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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 pts <50 kg, properly program infusion pumps, and do not exceed maximum total daily dose limits of acetaminophen from all sources
Hepatotoxicity
acetaminophen assoc. w/ acute liver failure incl. cases of liver transplant and death; most liver injury assoc. w/ 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 w/ opioids for mod-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 w/ opioids for mod-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 dz: consider decr. usual dose; severe impairment/active dz: 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 w/ opioids for mod-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 w/ opioids for mod-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 w/ opioids for mod-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 dz: consider decr. usual dose; severe impairment/active dz: contraindicated