What are the dangers of accidentally taking too much Tylenol PM. How to recognize acetaminophen overdose symptoms. When to seek immediate medical care for Tylenol poisoning. What treatment options are available for acetaminophen toxicity.

Understanding Acetaminophen and Its Prevalence in Medications

Acetaminophen, also known as paracetamol, is an incredibly common over-the-counter medication found in countless households. It’s the active ingredient in Tylenol and is present in numerous other medications, both prescription and non-prescription. While generally safe and effective when used as directed, acetaminophen can pose serious health risks if taken in excessive amounts.

Why is acetaminophen so ubiquitous? Its effectiveness in treating pain and reducing fever makes it a go-to choice for many common ailments. However, this widespread use also increases the risk of accidental overdose, especially when people are unaware of its presence in multiple medications they may be taking concurrently.

Common Medications Containing Acetaminophen

• Tylenol (various formulations)
• Actifed
• Alka-Seltzer Plus
• Benadryl (some formulations)
• Excedrin
• Nyquil and Dayquil
• Percocet
• Vicodin

Do you know the maximum recommended daily dose of acetaminophen? Unless otherwise directed by a healthcare provider, adults should not exceed 3 grams (3000 mg) in a 24-hour period. Exceeding this limit significantly increases the risk of liver damage and other serious complications.

The Dangers of Acetaminophen Overdose

While acetaminophen is safe when used as directed, taking too much can lead to severe health consequences. The primary concern with acetaminophen overdose is its potential to cause serious, even life-threatening liver damage. In severe cases, this damage may necessitate a liver transplant to save the patient’s life.

Why does acetaminophen affect the liver so dramatically? The liver is responsible for metabolizing acetaminophen. When taken in excessive amounts, it can overwhelm the liver’s normal functioning, leading to the accumulation of toxic byproducts that damage liver cells.

Factors Increasing Risk of Liver Damage

• Pre-existing liver conditions
• Chronic alcohol consumption
• Concurrent use of other medications that affect liver function
• Malnutrition

Can long-term use of acetaminophen in recommended doses harm the liver? According to current research, using acetaminophen as directed over extended periods has not been shown to cause liver damage in healthy individuals. However, those with liver conditions or who regularly consume alcohol should consult their healthcare provider before using acetaminophen-containing products.

Recognizing the Symptoms of Acetaminophen Poisoning

One of the most challenging aspects of acetaminophen overdose is that symptoms may not appear immediately. In fact, a person may remain symptom-free for up to 24 hours after taking a toxic dose. This delay can lead to a false sense of security and potentially postpone crucial treatment.

When symptoms do manifest, they often include:

• Nausea and vomiting
• Loss of appetite
• Abdominal pain
• Confusion
• General malaise

As liver damage progresses, more severe symptoms may develop, including jaundice (yellowing of the skin and eyes), severe abdominal pain, and signs of liver failure. It’s crucial to understand that by the time these symptoms appear, significant liver damage may have already occurred.

How quickly should you seek medical attention if you suspect an acetaminophen overdose? It’s imperative to seek medical care immediately, even if no symptoms are present. Early treatment can significantly improve outcomes and prevent severe liver damage.

When to Seek Immediate Medical Care

Given the potential severity of acetaminophen poisoning and the importance of early intervention, it’s crucial to know when to seek immediate medical attention. Any suspected overdose should be treated as a medical emergency.

Situations Requiring Emergency Care

1. Suspected overdose in a child who accessed medication without supervision
2. Unconsciousness or difficulty breathing following acetaminophen ingestion
3. Uncertainty about the amount or type of medication taken
4. Instruction from a poison control center to seek emergency care

Is it necessary to go to the emergency room even if you’re not experiencing symptoms? Absolutely. The absence of immediate symptoms doesn’t indicate that an overdose hasn’t occurred. Prompt medical evaluation and potential treatment can be life-saving.

Diagnosing Acetaminophen Overdose

When a patient arrives at a healthcare facility with a suspected acetaminophen overdose, healthcare providers will employ several methods to diagnose and assess the situation.

