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acetaminophen
generic
Black Box Warnings .
Medication Error Risk (IV use)
ensure accuracy when prescribing, dispensing, and administering acetaminophen inj; dosing errors can result in overdose and death; do not confuse dose in mg and mL, use weight-based dosing for patients <50 kg, properly program infusion pumps, and do not exceed maximum total daily dose limits of acetaminophen from all sources
Hepatotoxicity
acetaminophen associated with acute liver failure including cases of liver transplant and death; most liver injury associated with acetaminophen doses >4000 mg per day and >1 acetaminophen-containing product
Adult Dosing .
Dosage forms: CAP: 325 mg, 500 mg; TAB: 325 mg, 500 mg, 650 mg; ER TAB: 650 mg; CHEWABLE: 80 mg, 160 mg; SUSP: 160 mg per 5 mL; SOL: 160 mg per 5 mL, 500 mg per 15 mL; INJ: various
pain
- [PO route, immediate-release form]
- Dose: 325-1000 mg PO q4-6h prn; Max: 4 g/day from all sources
- [PO route, extended-release form]
- Dose: 650-1300 mg ER PO q8h prn; Max: 4 g/day from all sources
- [IV route, <50 kg]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose and 75 mg/kg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn; Info: may use with opioids for moderate-severe pain
- [IV route, >50 kg]
- Dose: 1 g IV q6h prn; Max: 1 g/dose and 4 g/day from all sources; Alt: 650 mg IV q4h prn; Info: may use with opioids for moderate-severe pain
fever
- [PO route, immediate-release form]
- Dose: 325-1000 mg PO q4-6h prn; Max: 4 g/day from all sources
- [PO route, extended-release form]
- Dose: 650-1300 mg ER PO q8h prn; Max: 4 g/day from all sources
- [IV route, <50 kg]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose and 75 mg/kg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn
- [IV route, >50 kg]
- Dose: 1 g IV q6h prn; Max: 1 g/dose and 4 g/day from all sources; Alt: 650 mg IV q4h prn
renal dosing
- [PO route, immediate-release form]
- CrCl 10-50: give usual dose q6h prn; CrCl <10: give usual dose q8h prn
- HD: give usual dose q8h prn; no supplement after dialysis; PD: give usual dose q8h prn; no supplement
- [PO route, extended-release form]
- renal impairment: consider decr. usual dose or frequency
- HD: consider decr. usual dose or frequency; no supplement after dialysis; PD: consider decr. usual dose or frequency; no supplement
- [IV route]
- CrCl <31: consider decr. usual dose or frequency
- HD: consider decr. usual dose or frequency; no supplement after dialysis; PD: consider decr. usual dose or frequency; no supplement
hepatic dosing
- [PO route]
- hepatic impairment: consider decr. usual dose
- [IV route]
- mild-moderate impairment/active disease: consider decr. usual dose; severe impairment/active disease: contraindicated
Peds Dosing .
- Dosage forms: CAP: 325 mg, 500 mg; TAB: 325 mg, 500 mg, 650 mg; ER TAB: 650 mg; CHEWABLE: 80 mg, 160 mg; SUSP: 160 mg per 5 mL; SOL: 160 mg per 5 mL, 500 mg per 15 mL; INJ: various
pain
- [PO route, neonates]
- Dose: 10-15 mg/kg/dose PO q6-8h prn; Max: 60 mg/kg/day from all sources
- [PO route, infants/children]
- Dose: 10-15 mg/kg/dose PO q4-6h prn; Max: 75 mg/kg/day up to 4 g/day from all sources
- [PO route, 12-18 yo, immediate-release form]
- Dose: 325-650 mg PO q4-6h prn; Max: 4 g/day from all sources
- [PO route, 12-18 yo, extended-release form]
- Dose: 650-1300 mg ER PO q8h prn; Max: 4 g/day from all sources
- [IV route, 2-12 yo]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose up to 750 mg/dose and 75 mg/kg/day up to 3750 mg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn; Info: may use with opioids for moderate-severe pain
- [IV route, 13 yo and older, <50 kg]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose and 75 mg/kg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn; Info: may use with opioids for moderate-severe pain
- [IV route, 13 yo and older, >50 kg]
- Dose: 1 g IV q6h prn; Max: 1 g/dose and 4 g/day from all sources; Alt: 650 mg IV q4h prn; Info: may use with opioids for moderate-severe pain
fever
- [PO route, neonates]
- Dose: 10-15 mg/kg/dose PO q6-8h prn; Max: 60 mg/kg/day from all sources
- [PO route, infants/children]
- Dose: 10-15 mg/kg/dose PO q4-6h prn; Max: 75 mg/kg/day up to 4 g/day from all sources
- [PO route, 12-18 yo, immediate-release form]
- Dose: 325-650 mg PO q4-6h prn; Max: 4 g/day from all sources
- [PO route, 12-18 yo, extended-release form]
- Dose: 650-1300 mg ER PO q8h prn; Max: 4 g/day from all sources
- [IV route, 32 wk gestation and older, <29 days old]
- Dose: 12.5 mg/kg/dose IV q6h prn; Max: 50 mg/kg/day from all sources
- [IV route, 29 days old-23 mo]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 60 mg/kg/day from all sources
- [IV route, 2-12 yo]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose up to 750 mg/dose and 75 mg/kg/day up to 3750 mg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn
- [IV route, 13 yo and older, <50 kg]
- Dose: 15 mg/kg/dose IV q6h prn; Max: 15 mg/kg/dose and 75 mg/kg/day from all sources; Alt: 12.5 mg/kg/dose IV q4h prn
- [IV route, 13 yo and older, >50 kg]
- Dose: 1 g IV q6h prn; Max: 1 g/dose and 4 g/day from all sources; Alt: 650 mg IV q4h prn
renal dosing
- [PO route, immediate-release form]
- CrCl 10-50: give usual dose q6-8h prn; CrCl <10: give usual dose q8h prn
- HD: give usual dose q8h prn; no supplement after dialysis; PD: give usual dose q8h prn; no supplement
- [PO route, extended-release form]
- renal impairment: consider decr. usual dose or frequency
- HD: consider decr. usual dose or frequency; no supplement after dialysis; PD: consider decr. usual dose or frequency; no supplement
- [IV route]
- CrCl <31: consider decr. usual dose or frequency
- HD: consider decr. usual dose or frequency; no supplement after dialysis; PD: consider decr. usual dose or frequency; no supplement
hepatic dosing
- [PO route]
- hepatic impairment: consider decr. usual dose
- [IV route]
- mild-moderate impairment/active disease: consider decr. usual dose; severe impairment/active disease: contraindicated