I Worry That I Have Taken Too Much Tylenol .
Hello and welcome,
You are definitely at the upper limit of safety if you weigh 180 lbs and have no history of liver disease as what you took adds up to 4000 mg. It's recommended not to exceed 3000 mg in 24 hours, but in general, for most people, 4000 mg can be ok.
If you are not elderly (I don't know your age) and have no history of liver disease or elevated liver enzymes, then you will likely be ok if you take nor further acetaminophen in any form (including cold medicines, etc) AND absolutely no alcohol in any form.
However, if you want to play it safe, you can go in to the ER where they can measure your liver enzymes (but a rise in these is usually delayed - doesn't happen immediately), and if they think you need treatment, will give you something called mucomyst - a drug that protects the liver. Mucomyst is N-acetylcholine which is sold over the counter but taken orally may not really get where it needs to because it is broken down before it enters the blood. The mucomyst they give in the ER or hospital is given IV.
So - if you took 4 instead of 2, you are right on the edge of what is safe, and so if you are pretty sure that you took 4, and if you have any history of recent alcohol use, or liver enzyme elevations, then I would recommend going in.
Thoughts on this
Your age and no alcohol or liver problems are noted. It is probably ok, but don't have anymore acetaminophen in any form for at least several days.
For your reference, I'm including an article here on management of acetaminophen overdose. For people with no liver disease, and not of low weight, toxicity usually requires over 4 grams (4000 mg or 8 extra strength tablets), and this article is suggesting it usually does not happen until 7 g (7000 mg). But if you are concerned, you can go in and they can test your blood level of acetaminophen.
https://emedicine.medscape.com/article/820200-overview (copy and paste into your search bar to see the article).
Of the medications that you take that might be optional (ie Zoloft should not be skipped), if you want to decrease the burden on the liver, consider skipping the Claritin in the next 24 hours. If you have already taken it or if you really need it badly, it's not a big problem, I am just thinking on ways to give your liver less of a burden right now.