Acetaminophen is the most common analgesic prescribed in pediatrics in the United States today. It is an effective analgesic and antipyretic for the management of mild pain however, it does not possess anti-inflammatory properties. It has been substituted for aspirin for pain and fever management as it does not inhibit platelet function. It causes less gastric irritation and is not implicated in Reye syndrome. Over dosage (more than 3 grams in a child under 2 years or more than 15 grams in an adult) may result in acute liver failure and nephrotoxicity. Allergic reactions are very rare. Chewable tablets may contain phenylalanine and thus should be prescribed with caution in patients exhibiting phenylketonuria.

Its mechanism of action is inhibition of the synthesis of prostaglandins in the central nervous system and blockage of pain-impulse generation peripherally. Its antipyretic properties are produced from inhibition of the hypothalamic heat regulating center.

Contraindications: Hypersensitivity to acetaminophen or any component of the formulation.

Warnings/Precautions: Do not exceed the maximum dose. Acute over dosage may cause severe hepatic toxicity. Patients should be instructed to contact healthcare provider if used for fever lasting >3 days or pain lasting >5 days in children and 10 days in adults.

Children < 12 years: 10-15 mg/kg dose every 4 to 6 hours as needed. Do not exceed 5 doses (2.6 g) in 24 hours.
Adults: 325-650 mg every 4 to 6 hours or 1000 mg 3-4 times/day. Do not exceed 4 grams/day.

Supplied as:
Drops: 100 mg/ml (15 ml) or 80 mg/0.8 ml (15ml)
Elixir: 32 mg/ml (120 ml)
Tablets: 80 mg chewable or 325 mg regular or 500 mg extra strength
Suppository, rectal: 120 mg, 325 mg, 650 mg