Acetaminophen

Acetaminophen Brand Names

7T Gummy ES | Acephen | Aceta | Actamin | Adult Pain Relief | Anacin Aspirin Free | Apra | Children’s Acetaminophen | Children’s Pain & Fever | Comtrex Sore Throat Relief | ED-APAP | ElixSure Fever/Pain | Feverall | Genapap | Genebs | Goody’s Back & Body Pain | Infantaire | Infants’ Acetaminophen | LIQUID PAIN RELIEF | Little Fevers | Little Remedies Infant Fever + Pain Reliever | Mapap | Mapap Arthritis Pain | Mapap Infants | Mapap Junior | M-PAP | Nortemp | Ofirmev | Pain & Fever | Pain and Fever | PAIN RELIEF | PAIN RELIEF Extra Strength | Panadol | PediaCare Children’s Fever Reducer/Pain Reliever | PediaCare Children’s Smooth Metls Fever Reducer/Pain Reliever | PediaCare Infant’s Fever Reducer/Pain Reliever | Pediaphen | PHARBETOL | Q-Pap | Q-Pap Extra Strength | Silapap | Triaminic Fever Reducer and Pain Reliever | Triaminic Infant Fever Reducer and Pain Reliever | Tylenol | Tylenol 8 Hour | Tylenol Arthritis Pain | Tylenol Children’s | Tylenol Children’s Pain+Fever | Tylenol CrushableTablet | Tylenol Extra Strength | Tylenol Infants’ | Tylenol Infants Pain + Fever | Tylenol Junior Strength | Tylenol Sore Throat | XS No Aspirin | XS Pain Reliever

What is Acetaminophen

Acetaminophen (APAP, paracetamol) is a para-aminophenol analgesic and the active metabolite of phenacetin.

Due to the toxic effects of phenacetin at therapeutic doses and the availability of acetaminophen, phenacetin is no longer used.

Acetaminophen possesses analgesic and antipyretic activity similar to aspirin; however, acetaminophen has no peripheral anti-inflammatory activity or effects on platelet function.

Acetaminophen was first used in clinical medicine in the 1890s. It is effective in the relief of both acute and chronic pain and may be preferred over NSAIDs due to fewer hematologic, gastrointestinal, and renal effects.

Acetaminophen is the preferred analgesic/antipyretic for patients in whom aspirin is contraindicated and in those with underlying renal disease for episodic, though not chronic, use.

Indications

1. arthralgia
2. dental pain
3. dysmenorrhea
4. fever
5. headache
6. migraine
7. mild pain
8. moderate pain
9. musculoskeletal pain
10. myalgia
11. osteoarthritis
12. severe pain

Side Effects

1. acute generalized exanthematous pustulosis (AGEP)
2. agitation
3. agranulocytosis
4. anaphylactic shock
5. anaphylactoid reactions
6. anemia
7. angioedema
8. anorexia
9. anxiety
10. constipation
11. contact dermatitis
12. diarrhea
13. dyspnea
14. elevated hepatic enzymes
15. erythema
16. exfoliative dermatitis
17. fatigue
18. fever
19. headache
20. hearing loss
21. heart failure
22. hemolysis
23. hemolytic anemia
24. hepatic encephalopathy
25. hepatic failure
26. hepatic necrosis
27. hepatotoxicity
28. hypertension
29. hypoalbuminemia
30. hypokalemia
31. hypomagnesemia
32. hypophosphatemia
33. hypoprothrombinemia
34. hypotension
35. injection site reaction
36. insomnia
37. interstitial nephritis
38. jaundice
39. maculopapular rash
40. malaise
41. muscle cramps
42. myocarditis
43. nausea
44. neutropenia
45. oliguria
46. pancytopenia
47. peripheral edema
48. pleural effusion
49. pruritus
50. pulmonary edema
51. purpura
52. renal failure (unspecified)
53. renal papillary necrosis
54. renal tubular necrosis
55. rhabdomyolysis
56. Stevens-Johnson syndrome
57. thrombocytopenia
58. thrombocytosis
59. toxic epidermal necrolysis
60. trismus
61. urticaria
62. vomiting
63. wheezing

