Can you die from acetaminophen overdose?

YES: Acetaminophen in large dose is hepatotoxic. It can cause serious liver damage and can be lethal.

Depends on the dose: If you take Acetaminophen 7gm in one dose you will go into liver failure and probably die. If you use Acetaminophen on a daily basis and its in the region of 4gm per day then it is toxic especially if you consider some otc meds and use of alcohol taken with it. Current guidelines is no more than 2-2.5gm per day max.