CV: hypertension (IV), hypotension (IV).
Derm: ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS, rash, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, urticaria.
F and E: hypokalemia (IV).
GI: ↑liver enzymes, constipation (↑ in children) (IV), HEPATOTOXICITY (↑ DOSES), nausea (IV), vomiting (IV).
GU: renal failure (high doses/chronic use).
Hemat: neutropenia, pancytopenia.
MS: muscle spasms (IV), trismus (IV).
Neuro: agitation (↑ in children) (IV), anxiety (IV), fatigue (IV), headache (IV), insomnia (IV).
Resp: atelectasis (↑ in children) (IV), dyspnea (IV).
Children
12 yr should not receive >5 PO or rectal doses/24 hr without notifying physician or other health care professional. No dose adjustment needed when converting between IV and PO acetaminophen in adults and children
50 kg
- PO (Adults and Children >12 yr): 325–650 mg every 6 hr or 1 g 3–4 times daily or 1300 mg every 8 hr (not to exceed 3 g or 2 g/24 hr in patients with hepatic/renal impairment).
- PO (Children 1–12 yr): 10–15 mg/kg/dose every 6 hr as needed (not to exceed 5 doses/24 hr).
- PO (Infants): 10–15 mg/kg/dose every 6 hr as needed (not to exceed 5 doses/24 hr).
- PO (Neonates): 10–15 mg/kg/dose every 6–8 hr as needed.
- IV (Adults and Children 13 yr and 50 kg): 1000 mg every 6 hr or 650 mg every 4 hr (not to exceed 1000 mg/dose, 4 g/day [by all routes], and less than 4 hr dosing interval).
- IV (Adults and Children 13 yr and <50 kg): 15 mg/kg every 6 hr or 12.5 mg/kg every 4 hr (not to exceed 15 mg/kg/dose [up to 750 mg/dose], 75 mg/kg/day [up to 3750 mg/day] [by all routes], and less than 4 hr dosing interval).
- IV (Children 2–12 yr): 15 mg/kg every 6 hr or 12.5 mg/kg every 4 hr (not to exceed 15 mg/kg/dose [up to 750 mg/dose], 75 mg/kg/day [up to 3750 mg/day] [by all routes], and less than 4 hr dosing interval).
- IV (Infants 29 days-2 yr): 15 mg/kg every 6 hr (not to exceed 60 mg/kg/day [by all routes]).
- IV (Neonates Birth–28 days): 12.5 mg/kg every 6 hr (not to exceed 50 mg/kg [by all routes]).
- Rect (Adults and Children >12 yr): 325–650 mg every 4–6 hr as needed or 1 g 3–4 times/day (not to exceed 4 g/24 hr).
- Rect (Children 1–12 yr): 10–20 mg/kg/dose every 4–6 hr as needed.
- Rect (Infants): 10–20 mg/kg/dose every 4–6 hr as needed.
- Rect (Neonates): 10–15 mg/kg/dose every 6–8 hr as needed.
Therapeutic Classification: antipyretics, nonopioid analgesics
Absorption: Well absorbed following oral administration. Rectal absorption is variable. Intravenous administration results in complete bioavailability.
Distribution: Widely distributed. Crosses the placenta; enters breast milk in low concentrations.
Metabolism/Excretion: 85–95% metabolized by the liver (CYP2E1 enzyme system). Metabolites may be toxic in overdose situation. Metabolites excreted by the kidneys.
Half-life: Neonates: 7 hr; Infants and Children: 3–4 hr; Adults: 1–3 hr.
Abenol, Acet, Children Feverhalt, Fortolin, Pediaphen, Pediatrix, Taminol, Tempra
(analgesia and antipyresis)
†Depends on dose.
†Antipyretic effects.