Monitoring Parameters

• LFTs
• serum creatinine/BUN: in chronic use or acute toxicity

Contraindications

• acetaminophen hypersensitivity
• alcoholism
• bone marrow suppression
• breast-feeding
• children
• diabetes mellitus
• ethanol intoxication
• G6PD deficiency
• geriatric
• hepatic disease
• hepatitis
• hepatotoxicity
• hypertension
• hypovolemia
• immunosuppression
• infants
• infection
• malnutrition
• neonates
• neutropenia
• phenylketonuria
• potential for overdose or poisoning
• pregnancy
• renal disease
• renal failure
• renal impairment
• tobacco smoking

Interactions

• Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Amobarbital
• Antacids
• Aprepitant, Fosaprepitant
• Articaine; Epinephrine
• Aspirin, ASA
• Aspirin, ASA; Butalbital; Caffeine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Caffeine; Orphenadrine
• Aspirin, ASA; Carisoprodol
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Citric Acid; Sodium Bicarbonate
• Aspirin, ASA; Dipyridamole
• Aspirin, ASA; Omeprazole
• Aspirin, ASA; Oxycodone
• Aspirin, ASA; Pravastatin
• Atropine; Hyoscyamine; Phenobarbital; Scopolamine
• Barbiturates
• Belladonna Alkaloids; Ergotamine; Phenobarbital
• Bismuth Subsalicylate
• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Boceprevir
• Bupivacaine
• Bupivacaine Liposomal
• Bupivacaine; Lidocaine
• Busulfan
• Butabarbital
• Carbamazepine
• Charcoal
• Chloroprocaine
• Cholestyramine
• Choline Salicylate; Magnesium Salicylate
• Dapsone
• Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
• Diflunisal
• Drospirenone; Ethinyl Estradiol
• Drospirenone; Ethinyl Estradiol; Levomefolate
• Efavirenz
• Efavirenz; Emtricitabine; Tenofovir
• Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
• Eltrombopag
• Ethanol
• Ethinyl Estradiol
• Ethinyl Estradiol; Desogestrel
• Ethinyl Estradiol; Ethynodiol Diacetate
• Ethinyl Estradiol; Etonogestrel
• Ethinyl Estradiol; Levonorgestrel
• Ethinyl Estradiol; Levonorgestrel; Ferrous bisglycinate
• Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
• Ethinyl Estradiol; Norelgestromin
• Ethinyl Estradiol; Norethindrone
• Ethinyl Estradiol; Norethindrone Acetate
• Ethinyl Estradiol; Norethindrone Acetate; Ferrous fumarate
• Ethinyl Estradiol; Norethindrone; Ferrous fumarate
• Ethinyl Estradiol; Norgestimate
• Ethinyl Estradiol; Norgestrel
• Exenatide
• Hydantoins
• Hydroxyprogesterone
• Imatinib
• Insulin Glargine; Lixisenatide
• Isavuconazonium
• Isoniazid, INH
• Isoniazid, INH; Pyrazinamide, PZA; Rifampin
• Isoniazid, INH; Rifampin
• Lamivudine, 3TC; Zidovudine, ZDV
• Lamotrigine
• Lanthanum Carbonate
• Lidocaine
• Lidocaine; Prilocaine
• Lixisenatide
• Lomitapide
• Lopinavir; Ritonavir
• Magnesium Salicylate
• Mephobarbital
• Mepivacaine
• Mepivacaine; Levonordefrin
• Methohexital
• Metyrapone
• Mipomersen
• Mitotane
• Ombitasvir; Paritaprevir; Ritonavir
• Omeprazole; Amoxicillin; Rifabutin
• Omeprazole; Sodium Bicarbonate
• Penicillin G Benzathine; Penicillin G Procaine
• Penicillin G Procaine
• Pentobarbital
• Phenobarbital
• Pneumococcal Vaccine, Polyvalent
• Posaconazole
• Pramlintide
• Prilocaine
• Prilocaine; Epinephrine
• Primidone
• Rifabutin
• Rifampin
• Ritonavir
• Ropivacaine
• Salsalate
• Secobarbital
• Segesterone Acetate; Ethinyl Estradiol
• Sodium Bicarbonate
• St. John’s Wort, Hypericum perforatum
• Sulfinpyrazone
• Telaprevir
• Telotristat Ethyl
• Tetracaine
• Thiopental
• Tizanidine
• tobacco
• Trimetrexate
• Vemurafenib
• Warfarin
• Zidovudine, ZDV
• Zolmitriptan