Key Diagnostic Steps

• Detailed patient history, including timing and amount of acetaminophen ingested
• Physical examination to look for signs of liver damage or other symptoms
• Blood tests to measure acetaminophen levels and assess liver function
• Additional tests to rule out other potential causes or complications

Why is accurate timing information crucial in acetaminophen overdose cases? The effectiveness of the antidote, N-acetylcysteine (NAC), is highly dependent on how quickly it’s administered after ingestion. Providing healthcare providers with precise timing can significantly impact treatment decisions and outcomes.

Treatment Options for Acetaminophen Poisoning

The primary goal in treating acetaminophen overdose is to prevent or minimize liver damage. The approach to treatment depends on various factors, including the amount ingested, the time since ingestion, and the patient’s overall health status.

Key Treatment Strategies

1. Administration of activated charcoal (if within 1 hour of ingestion)
2. N-acetylcysteine (NAC) antidote therapy
3. Supportive care and monitoring of liver function
4. In severe cases, liver transplantation may be necessary

What makes N-acetylcysteine such an effective antidote for acetaminophen poisoning? NAC works by replenishing glutathione, a compound that helps the liver metabolize acetaminophen safely. When administered early (ideally within 8 hours of ingestion), NAC can prevent or significantly reduce liver damage.

The duration of NAC treatment typically ranges from 20 to 72 hours, depending on the severity of the overdose and the patient’s response to treatment. Throughout this period, healthcare providers will closely monitor liver function and adjust treatment as needed.

Preventing Acetaminophen Overdose

While treatment options exist for acetaminophen poisoning, prevention is always preferable. Understanding how to use acetaminophen safely and being aware of its presence in various medications can significantly reduce the risk of accidental overdose.

Key Prevention Strategies

• Always read medication labels carefully
• Keep track of total daily acetaminophen intake from all sources
• Use medication tracking apps or journals if taking multiple medications
• Consult a healthcare provider or pharmacist if unsure about medication interactions
• Store medications safely, out of reach of children

How can you ensure you’re not accidentally doubling up on acetaminophen? When taking multiple medications, always check the active ingredients. Many combination cold and flu remedies contain acetaminophen, which could lead to unintentional overconsumption if combined with standalone acetaminophen products.

For individuals with chronic pain conditions or those who regularly use acetaminophen-containing products, discussing alternative pain management strategies with a healthcare provider can help minimize the risk of liver damage while effectively managing symptoms.

Long-Term Outlook and Recovery from Acetaminophen Overdose

The prognosis for individuals who have experienced acetaminophen overdose varies significantly based on several factors, including the amount ingested, the time elapsed before treatment, and the individual’s overall health status.

Factors Influencing Recovery

• Severity of liver damage
• Timeliness of treatment initiation
• Pre-existing liver conditions
• Overall health and age of the patient

Can the liver recover from acetaminophen-induced damage? In many cases, yes. The liver has a remarkable capacity for regeneration, and with prompt, appropriate treatment, many patients can recover fully without long-term consequences. However, in severe cases where extensive liver damage has occurred, recovery may be prolonged, and some patients may require ongoing liver function monitoring or, in extreme cases, liver transplantation.

For patients who recover from acetaminophen overdose, follow-up care is crucial. This typically involves regular liver function tests and careful consideration of future acetaminophen use. Healthcare providers may recommend alternative pain management strategies or provide guidance on safe acetaminophen use to prevent future incidents.

It’s important to note that experiencing an acetaminophen overdose doesn’t necessarily mean a person can never use the medication again. However, it does underscore the need for heightened awareness and caution. Working closely with healthcare providers to develop a safe pain management plan is essential for those with a history of acetaminophen toxicity.

Psychological Impact and Support

Beyond the physical effects, acetaminophen overdose can have significant psychological implications, especially in cases of accidental overdose. Feelings of guilt, anxiety about medication use, or fear of recurrence are common. Mental health support and education about safe medication practices can be valuable components of the recovery process.

How can individuals rebuild confidence in managing their health after an overdose experience? Working closely with healthcare providers, participating in medication safety education programs, and utilizing tools like pill organizers or medication tracking apps can help restore a sense of control and safety in medication management.

Advances in Acetaminophen Safety and Research

The medical community’s understanding of acetaminophen toxicity and its treatment continues to evolve. Ongoing research aims to improve both prevention strategies and treatment outcomes for acetaminophen overdose.

