While it is generally safely used, overdose can result in the development of liver failure due to APAPs hepatotoxic metabolites
Heres why: Some pills need food to work properly and may upset your stomach if taken while fasting

Water, Methylpropanediol, Glycerin, Beta-Glucan, Dimethicone, Titanium Dioxide, Niacinamide, Cyclopentasiloxane, Betaine, Polyglycerin-3, Eclipta Prostrata Leaf Extract, Laminaria Japonica Extract, 1,2-Hexanediol, Sodium Acrylate/Sodium Acryloyldimethyl Taurate Copolymer, Sodium Polyacrylate, Ethylhexyl Stearate, Isohexadecane, Panthenol, Dimethiconol, Hydroxyacetophenone, Butylene Glycol, Polysorbate 80, Centella Asiatica Extract, Ficus Carica (Fig) Fruit Extract, Fragrance, Glutathione, Glycyrrhiza Glabra (Licorice) Root Extract, Lactobacillus/Rice Ferment, Sorbitan Oleate, Triethoxycaprylylsilane, Trideceth-6, Hydrogenated Lecithin, Fructooligosaccharides, Hydrogenated Polyisobutene, Squalane, Disodium Edta, Argania Spinosa Kernel Oil, Isononyl Isononanoate, Polyglyceryl-10 Stearate, Amaranthus Caudatus Seed Extract, Butyrospermum Parkii (Shea) Butter, Cetearyl Alcohol, Panax Ginseng Root Extract, Polyglyceryl-2 Dipolyhydroxystearate, Stearic Acid, Ulmus Davidiana Root Extract, Hydrolyzed Hyaluronic Acid, Inulin Lauryl Carbamate, Carbomer, Pearl Powder, Ceramide Np, Polysorbate 20, Disodium Stearoyl Glutamate, Palmitoyl Pentapeptide-4

J Am Coll Surg 212(5):821-6, 2011