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Jul.20.2021

Acetaminophen

Indications/Dosage

Labeled

  • arthralgia
  • dental pain
  • dysmenorrhea
  • fever
  • headache
  • mild pain
  • moderate pain
  • musculoskeletal pain
  • myalgia
  • severe pain

General dosing information:

  • Maximum daily dosage limits are based on all routes of administration (e.g., intravenous, oral, rectal) and all products containing acetaminophen, including both single-entity and combination products. Exceeding maximum daily dosage limits can result in hepatic injury, hepatic failure, and death.[42289] In an attempt to reduce the risk of hepatotoxicity, the FDA has recommended limiting the amount of acetaminophen in prescription combination products to 325 mg per dosage unit.[43086][56615]

Off-Label

  • migraine
† Off-label indication

For the treatment of fever

Oral dosage (immediate-release formulations)

Adults

325 to 650 mg PO every 4 to 6 hours, as needed. Alternatively, 1,000 mg PO 2 to 4 times per day can be given. Do not exceed 1 g/dose or 4 g/day.

Children and Adolescents weighing 60 kg or more

325 mg to 650 mg PO every 4 to 6 hours as needed. Alternatively, 1,000 mg PO every 6 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[52221] [54020] [54150]

Children and Adolescents weighing less than 60 kg

10 to 15 mg/kg/dose PO every 4 to 6 hours as needed. Max single dose: 15 mg/kg/dose or 1,000 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 4,000 mg/day, whichever is less.[54020] [54154]

Infants

10 to 15 mg/kg/dose PO every 4 to 6 hours as needed. Max single dose: 15 mg/kg/dose. Max daily dose: 75 mg/kg/day.[54020] [54154]

Neonates 10 to 29 days

10 to 15 mg/kg/dose PO every 4 to 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 90 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Neonates 0 to 9 days

10 to 15 mg/kg/dose PO every 6 to 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 32 to 37 weeks gestation

10 to 15 mg/kg/dose PO every 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 28 to 31 weeks gestation

10 to 15 mg/kg/dose PO every 12 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 40 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Oral dosage (extended-release formulations)

Adults

650 mg to 1,300 mg PO every 8 hours as needed. Max single dose: 1,300 mg/dose. Max daily dose: 3,900 mg/day.[54020]

Children and Adolescents 12 to 17 years

650 mg to 1,300 mg PO every 8 hours as needed. Max single dose: 1,300 mg/dose. Max daily dose: 3,900 mg/day.[54020]

Rectal dosage

Adults

325 to 650 mg PR every 4 to 6 hours as needed. Alternatively, 1,000 mg PR 2 to 4 times per day can be given. Do not exceed 1 g/dose or 4 g/day.[52221]

Children and Adolescents weighing 60 kg or more

325 to 650 mg PR every 4 to 6 hours as needed. Alternatively, 1,000 mg PR 2 to 4 times per day can be given. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[52221]

Children and Adolescents weighing less than 60 kg

10 to 20 mg/kg/dose PR every 4 to 6 hours as needed. Max single dose: 20 mg/kg/dose or 1,000 mg/dose, whichever is less. Max daily dose: 100 mg/kg/day or 4,000 mg/day, whichever is less.[54116] [54150] [54153] [54154]

Infants

10 to 20 mg/kg/dose PR every 4 to 6 hours as needed. Max single dose: 20 mg/kg/dose. Max daily dose: 75 mg/kg/day.[54111] [54153] [54154]

Neonates 10 to 29 days

20 mg/kg/dose PR every 6 to 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 90 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54121] [54157]

Neonates 0 to 9 days

20 mg/kg/dose PR every 6 to 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54121] [54157]

Premature Neonates 32 to 37 weeks gestation

20 mg/kg/dose PR every 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 28 to 31 weeks gestation

15 mg/kg/dose PR every 12 hours as needed. Some experts recommend an initial load of 20 mg/kg PR. Max: 40 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Intravenous dosage

Adults weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Adults weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Adolescents weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Children 2 to 12 years and Adolescents weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Infants and Children 1 to 23 months