Current Areas of Research

• Development of more effective antidotes
• Improved methods for early detection of liver damage
• Exploration of genetic factors influencing acetaminophen metabolism
• Enhanced public education strategies to prevent accidental overdose

What potential breakthroughs are on the horizon for acetaminophen safety? Researchers are exploring biomarkers that could indicate liver damage earlier in the course of acetaminophen toxicity, potentially allowing for even more timely intervention. Additionally, studies into personalized medicine approaches may lead to more tailored dosing recommendations based on individual genetic profiles.

Efforts to improve packaging and labeling of acetaminophen-containing products are also ongoing. These initiatives aim to make dosage information more clear and prominent, reducing the risk of accidental overdose.

As our understanding of acetaminophen’s effects on the body deepens, so too does our ability to use this medication safely and effectively. While acetaminophen remains a valuable tool in pain management and fever reduction, ongoing research and education efforts underscore the importance of responsible use and awareness of potential risks.

In conclusion, while acetaminophen poisoning poses serious health risks, increased awareness, prompt recognition of symptoms, and timely medical intervention can significantly improve outcomes. By understanding the dangers, recognizing the signs of overdose, and knowing when to seek help, individuals can use acetaminophen safely and effectively while minimizing the risk of accidental toxicity.

Tylenol Poisoning (Acetometophen Overdose)

Written by WebMD Editorial Contributors

• Acetaminophen (Tylenol) Poisoning Overview
• Acetaminophen (Tylenol) Poisoning Causes
• Acetaminophen (Tylenol) Poisoning Symptoms
• When to Seek Medical Care
• Exams and Tests
• Acetaminophen (Tylenol) Poisoning Treatment
• Self-Care at Home
• Medical Treatment
• Next Steps
• Prevention
• Outlook
• More

Acetaminophen is one of the most common medications found in households. It is used for the treatment of pain and to lower fever.

Over many years, it has been used countless times by many people, and it has proven to be a safe and effective medication. However, if taken in excess amounts (overdose, whether on purpose or by accident), acetaminophen can cause life-threatening illness. Unless otherwise directed by your care provider, the usual maximum recommended dose is 3 grams in 24 hours.

Acetaminophen is the active ingredient in Tylenol. It is also found in many other over-the-counter medications and in prescription drugs. Acetaminophen is in Actifed, Alka-Seltzer Plus, Benadryl, Co-Gesic, Contac, Excedrin, Fioricet, Lortab, Midrin, Norco, Percocet, Robitussin, Sedapap, Sinutab, Sudafed, TheraFlu, Unisom PM Pain, Vick’s Nyquil and DayQuil, Vicodin, and Zydone.

Acetaminophen in overdose can seriously damage the liver. If the damage is severe, a liver transplant may be necessary in order to save someone’s life.

The antidote to acetaminophen overdose is N-acetylcysteine (NAC). It is most effective when given within eight hours of ingesting acetaminophen. Indeed, NAC can prevent liver failure if given early enough. For this reason, it is absolutely necessary that acetaminophen poisoning be recognized, diagnosed, and treated as early as possible.

Illness from acetaminophen overdose is caused primarily by liver damage.

Acetaminophen is primarily metabolized by the liver. Too much acetaminophen can overwhelm the way the liver normally functions.

If the liver is already damaged because of infection, alcohol abuse, or other illness, a person may be more susceptible to damage from acetaminophen overdose. For this reason, people with liver illnesses or people who chronically consume large amounts of alcohol should be particularly careful when taking acetaminophen and should consult their doctor prior to taking acetaminophen compounds. The FDA currently recommends that anyone taking medications that contain acetaminophen should not drink alcoholic beverages.

Long-term use of acetaminophen in recommended doses has not been shown to be harmful to the liver.

Soon after taking an overdose of acetaminophen, you may have no symptoms from taking a toxic amount. You may remain symptom-free for up to 24 hours after taking a toxic overdose of acetaminophen.

After this initial period, the following symptoms are common:

• Nausea
• Vomiting
• Not feeling well
• Not able to eat or poor appetite
• Abdominal pain
• Confusion

You must call a doctor, a poison control center, or emergency medical services for any suspected acetaminophen overdose.

