Which condition is a contraindication for the administration of acetaminophen?

• Uses
  • What Is Acetaminophen and How Does It Work?
• Dosage
  • What Are Dosages of Acetaminophen?
• Side Effects
  • What Are Side Effects Associated with Using Acetaminophen?
• Drug Interactions
  • What Other Drugs Interact with Acetaminophen?
• Warnings and Precautions
  • What Are Warnings and Precautions for Acetaminophen?

What Is Acetaminophen and How Does It Work?

Acetaminophen is an analgesic used to temporarily relieve minor aches and pains due to headache, muscular aches, backache, minor pain of arthritis, the common cold, toothache, and premenstrual and menstrual cramps. Acetaminophen is also used to temporarily reduce fever.

• Acetaminophen is available under the following different brand names: Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain Reliever, Little Fevers Infant Fever/Pain Reliever, and PediaCare Single Dose Acetaminophen Fever Reducer/Pain Reliever.

What Are Dosages of Acetaminophen?

Dosages of Acetaminophen Should Be Given As Follows:

Adult Dosage Forms & Strengths

Tablets

• 325 mg
• 500 mg

Caplets

• 325 mg
• 500 mg
• 650 mg

Capsules

• 500 mg

Gelcaps/Geltabs

• 500 mg

Caplets, Extended Release

• 650 mg

Tablets, Chewable

• 80 mg

Oral solution/suspension

• 160 mg/5 mL
• 80mg/0.8mL (oral drops)

Liquid Oral

• 500mg/5mL
• 160mg/15mL
• 500mg/15mL

Oral Syrup

• 160mg/5mL

Elixir

• 160mg/5mL

Dosage Considerations Analgesia and Fever

Immediate release

• Regular strength: 325-650 mg orally/rectally once every 4 hours as needed; not to exceed 3250 mg/day; under supervision of healthcare professional, daily doses of up to 4 g/day may be used
• Extra Strength: 1000 mg orally once every 6-8 hours as needed; not to exceed 3000 mg/day; under supervision of healthcare professional, daily doses of up to 4 g/day may be used

Extended-release

• 2 capsules (1300 mg) orally once every 8 hours as needed; not to exceed 3.9 g/day

Maximum dose

• Acetaminophen containing products: Not to exceed a cumulative dose of 3.25 g/day of acetaminophen; under supervision of healthcare professional, daily doses of up to 4 g/day may be used
• Tylenol Extra-Strength (i.e., 500 mg/tab or cap): Not to exceed 3 g/day (6 tabs or caps); under supervision of a healthcare professional, daily doses of up to 4 g/day may be used

Renal Impairment

Longer dosing intervals and the reduced total dose may be warranted in patients with severe renal impairment (CrCl less than or equal to 30 mL/min)

Hepatic Impairment

Use caution with any type of liver disease.

Pediatric Pain & Fever Relief

Weight-based dosing

• Children under 12 years: 10-15 mg/kg/dose taken orally once every 4-6 hours; not to exceed 5 doses in 24 hours

Fixed dosing

• Children under 6 years: Ask a healthcare provider
• Children 6-12 years: 325 mg orally once every 4-6 hours; not to exceed 1.625 g/day for not more than 5 days unless directed by a healthcare provider
• Children under 12 years and older:
  • Regular strength: 650 mg once every 4-6 hours; not to exceed 3.25 g in 24 hours; under supervision of healthcare professional, doses of up to 4 g/day may be used
  • Extra strength: 1000 mg once every 6 hours; not to exceed 3 g in 24 hours; under supervision of healthcare professional, doses of up to 4 g/day may be used
  • Extended-release: 1.3 g once every 8 hours; not to exceed 3.9 g in 24 hours

SLIDESHOW

What Are Warnings and Precautions for Acetaminophen?

Warnings

This medication contains acetaminophen. Do not take Tylenol, Tylenol Arthritis Pain, Tylenol Ext, Little Fevers Children's Fever/Pain Reliever, Little Fevers Infant Fever/Pain Reliever, or PediaCare Single Dose Acetaminophen Fever Reducer/Pain Reliever if you are allergic to acetaminophen or any ingredients contained in this drug.

Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

Hypersensitivity

Effects of Drug Abuse

There are no effects of drug abuse with the use of acetaminophen.

Short-term Effects

See “What Are Side Effects Associated with Using Acetaminophen?”

Long-term Effects

• The risk of hepatotoxicity is higher in chronic high dose
• See “What Are Side Effects Associated with Using Acetaminophen?”

Cautions

• Acetaminophen is available in many dosage forms and products, check labels carefully to avoid overdose.
• Repeated administration in patients with anemia or cardiac, pulmonary, or renal disease.
• The risk of hepatotoxicity is higher in alcoholics, chronic high dose, or use of more than one acetaminophen-containing product.
• Use caution in patients with G6PD deficiency.
• Use caution in patients with chronic malnutrition.
• Risk for rare, but serious skin reactions that can be fatal; these reactions include Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP); symptoms may include skin redness, blisters, and rash.

Pregnancy and Lactation

• Acetaminophen may be acceptable to use during pregnancy. Either animal studies show no risk but human studies are not available or animal studies showed minor risks and human studies are done and showed no risk. Acetaminophen crosses the placenta; it is safe to use in all stages of pregnancy short term.
• Acetaminophen is excreted in breast milk; it is compatible with breastfeeding.

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