15 mg/kg/dose IV every 6 hours as needed. Max daily dose: 60 mg/kg/day.[42289]

Neonates

12.5 mg/kg/dose IV every 6 hours as needed. Max daily dose: 50 mg/kg/day.[42289]

Premature Neonates 32 to 37 weeks gestation

12.5 mg/kg/dose IV every 6 hours as needed. Max daily dose: 50 mg/kg/day.[42289]

Premature Neonates 28 to 31 weeks postmenstrual age†

Limited data available; dose not established. Some experts do not recommend use of IV acetaminophen in premature neonates less than 32 weeks PMA until sufficient pharmacokinetic and pharmacodynamic studies have been conducted.[54139] A loading dose of 20 mg/kg IV, then 10 mg/kg/dose IV every 12 hours as needed has been recommended.[54118] [54141] Alternatively, 7.5 mg/kg/dose IV every 8 hours as needed has been suggested.[54142] Max single dose: 10 mg/kg/dose. Max daily dose: 22.5 mg/kg/day.[54118] [54141] [54142]

For the treatment of mild pain or for the temporary relief of headache, myalgia, back pain, musculoskeletal pain, dental pain (e.g., toothache), dysmenorrhea, arthralgia, or minor aches and pains associated with the common cold or flu

Oral dosage (immediate-release formulations)

Adults

325 to 650 mg PO every 4 to 6 hours, as needed. Alternatively, 1,000 mg PO, 2 to 4 times per day can be given. It is important to note that doses effective for acute pain relief (1 to 2 tablets/day) may not be effective in chronic pain states, which require higher daily doses. Do not exceed 1 g/dose or 4 g/day.

Children and Adolescents weighing 60 kg or more

325 mg to 650 mg PO every 4 to 6 hours as needed. Alternatively, 1,000 mg PO every 6 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[52221] [54020] [54150]

Children and Adolescents weighing less than 60 kg

10 to 15 mg/kg/dose PO every 4 to 6 hours as needed. Max single dose: 15 mg/kg/dose or 1,000 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 4,000 mg/day, whichever is less.[54020] [54154]

Infants

10 to 15 mg/kg/dose PO every 4 to 6 hours as needed. Max single dose: 15 mg/kg/dose. Max daily dose: 75 mg/kg/day.[54020] [54154]

Neonates 10 to 29 days

10 to 15 mg/kg/dose PO every 4 to 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 90 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Neonates 0 to 9 days

10 to 15 mg/kg/dose PO every 6 to 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 32 to 37 weeks gestation

10 to 15 mg/kg/dose PO every 8 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 28 to 31 weeks gestation

10 to 15 mg/kg/dose PO every 12 hours as needed. Some experts recommend an initial load of 20 mg/kg PO. Max: 40 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Oral dosage (extended-release formulations)

Adults

650 mg to 1,300 mg PO every 8 hours as needed. Max single dose: 1,300 mg/dose. Max daily dose: 3,900 mg/day.[54020]

Children and Adolescents 12 to 17 years

650 mg to 1,300 mg PO every 8 hours as needed. Max single dose: 1,300 mg/dose. Max daily dose: 3,900 mg/day.[54020]

Rectal dosage

Adults

325 to 650 mg PR every 4 to 6 hours as needed. Alternatively, 1,000 mg PR 2 to 4 times per day can be given. It is important to note that doses effective for acute pain relief may not be effective in chronic pain states, which require higher daily doses. Do not exceed 1 g/dose or 4 g/day.[52221]

Children and Adolescents weighing 60 kg or more

325 to 650 mg PR every 4 to 6 hours as needed. Alternatively, 1,000 mg PR 2 to 4 times per day can be given. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[52221]

Children and Adolescents weighing less than 60 kg

10 to 20 mg/kg/dose PR every 4 to 6 hours as needed. Max single dose: 20 mg/kg/dose or 1,000 mg/dose, whichever is less. Max daily dose: 100 mg/kg/day or 4,000 mg/day, whichever is less. High-dose rectal acetaminophen (25 to 45 mg/kg/dose) has been studied and recommended as an initial loading dose for pain management, as well as for the scheduled management of peri- and postoperative pain, in pediatric patients. Its use is controversial, as optimal dosing has not been established.[54111] [54116] [54150] [54153] [54154]