Overall it is important that anyone suspected to have taken an overdose of acetaminophen get treatment early, before symptoms occur. Starting treatment early can greatly improve the outcome.

Seek emergency medical care at a hospital’s emergency department in the following situations:

If the person suspected to have taken an overdose of acetaminophen is unconscious, semiconscious, or not breathing, call 911 immediately.

Go to the hospital’s emergency department if the poison control center tells you to go.

Seek emergency care if you are unsure of the types and amounts of medication taken.

If a child took acetaminophen without adult supervision and may have taken an overdose, seek immediate medical attention.

Your doctor will diagnose acetaminophen overdose with the following methods:

• History. The doctor will attempt to determine the time and amount of acetaminophen taken. Having access to all medication bottles that the person may have taken will help the doctor to determine the maximum amount taken.
• Physical. The doctor will look for signs and symptoms of acetaminophen poisoning. These may include jaundice (yellow skin), abdominal pain, vomiting, and other signs and symptoms.
• Laboratory tests. A blood level of acetaminophen will aid in determining if a toxic dose was taken. The doctor may order more than one blood level of acetaminophen and test for other drugs taken. In addition, the doctor may order other blood and urine tests as needed.

If you or a member of your household has taken or may have taken an overdose of acetaminophen, take quick action.

• If the person is unconscious or not breathing, call 911 immediately for emergency medical services.
• If the person is awake and breathing without symptoms, call your local poison control center or the American Association of Poison Control Centers at (800) 222-1222.

The following information is helpful for both medical personnel and a poison control center:

• All medication that the person has taken, both prescribed and nonprescribed (have the bottles close)
• All medications that are available in the house, prescribed and nonprescribed
• The time that the person took the medication

Treatment in the emergency department depends on the condition of the person and any other medications taken.

If someone is suspected of having taken an overdose but has no symptoms, the doctor will begin the following treatment:

• Emptying of the stomach. In the very few cases in which a person comes to the hospital minutes after taking the overdose, the doctor may attempt to empty the stomach by running a tube through the mouth into the stomach.
• Activated charcoal.Activated charcoal should be given by mouth within 4 hours of the overdose to bind any drug remaining in the gastrointestinal tract.
• N-acetylcysteine (NAC). NAC is the antidote for toxic acetaminophen overdose. It is generally given by mouth. The medication has a foul odor but may be mixed with juice or other flavorings to make it taste better. If the person cannot take NAC by mouth, a tube may be placed through the mouth and into the stomach to help administer it. If giving NAC by this method is not possible, the doctor may give it by IV. NAC should be given within 8 hours of ingestion, and is generally given for 20 hours to 72 hours.

Follow-up

After being discharged from the hospital or doctor’s office, you may be asked to return for an examination or blood tests to check the condition of your liver and your general health. Your doctor may instruct you to avoid alcohol and certain medications.

You can take these steps to avoid acetaminophen overdose:

• Always securely close acetaminophen containers and use child-proof bottles. Keep all medication out of the reach of children and securely locked up.
• Know the correct dose of acetaminophen and the amount of acetaminophen in the preparation you are using. If taken in recommended doses, there is no risk of poisoning from acetaminophen. In fact, to prevent accidental overdose, the maker of Extra-Strength Tylenol brand acetaminophen has reduced the maximum dose from 8 pills (4,000 milligrams) to 6 pills (3,000 milligrams) a day. Also, the FDA has asked drug companies to limit the amount of acetaminophen in prescription medications to 325 milligrams per dose.
• Never mix different medications if both medications contain acetaminophen, except if instructed to do so by your doctor. For example, acetaminophen with codeine and cold medicine containing acetaminophen should not be taken together. Read product labels. They clearly indicate the contents.

If you or a family member is depressed and suicidal, remove all medications and dangerous substances from the house and seek medical attention immediately.

If you are unsure about how and when to take pain medications, ask your doctor for a plan. Write down this plan and follow it.

• When you are given a new medication, always make sure the doctor knows all of the medication and supplements that you are taking, both prescribed and nonprescribed. The easiest way to do this is to keep a written list of medications and supplements and go over it with your doctor.

