Australians would require a pharmacist's approval to buy bulk packs of paracetamol under proposed new rules.
The medicines regulator has made an interim decision to reduce maximum pack sizes in a bid to lower rates of intentional overdose.
Customers are currently able to purchase packs of up to 100 paracetamol tablets or capsules over the counter without talking to a pharmacist.
That number would be reduced to 32 under the proposed changes, with anything above that requiring a pharmacist's supervision.
The maximum size of packs available in supermarkets or convenience stores would be reduced from 20 tablets to 16, the Therapeutic Goods Administration said on Friday.
A final decision is expected to be made later this year with public submissions invited until March 3.
About 50 Australians die of intentional paracetamol overdose each year, according to an independent report commissioned by the regulator.
Overdose rates are highest among adolescents and young adults.
Other previously flagged changes included potentially restricting minors from buying the painkiller without a prescription.
In its interim decision, the regulator found age restrictions would have a limited impact on impulsive overdoses and would "disproportionately and unjustifiably" affect access for minors who lived independently.
Blister packaging would instead be required for packs sold without a pharmacist's supervision to deter overdose from ingesting large numbers of tablets.
The regulator is also encouraging supermarkets to restrict sales to a single pack at a time and urging consumers not to stockpile paracetamol.
It said the interim decision was intended to strike a balance between minimising misuse of the drug and ensuring access for the treatment of acute and chronic pain.
While survival rates from a paracetamol overdose are typically excellent, this is only if treatment occurs within six hours of ingestion.
Delayed treatment can result in serious liver injury and sometimes death and can be complicated by different forms of the drug.
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