Infants

10 to 20 mg/kg/dose PR every 4 to 6 hours as needed. Max single dose: 20 mg/kg/dose. Max daily dose: 75 mg/kg/day. High-dose rectal acetaminophen (25 to 45 mg/kg/dose) has been studied and recommended as an initial loading dose for pain management, as well as for the scheduled management of peri- and postoperative pain, in pediatric patients. Its use is controversial, as optimal dosing has not been established.[32702] [54111] [54153] [54154]

Neonates 10 to 29 days

20 mg/kg/dose PR every 6 to 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 90 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54121] [54157]

Neonates 0 to 9 days

20 mg/kg/dose PR every 6 to 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54121] [54157]

Premature Neonates 32 to 37 weeks gestation

20 mg/kg/dose PR every 8 hours as needed. Some experts recommend an initial load of 30 mg/kg PR. Max: 60 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Premature Neonates 28 to 31 weeks gestation

15 mg/kg/dose PR every 12 hours as needed. Some experts recommend an initial load of 20 mg/kg PR. Max: 40 mg/kg/day. Do not exceed 48 consecutive hours at the maximum dose.[52218] [54157]

Intravenous dosage

Adults weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Adults weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Adolescents weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Children 2 to 12 years and Adolescents weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Infants and Children 1 to 23 months†

7.5 to 15 mg/kg/dose IV every 6 hours as needed.[54132] [64934] Max daily dose: 60 mg/kg/day.[42289] [64934] Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289]

Neonates†

The FDA-approved dose for fever in this age group is 12.5 mg/kg/dose IV every 6 hours as needed; Max daily dose: 50 mg/kg/day. Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289] In the literature, a loading dose of 20 mg/kg IV, then 7.5 to 15 mg/kg/dose IV every 6 hours as needed has been suggested.[54118] [54141] [54142] [56547] For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

Premature Neonates 32 to 37 weeks gestation†

The FDA-approved dose for fever in this age group is 12.5 mg/kg/dose IV every 6 hours as needed; Max daily dose: 50 mg/kg/day. Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289] In the literature, a loading dose of 20 mg/kg IV, then 10 mg/kg/dose IV every 8 hours as needed has been recommended.[54141] [54118] Alternatively, 7.5 to 10 mg/kg/dose IV every 6 hours as needed has been suggested.[54118] [54142] For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

Premature Neonates 28 to 31 weeks postmenstrual age†

Limited data available; dose not established. Some experts do not recommend use of IV acetaminophen in premature neonates less than 32 weeks PMA until sufficient pharmacokinetic and pharmacodynamic studies have been conducted.[54139] A loading dose of 20 mg/kg IV, then 10 mg/kg/dose IV every 12 hours as needed has been recommended.[54118] [54141] Alternatively, 7.5 mg/kg/dose IV every 8 hours as needed has been suggested.[54142] Max single dose: 10 mg/kg/dose. Max daily dose: 22.5 mg/kg/day. For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

For the treatment of moderate pain to severe pain with adjunctive opioid analgesics

Intravenous dosage

Adults weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Adults weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Adolescents weighing 50 kg or more

1,000 mg IV every 6 hours or 650 mg IV every 4 hours as needed. Max single dose: 1,000 mg/dose. Max daily dose: 4,000 mg/day.[42289]

Children 2 to 12 years and Adolescents weighing less than 50 kg

15 mg/kg/dose IV every 6 hours or 12.5 mg/kg/dose IV every 4 hours as needed. Max single dose: 15 mg/kg/dose or 750 mg/dose, whichever is less. Max daily dose: 75 mg/kg/day or 3,750 mg/day, whichever is less.[42289]

Infants and Children 1 to 23 months†

7.5 to 15 mg/kg/dose IV every 6 hours as needed.[54132] [64934] Max daily dose: 60 mg/kg/day.[42289] [64934] Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289]