• Do not take acetaminophen if you consume alcoholic beverages.

The outcome for someone who has an acetaminophen overdose depends largely on three factors: the amount of acetaminophen ingested, the timing of emergency treatment, and the initial general health of the person.

If a toxic dose is taken and emergency treatment is delayed, liver failure may follow. Liver failure may mean that a liver transplant is needed to prevent death. Alternatively, if treatment of a toxic overdose is begun early, the person may recover with no long-term health problems.

Top Picks

Acetaminophen Overdose: Symptoms & Treatment Options

Medically reviewed by Drugs.com. Last updated on Jul 3, 2023.

• Care notes
• Aftercare
• Ambulatory
• Discharge
• Inpatient
• Español

What is an acetaminophen overdose?

Acetaminophen overdose means you took more than is safe to take. It may also be called acetaminophen poisoning. Acetaminophen is called paracetamol in countries outside the United States. When used correctly, acetaminophen is a safe drug that decreases pain and fever. Many medicines contain acetaminophen, including some that you can buy without a prescription.

What causes an acetaminophen overdose?

• You took more than the recommended dose. Acetaminophen comes in many forms, such as pills, capsules, and liquids. Strengths include regular strength, extra strength, and extended release. The most acetaminophen that is safe for most people to take is 4,000 milligrams (4 grams) in a 24-hour period. Some forms of acetaminophen need to be limited to lower doses, such as 3,000 mg (3 grams). Only a healthcare provider can recommend a larger maximum dose. You might accidentally take too much if your pain or fever did not go away after the recommended dose. You may also get too much if you take acetaminophen for too many days in a row.
• You accidentally took more than one medicine that contains acetaminophen at a time. Many medicines contain acetaminophen along with other drugs. These include medicines for colds, the flu, allergies, or trouble sleeping. You may have taken more than one medicine that contains acetaminophen, and the total was too much.
• You took an extended-release form. When you take extended-release pills, the medicine stays in your body longer. You are supposed to take these medicines less often than you would take regular acetaminophen. If you take this medicine too often, you will have too much in your body at one time.

What are the signs and symptoms of an acetaminophen overdose?

You might not have any signs or symptoms at first. Early signs and symptoms may make you feel like you have the flu. Common signs and symptoms happen during each stage of an acetaminophen overdose. If the overdose is treated right away, you might have fewer or easier symptoms in the later stages.

• First 24 hours:
  • Nausea, vomiting, stomach pain, and loss of appetite
  • Paleness
  • Tiredness
  • Sweating
• 24 to 72 hours after the overdose:
  • Pain in your upper right side
  • Dark urine
  • Urinating less often than usual
  • Skin and the whites of your eyes turn yellow
• 72 to 96 hours after the overdose:
  • Blood in your urine
  • Fever, lightheadedness, or fainting
  • Fast breathing or trouble breathing
  • Extreme weakness or tiredness
  • Feeling very hungry, or shaking
  • Blurred vision, a fast heartbeat, or headache that will not go away
  • Trouble staying awake
  • Confusion
  • Coma

How is an acetaminophen overdose diagnosed?

Tell your healthcare provider when you took the acetaminophen and how much you took. He or she may ask how long you have been taking acetaminophen. He or she may ask about other medicines you take and when you take them. Your provider may ask if you have any medical problems, such as liver disease. He or she may ask if you drink alcohol and how much you drink. Your blood pressure and temperature will be checked. Your provider may check your skin for color changes and your stomach for pain. You may also need any of the following:

• Blood tests are used to check the amount of acetaminophen in your blood.
• Liver function tests may show if your liver is working properly.
• Prothrombin time (PT) and INR rates measure how long it takes for your blood to clot. If your liver is damaged, your blood may not clot properly. You could have serious bleeding problems.

How is an acetaminophen overdose treated?

