Overuse of Acetaminophen More Common During Flu Season

MARCH 15, 2018
Kristen Coppock, MA, Editor
Acetaminophen overuse becomes much more common in the United States during cold and flu season, according to a recently published study.

Research results published in the British Journal of Clinical Pharmacology indicate 6.3% of all acetaminophen users exceeded the maximum recommended daily dose of 4 grams at least once during a week that the drug was administered, with 1.2% of users more than doubling the recommended amount.1 

Acetaminophen users were more likely to exceed 4 grams daily during cold and flu season than in the off-season (6.5% vs. 2.8%; OR= 1.24, 1.04-1.48).1

Researchers noted that the likely reason for the increase in overdosing during cold and flu season was due to an overall increase in use of OTC combination medications for treating upper respiratory cold/flu symptoms as well as pain and fever. When OTC combination medications were omitted, the study data revealed no significant seasonal variation in participants exceeding the recommended dose. According to the researchers, their findings suggest a need for consumer education about the proper use of acetaminophen medications, which includes adherence to recommended dosage. They suggested that pharmacists instruct users to follow dosing directions indicated on medication labels.

Sponsored by Johnson & Johnson Consumer Inc., the study included 18,689 volunteers who completed diary entries for 7 days and an exit survey, of which 14,481 used acetaminophen during the period. The participants were not told the researchers were studying acetaminophen, but rather were instructed to identify all medications used from a list of 423 products during a 7-day period. Responses indicated 14,481 participants used acetaminophen with 122,854 dosing occasions on 59,220 days. Of those who used acetaminophen, 55.2% (7,991) reported dosing on 4 or more days during the study.1

The median age of study participants was 44 and 61% were female. Participants also reflected a pool that was 24% non-white, had 46% with a reported income below $50,000, and had 82% with an education beyond high school.1


Shiffman S, Battista D, Kelly J, Malone M, Weinstein R, Kaufman D. Prevalence of exceeding maximum daily dose of acetaminophen, and seasonal variations of cold-flu season. Br J Clin Pharmacol. 2018. doi: 10.1111/bcp.13551.