Neonates†

The FDA-approved dose for fever in this age group is 12.5 mg/kg/dose IV every 6 hours as needed; Max daily dose: 50 mg/kg/day. Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289] In the literature, a loading dose of 20 mg/kg IV, then 7.5 to 15 mg/kg/dose IV every 6 hours as needed has been suggested.[54118] [54141] [54142] [56547] For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

Premature Neonates 32 to 37 weeks gestation†

The FDA-approved dose for fever in this age group is 12.5 mg/kg/dose IV every 6 hours as needed; Max daily dose: 50 mg/kg/day. Efficacy of IV acetaminophen for the treatment of acute pain has not been established in patients younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in those younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo.[42289] In the literature, a loading dose of 20 mg/kg IV, then 10 mg/kg/dose IV every 8 hours as needed has been recommended.[54141] [54118] Alternatively, 7.5 to 10 mg/kg/dose IV every 6 hours as needed has been suggested.[54118] [54142] For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

Premature Neonates 28 to 31 weeks postmenstrual age†

Limited data available; dose not established. Some experts do not recommend use of IV acetaminophen in premature neonates less than 32 weeks PMA until sufficient pharmacokinetic and pharmacodynamic studies have been conducted.[54139] A loading dose of 20 mg/kg IV, then 10 mg/kg/dose IV every 12 hours as needed has been recommended.[54118] [54141] Alternatively, 7.5 mg/kg/dose IV every 8 hours as needed has been suggested.[54142] Max single dose: 10 mg/kg/dose. Max daily dose: 22.5 mg/kg/day. For scheduled postoperative analgesia in neonates, decreasing the dose by 50% after 4 days of continuously scheduled acetaminophen has been recommended; do not exceed 6 days of scheduled acetaminophen therapy.[54118] [54141] [54142]

For the treatment of acute migraine†

Oral dosage

Adults

1,000 mg PO once. Guidelines classify acetaminophen as having established efficacy for the treatment of acute migraine for non-incapacitating attacks.[64565]

Children and Adolescents 4 to 17 years

15 mg/kg/dose PO once at the onset of attack has been evaluated in a crossover study of pediatric patients (n = 88 intent to treat analysis; n = 66 efficacy analysis; age range: 4 to 16 years) in which 3 attacks were treated separately with acetaminophen (15 mg/kg), ibuprofen (10 mg/kg), or placebo. An hour after administration, acetaminophen was more than 3 times as effective as placebo with regard to pain relief (OR 3.9, 95% CI 1.4 to 11) and complete pain resolution (OR 3.3, 95% CI 1 to 11.1); there was no difference between the active drugs. At 2 hours after administration, acetaminophen was not superior to placebo and inferior to ibuprofen (OR 2.2, 95% CI 1.1 to 4 for acetaminophen vs. ibuprofen). In the intent to treat analysis, acetaminophen was twice as effective as placebo at both 1 and 2 hours with no clear difference in efficacy between the active drugs (OR 0.9, 95% CI 0.6 to 1.3 for acetaminophen vs. ibuprofen). At 2 hours, acetaminophen provided headache alleviation in 54% of patients (compared to 37% for placebo and 68% for ibuprofen). Complete resolution occurred in 39% of acetaminophen-treated, 60% of ibuprofen-treated, and 28% of placebo-treated patients.[56544] Guidelines state that acetaminophen is probably effective and should be considered in the acute treatment of migraine in children.[33312]

Therapeutic Drug Monitoring

Maximum Dosage Limits

  • Adults

    1,000 mg/dose PO/PR/IV or 4,000 mg/day PO/PR/IV for most formulations; some OTC formulations have lower max doses, see individual products. For the extended-release oral product, 1,300 mg/dose PO, with the same overall daily dose limits as other formulations. The total daily maximum dose of 4,000 mg is the maximum dose of acetaminophen from all sources.