Acetaminophen overdose is a serious problem. Treatment should be started as soon as possible. Treatment depends on how much time has passed since the overdose and if the overdose happened all at one time:

• Activated charcoal medicine may be given to soak up the acetaminophen that is still in your stomach. Activated charcoal will make you vomit.
• Gastric lavage may be needed to clean out your stomach to get rid of the acetaminophen. Gastric lavage is also called having your stomach pumped.
• Antidote medicine may be given to stop the effect of the overdose. You may also be given medicine to slow the effects of acetaminophen.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

• acetylcysteine
• Acetadote

How can an acetaminophen overdose be prevented?

Ask your healthcare provider or a pharmacist if you are not sure about any of the following:

• Read labels carefully. Read the labels of all the medicines you take. If your medicine contains acetaminophen, it will be listed in the active ingredients section. Acetaminophen may be listed on the label as APAP, Acetaminoph, Acetaminop, Acetamin, or Acetam. Check carefully to see if the acetaminophen is a regular or extended-release form.
• Do not take more than 1 type of acetaminophen at a time. Many combination medicines contain acetaminophen. Make sure the total dose of acetaminophen you take is not more than 4,000 milligrams (4 grams) in 1 day. Check other medicines to see if they contain acetaminophen. Do not take these medicines together with acetaminophen. The combined amount of acetaminophen may be too much.
• Take the correct dose. Make sure you take the right amount and wait the right number of hours between doses. Never take more than the label says to take. If the medicine came with a device such as a spoon or dropper, use it to measure your medicine. If you need to give acetaminophen to your child, check the label to find out how much to give. The amount and timing will be based on your child’s age and weight.
  
• Do not take acetaminophen for too many days in a row. Do not take acetaminophen for more than 10 days to treat pain, unless your healthcare provider tells you to. Do not take acetaminophen for more than 3 days to treat a fever, unless your healthcare provider tells you to. Your pain or fever may need to be treated another way if it lasts longer than a few days.

What should I do if I think I took too much acetaminophen?

Immediately call the Poison Control Center at 1-800-222-1222 .

Where can I find more information?

• 24-Hour Nationwide Poison Control Hotline
  National Capital Poison Center
  3201 New Mexico Avenue, Suite 310
  Washington , DC 20016
  Phone: 1- 800 – 222-1222
  Web Address: http://www.poison.org

• US Food and Drug Administration
  10903 New Hampshire Avenue
  Silver Spring , MD 20993
  Phone: 1- 888 – 463-6332
  Web Address: http://www.fda.gov

When should I seek immediate care?

• You or another person took too much acetaminophen.
• You feel confused or more tired than usual, or you are sweating more than usual.
• You have severe nausea and are vomiting.
• You cannot have a bowel movement or urinate.
• Your skin and the whites of your eyes turn yellow.

When should I call my doctor?

• You have a fever.
• You have taken too much acetaminophen by mistake, even if you do not have any signs or symptoms.
• You have pain in the upper right side of your abdomen.
• You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright Merative 2023 Information is for End User’s use only and may not be sold, redistributed or otherwise used for commercial purposes.

Learn more about Acetaminophen Overdose

Treatment options

• Medications for Acetaminophen Overdose

Care guides

• Nonprescription Medication Overdose in Children
• Prescription Opioid Overdose
• Safe Use of Acetaminophen
• Safe Use of Nsaids

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

In the footsteps of a drugstore poisoner, the FBI undertook to investigate the 1982 murders with renewed vigor: Mir: Lenta.ru

On Wednesday, February 4, FBI agents searched one of the apartments at 170 Gore Street in Cambridge, a suburb of Boston. The owner of the premises – James Lewis – was once a key figure in the case of the Chicago poisonings, committed 26-odd years ago. The motives and perpetrators of the crime that claimed the lives of seven people have not yet been established, but now there is hope again.

The Chicago poisonings are dated September 1982. An unknown perpetrator – or perpetrators – “worked” in stores selling Tylenol, a paracetamol-based pain reliever and antipyretic popular in the US manufactured by Johnson & Johnson. It was about one of the drugs of this brand, namely Extra-Strength Tylenol, the capsules of which were poisoned with potassium cyanide.

All seven deaths occurred in Chicago and its suburbs. The first victim was 12-year-old Chicago schoolgirl Mary Kellerman. Morning 29September, she took two Tylenol capsules and died soon after. On the same morning, 27-year-old Adam Janus, a postal worker, died, and then – his age, young mother Mary Reiner (Mary Reiner). Then died 31-year-old Mary Makfarlend (Mary McFarland) – an employee of the telephone company Illinois Bell.

