburgh, and colleagues estimated the prevalence of excess intake of acetaminophen as well as seasonal variations in acetaminophen intake using data from 14,481 US adults who used acetaminophen in the preceding 30 days between 2011 and 2016.

The researchers found that 6.3% of users exceeded 4 g (the recommended daily maximum) on at least one day; usage exceeded 4 g on 3.7% of usage days. Compared with off-season, cold/flu symptoms were more likely to be experienced and treated with acetaminophen in CFS. During CFS, acetaminophen users were more likely to exceed 4 g (6.5% vs 5.3%; odds ratio, 1.24); there was also an increase in days exceeding 4 g (3.9% vs 2.8%; odds ratio, 1.37). This was primarily due to an increase in use of over-the-counter (OTC) combination medications designed to treat upper respiratory cold/flu symptoms (33.2% vs 24.8% of usage days in CFS versus off-season; odds ratio, 1.6) and was not due to differences in characteristics of individuals using acetaminophen in CFS. There was no statistically significant seasonal variation in exceeding 4 g when such medications were omitted.

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“Acetaminophen use and overdosing increases in CFS, primarily due to increased use of OTC combinations treating upper respiratory cold/flu symptoms,” the authors write.

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The study was funded by Johnson & Johnson Consumer Inc., which markets Tylenol-brand acetaminophen medications.


Shiffman S, Battista DR, Kelly JP, Malone MK, Weinstein RB, Kaufman DW. Prevalence of exceeding maximum daily dose of acetaminophen, and seasonal variations in cold-flu season. Br J Clin Pharmacol. 2018 Mar 7. doi: 10.1111/bcp.13551