  • Geriatric

    1,000 mg/dose PO/PR/IV or 4,000 mg/day PO/PR/IV for most formulations; some OTC formulations have lower max doses, see individual products. For the extended-release oral product, 1,300 mg/dose PO, with the same overall daily dose limits as other formulations. The total daily maximum dose of 4,000 mg is the maximum dose of acetaminophen from all sources.

  • Adolescents

    Weighing 60 kg or more: 1,000 mg/dose PO/IV/PR (Max daily dose: 4,000 mg/day PO/IV/PR).

    Weighing 50 to 59 kg: 15 mg/kg/dose PO (Max daily dose: 75 mg/kg/day [Max: 4,000 mg/day] PO); 20 mg/kg/dose PR (Max single dose: 1,000 mg/dose PR; Max daily dose: 100 mg/kg/day [Max: 4,000 mg/day] PR); 1,000 mg/dose IV (Max daily dose: 4,000 mg/day IV).

    Weighing less than 50 kg: 15 mg/kg/dose PO/IV (Max daily dose: 75 mg/kg/day [Max: 3,750 mg/day] PO/IV); 20 mg/kg/dose PR (Max daily dose: 100 mg/kg/day [Max: 4,000 mg/day] PR).

  • Children

    2 to 12 years weighing 60 kg or more: 1,000 mg/dose PO/PR (Max daily dose: 4,000 mg/day PO/PR); 15 mg/kg/dose IV (Max single dose: 750 mg/dose IV; Max daily dose: 75 mg/kg/day [Max: 3,750 mg/day] IV).

    2 to 12 years weighing 50 to 59 kg: 15 mg/kg/dose PO (Max daily dose: 75 mg/kg/day [Max: 4,000 mg/day] PO); 20 mg/kg/dose PR (Max single dose: 1,000 mg/dose PR; Max daily dose: 100 mg/kg/day [Max: 4,000 mg/day] PR); 15 mg/kg/dose IV (Max single dose: 750 mg/dose IV; Max daily dose: 75 mg/kg/day [Max: 3,750 mg/day] IV).

    2 to 12 years weighing less than 50 kg: 15 mg/kg/dose PO/IV (Max daily dose: 75 mg/kg/day [Max: 3,750 mg/day] PO/IV); 20 mg/kg/dose PR (Max daily dose: 100 mg/kg/day [Max: 4,000 mg/day] PR).

    1 to 2 years: 15 mg/kg/dose PO (Max daily dose: 75 mg/kg/day PO); 20 mg/kg/dose PR (Max daily dose: 100 mg/kg/day PR); 15 mg/kg/dose IV (Max daily dose: 60 mg/kg/day IV).

  • Infants

    15 mg/kg/dose PO (Max daily dose: 75 mg/kg/day PO); 20 mg/kg/dose PR (Max daily dose: 75 mg/kg/day PR); 15 mg/kg/dose IV (Max daily dose: 60 mg/kg/day IV).

  • Neonates

    10 to 29 days: 20 mg/kg PO load and 15 mg/kg/dose PO maintenance dose (Max daily dose: 90 mg/kg/day PO); 30 mg/kg PR load and 20 mg/kg/dose PR maintenance dose (Max daily dose: 90 mg/kg/day PR); 12.5 mg/kg/dose IV (Max daily dose: 50 mg/kg/day IV). A loading dose up to 20 mg/kg IV and maintenance doses up to 15 mg/kg IV (Max daily dose: 60 mg/kg/day IV) have been used off-label.

    0 to 9 days: 20 mg/kg PO load and 15 mg/kg/dose PO maintenance dose (Max daily dose: 60 mg/kg/day PO); 30 mg/kg PR load and 20 mg/kg/dose PR maintenance dose (Max daily dose: 60 mg/kg/day PR); 12.5 mg/kg/dose IV (Max daily dose: 50 mg/kg/day IV). A loading dose up to 20 mg/kg IV and maintenance doses up to 15 mg/kg IV (Max daily dose: 60 mg/kg/day IV) have been used off-label.

