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
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