On the evening of September 29, 25-year-old brother of Adam Janus Stanley (Stanley Janus) and his wife Theresa (Theresa Janus) who came to the house of a relative after his death were poisoned and died. Unaware of the cause of Adam’s death, they used the medicine from the same jar. The latest victim was flight attendant Paula Jean Prince, 35, who was found dead in her Chicago apartment on October 1.

Further deaths were avoided with the active participation of Johnson & Johnson, which, in particular, warned consumers through television advertising and switched from Extra-Strength Tylenol capsules to the same product in tablets, was avoided. The poisoning story received a great response in the United States and led to the introduction of new standards for packaging and controlling the sale of drugs.

James Lewis, 1995 Photo (c)AP

Lenta.ru

James William Lewis, a man of undetermined profession, was convicted in connection with the Chicago murders, not for the poisoning itself, but for blackmail. December 19He was arrested for 82 years in New York, and in 1983 he confessed that he sent a letter to Johnson & Johnson demanding that he pay him a million dollars “to stop the murders. ” As for the murders, the unfortunate extortionist was listed as a suspect, but the grounds for bringing charges against him were never found.

After his arrest, Lewis told investigators in detail how “someone” could have carried out the Chicago murders – to acquire Tylenol, add poison to capsules, and return the deadly drug to store shelves. At the same time, the arrested man insisted that he himself was innocent of the murders and even extorted money from Johnson & Johnson not for selfish purposes: Lewis allegedly intended to transfer a million dollars to the account of his wife’s former employer in order to embarrass him. For extortion, the court sentenced Lewis to 20 years in prison, but at 19In 1995, he was released on parole and settled in Boston.

Strange Mr. Lewis

It is reported that after his conviction, Lewis actively cooperated with the investigation, tried to help solve the murders and speculated about how the same “someone” could have done his dirty deed. U.S. Attorney Jeremy Margolis, who handled the Lewis case, says: “He’s a prolific writer and artist, and he provided me with a huge amount of documents and diagrams, all about his theories about what happened.” Apparently, all these materials had no special value, because the killer was never found.

I have been slandered all over the world as a “Tylenol man”. They accused me of being the mass murderer who poisoned Tylenol with cyanide in Chicago and killed seven people. These grotesque accusations are obviously false, otherwise I could not have written these words. 25 years later, the “Tylenol murders” remain unsolved. I have lived a long and unusual life and seen a lot, but I am sufficiently educated and bright enough to see and describe, compare and contrast completely different worlds, cultures and topics without a single moment of boredom, while my gaze is directed at professionalism, demographics and competitiveness, and my ear and heart are susceptible to the good taste and feelings of the victims.

Lewis might well have been suspected of being a relatively harmless psychopath if it weren’t for his criminal record – and it’s not limited to the Tylenol case. It is known that once Lewis was accused of murdering his former client (Lewis provided accounting services). The dismembered corpse of 72-year-old Raymond West was found in an attic in Kansas City. As far as the press knows, the charges were then dropped, as during the investigation, the police conducted an unauthorized search, and the cause of West’s death could not be confirmed. It is also reported that Lewis once served in prison two of the ten years to which he was sentenced for tax evasion.

Charges were brought later, when Lewis had already served time for blackmail. The Middlesex County Attorney’s Office (Massachusetts) confirmed that in 2004 the “writer and artist” was arrested on suspicion of rape, kidnapping and other crimes. Lewis remained in prison until 2007, after which the charges were dropped because the alleged victim, Lewis’ neighbor, refused to testify.