    32 to 37 weeks gestation: 20 mg/kg PO load and 15 mg/kg/dose PO maintenance dose (Max daily dose: 60 mg/kg/day PO); 30 mg/kg PR load and 20 mg/kg/dose PR maintenance dose (Max daily dose: 60 mg/kg/day PR); 12.5 mg/kg/dose IV (Max daily dose: 50 mg/kg/day IV). A loading dose up to 20 mg/kg IV and maintenance doses up to 10 mg/kg IV (Max daily dose: 40 mg/kg/day IV) have been used off-label.

    28 to 31 weeks PMA: 20 mg/kg PO/PR load and 15 mg/kg/dose PO/PR maintenance dose (Max daily dose: 40 mg/kg/day PO/PR). Safety and efficacy of the IV formulation not established; however, loading doses up to 20 mg/kg IV and maintenance doses up to 10 mg/kg/dose IV (Max daily dose: 22.5 mg/kg/day IV) have been used off-label.

Patients with Hepatic Impairment Dosing

Use with caution in patients with hepatic dysfunction. In patients with chronic hepatic disease, acetaminophen can be used safely; use the smallest dose for the shortest duration necessary.[23562][54020][54066]

Patients with Renal Impairment Dosing

For patients with a CrCl of 30 mL/minute or less, reduced dosing and prolonged intervals are recommended for IV dosing; however no quantitative recommendations are available.[42289] For patients with a CrCl less than 10 mL/minute, administer acetaminophen (all dosage forms) at a minimum interval of every 8 hours.[32569] Chronic use should be discouraged in patients with underlying renal disease.[54096]

 

Intermittent hemodialysis

Administer acetaminophen every 8 hours.[32569]

 

Peritoneal dialysis

Administer acetaminophen every 8 hours.[32569]

 

Continuous renal replacement therapy (CRRT)

No dosage adjustment necessary.[32569]

