The treatment of choice for Tylenol overdose is administration of intravenous acetylcysteine (Mucomyst).

Acetaminophen overdose causes liver damage and has been known to cause liver failure requiring emergent transplant. The Kings College Criteria for listing a patient for liver transplant due to Tylenol overdose are:

pH < 7.3 after treatment

or

Serum creatinine > 3mg/dL

INR > 6.5

Grade 3 or 4 encephalopathy