In suburban Boston, Lewis is known to have been involved in the creation of several Internet companies with his wife, LeAnn Lewis. One of those companies purporting to be a web design company is called Cyberlewis and is registered at the same address that was raided on Wednesday. The site www.cyberlewis.com has a section called Tylenol, which contains Lewis’s high-flown address in text and voice recording:

“So you want to hear me lament. You’ve landed on the right page. After a quarter of a century, I somehow believe that only a select few, endowed with a critical mind, will believe what I say. Many are looking for hidden plots, ambiguities and I do not pay attention to the literal meaning of my words. Many people like to twist and twist my words into something sinister and frightening that I did not even think about. Such, my friends, is the curse of the “Tylenol man.” Anyway, I can’t change human tendencies. I won’t even try. Listen if you want. Send me your comments by e-mail. ”

New Technologies

More than a hundred investigators were involved in the Chicago investigation. They studied more than 6.5 thousand versions, more than four hundred people were on the list of suspects, and 20 thousand pages of investigative reports were collected. However, there has been no result so far, and the investigation team was almost disbanded. “Given the many recent advances in forensic technology, re-examination of available material seems quite natural,” the FBI’s Chicago office said in a statement issued in connection with the search.

FBI agents carrying boxes out of Lewis’s house. Photo (c)AP

Lenta.ru

The operatives took several boxes, a large roll of brown paper and a Macintosh computer out of Lewis’s house. In addition to the “Tylenol man’s” dwelling, a storage facility also located in Cambridge was searched. The FBI said in a statement that there was no talk of any arrests or charges yet, but some evidence of Lewis’s likely guilt was probably presented to the court in order to issue a search warrant. “For the sake of the families of the victims, we must use modern technology and new methods to investigate unsolved murders, and we hope to solve this case once and for all,” said FBI spokesman Tom Simon.

The FBI explained that the reopening of the investigation was due to heightened public interest in the 25th anniversary of the poisoning case. Then, in September 2007, Michelle Rosen, daughter of the late Mary Rainer, confessed: “I can never leave what happened because this man (the killer) is at large and lives his life, no matter how she’s worthless.” Now that the FBI’s new efforts have been made public, Alojza Janus, the 80-year-old mother of two of the poisoner’s victims, said through tears in her native Polish: “Two of my innocent children have left this world and I hope the culprit is found.” .

In 2007, Lewis – apparently recently released from prison – was invited to one of the local television shows called The Cambridge Rag. On the air, Lewis once again spoke about his innocence in the poisoning case, as well as the murder of West. However, from the idea of ​​a lie detector test, which was proposed by TV presenter Roger Nicholson (Roger Nicholson), “prolific writer” refused, calling it unscientific. It remains to be hoped that, using their new methods, the FBI will finally find out if Mr. Lewis is not the poisoner, whom he himself once called “a cold-blooded killer and a cruel monster.”

Tylenol™ – instructions for use, doses, side effects, reviews of the drug:

0.048 ‰

Analogs

All forms of release, dosages, registration certificates, drug manufacturers, drug characteristics

Description of the drug Tylenol™ (caplets (caplets), 500 mg) based on the official label, approved by the manufacturer in 2000

Approval date: 07/31/2000

Content

• Active substance
• ATX
• Pharmacological group
• Nosological classification (ICD-10)
• Composition and form of release
• pharmachologic effect
• pharmachologic effect
• Indications
• Contraindications
• Use during pregnancy and lactation
• Dosage and administration
• Side effects
• Precautionary measures
• Storage conditions
• Best before date

Active ingredient

Paracetamol* (Paracetamol*)

ATX

N02BE01 Paracetamol

Pharmacological group

Anilides

Nosological classification (ICD-10)

ICD-10 code list

Composition and formulation

1 caplet contains paracetamol 500 mg; in a blister of 10 pcs. , in a box 1 blister or in strips of 2 pcs., in a box of 50 strips.

Pharmacological action

Pharmacological action –

analgesic , antipyretic .

Inhibits cyclooxygenase, inhibits the synthesis of PG in the central nervous system and their stimulating effect on the thermoregulatory center of the hypothalamus; increases heat transfer.

Inhibits cyclooxygenase, inhibits the synthesis of PG in the central nervous system and their stimulating effect on the thermoregulatory center of the hypothalamus; increases heat transfer.

Indications

Pain of mild to moderate intensity (including headache, toothache, sore throat and general malaise), fever.

Contraindications

Hypersensitivity, severe impairment of liver and kidney function, deficiency of glucose-6-phosphate dehydrogenase, children’s age (up to 12 years).

Use in pregnancy and lactation

Acceptable, but only on prescription.