How much paracetamol constitutes a toxic dose?

In acute paracetamol poisoning, the toxic dose is 10 g (or 200 mg/kg in patients under 50 kg) or more. Toxic doses for different paracetamol preparations in cases of acute poisoning gives the equivalent toxic dose for different paracetamol preparations.

Table 1. Toxic doses for different paracetamol preparations in cases of acute poisoning
[NB1] [NB2]
Paracetamol preparation	Pack size	Toxic dose: 10 g equivalent or more	Toxic dose: 200 mg/kg equivalent or more
500 mg immediate-release tablets or capsules [NB3]	12 to 100 tablets or capsules	20 tablets or capsules	4 tablets or capsules per 10 kg body weight
24 mg/mL liquid	100 mL	417 mL	83 mL per 10 kg body weight
48 mg/mL liquid	200 mL	208 mL	42 mL per 10 kg body weight
100 mg/mL liquid	20 mL	100 mL	20 mL per 10 kg body weight
665 mg modified-release tablet	96 tablets	15 tablets	3 tablets per 10 kg body weight
Note: NB1: The toxic dose of paracetamol is 10 g (or 200 mg/kg in patients under 50 kg) or more. NB2: Paracetamol is also coformulated with other drugs (eg ibuprofen, caffeine, codeine, doxylamine, pseudoephedrine), which can cause paracetamol poisoning if ingested in a toxic dose. NB3: Paracetamol suppositories are also immediate-release preparations. Discuss cases with a poisons information centre.

In patients who have taken supratherapeutic doses of paracetamol, a toxic dose can be:

Maximum therapeutic doses (60 mg/kg up to 4 g daily) over several days can occasionally be toxic in susceptible individuals.