† Off-label indication
Revision Date: 07/20/2021, 10:44:49 AM

References

23562 - Benson GD. Acetaminophen in chronic liver disease. Clin Pharmacol Ther 1983;33:95-101.32569 - Aronoff GR, Bennett WM, Berns JS, et al. Drug prescribing in renal failure: dosing guidelines for adults and children, 5th ed. Philadelphia: American College of Physicians; 2007.32702 - Berde CB, Sethna NF. Analgesics for the treatment of pain in children. N Engl J Med 2002;347:1094-103.33312 - Lewis D, Ashwall S, Hershey A, et al. Practice parameter: pharmacological treatment of migraine headache in children and adolescents; report of the American Academy of Neurology Quality Standards Subcommittee and the Practice Committee of the Child Neurology Society. Neurology 2004;63:2215-24.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.43086 - Food and Drug Administration MedWatch. Acetaminophen Prescription Products Limited to 325 mg Per Dosage Unit: Drug Safety Communication. Retrieved January 13, 2011. Available at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm239955.htm52218 - Anand KJ, International Evidence-Based Group for Neonatal Pain. Consensus statement for the prevention and management of pain in the newborn. Arch Pediatr Adolesc Med 2001;155:173-80.52221 - Playfor S, Jenkins I, Boyles C, et al. Consensus guidelines on sedation and analgesia in critically ill children. Intensive Care Med 2006;32:1125-36.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf54066 - Benson GD, Koff RS, Tolman KG. The therapeutic use of acetaminophen in patients with liver disease. Am J Ther 2005;12:133-141.54096 - Henrich WL, Agodoa LE, Barrett B. Analgesics and the kidney: summary and recommendations to the scientific advisory board of the National Kidney Foundation form an ad hoc committee of the National Kidney Foundation. Am J Kidney Dis 1996;27:162-165.54111 - Buck ML. Perioperative use of high-dose rectal acetaminophen. Pediatric Pharmacother 2001;7:1-354116 - Birmingham PK, Tobin MJ, Fisher DM. Initial and subsequent dosing of rectal acetaminophen in children. Anesthesiology 2001;94:385-389.54118 - Allegaert K, Palmer GM, Anderson BJ. The pharmacokinetics of intravenous paracetamol in neonates: size matters most. Arch Dis Child 2011;96:575-580.54121 - van Lingen RA, Deinum HT, Quak CM. Multiple-dose pharmacokinetics of rectally administered acetaminophen in term infants. Clin Pharmacol Ther 1999;66:509-515.54132 - Wilson-Smith EM, Morton NS. Survey of I.V. paracetamol (acetaminophen) use in neonates and infants under 1 year of age by UK anesthetists. Paediatr Anaesth 2009;19:329-337.54139 - van den Anker JN, Tibboel D. Pain relief in neonates: when to use intravenous paracetamol. Arch Dis Child 2011;96:573-574.54141 - Allegaert K, Murat I, Anderson BJ. Not all intravenous paracetamol formulations are created equal...Paediatr Anaesth 2007;17:811-812.54142 - Bartocci M, Lundeberg S. Intravenous paracetamol: the 'Stockholm protocol' for postoperative analgesia of term and preterm neonates. Paediatr Anaesth 2007;17:1120-1121.54150 - Greco C, Berde C. Pain management for the hospitalized pediatric patient. Pediatr Clin North Am 2005;52:995-1027.54153 - Kraemer FW, Rose JB. Pharmacologic management of acute pediatric pain. Anesthesiol Clin 2009;27:241-268.54154 - Bauman BH, McManus JG. Pediatric pain management in the emergency department. Emerg Med Clin North Am 2005;23:393-414.54157 - Arana A, Morton NS, Hansen TG. Treatment with paracetamol in infants. Acta Anaesthesiol Scand 2001;45:20-29.56544 - Hamalainen JL, Hoppu K, Valkeila E. Ibuprofen or acetaminophen for the acute treatment of migraine in children: a double-blind, randomized, placebo-controlled, crossover study. Neurology 1997;48:103-107.56547 - Ceelie I, de Wildt SN, van Dijk M. Effect of intravenous paracetamol on postoperative morphine requirements in neonates and infants undergoing major noncardiac surgery: a randomized controlled trial. JAMA 2013;309:149-154.56615 - US Food and Drug Administration (FDA). FDA recommends health care professionals discontinue prescribing and dispensing prescription combination drug products with more than 325 mg of acetaminophen to protect consumers. Retrieved January 15, 2014. Available on the World Wide Web at: http://www.fda.gov/Drugs/DrugSafety/ucm381644.htm64565 - Marmura MJ, Silberstein SD, Schwedt TJ. The acute treatment of migraine in adults: The American Headache Society evidence assessment of migraine pharmacotherapies. Headache 2015;55:3-20.64934 - Shenoi RP, Timm N, AAP Committee on Drugs, AAP Committee on Emergency Medicine. Drugs used to treat pediatric emergencies. Pediatrics 2020;145:e20193450.

How Supplied

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (65162-0603) (Akyma Pharmaceuticals, a subsidiary of Amneal Pharmaceuticals) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (24385-0481) (AmerisourceBergen Corporation) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (24385-0492) (AmerisourceBergen Corporation) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00761-0917) (Basic Vitamins) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00761-0916) (Basic Vitamins) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (52735-0705) (Family Pharmacy) null

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (52735-0726) (Family Pharmacy) null

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (53746-0020) (Interpharm Inc) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00820-0145) (Logen Pharmaceuticals Inc.) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (null) (Mason Vitamins) null

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (49348-0199) (McKesson Corporation) null

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00084-0426) (Natural Nutritionals Company) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00084-0419) (Natural Nutritionals Company) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (17236-0603) (R&S Northeast, LLC, formerly Dixon-Shane Drug Company) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (69618-0012) (Reliable 1 Laboratories LLC) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00122-0868) (Rexall Group) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (60814-0145) (Rexall Group) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00122-0873) (Rexall Group) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (60814-0144) (Rexall Group) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (00364-0643) (Teva/Actavis US) (off market)

Acetaminophen Chewable tablet

Acetaminophen 80mg Chewable Tablet (11383-0142) (Weeks and Leo) null

Acetaminophen Chewable tablet

Children's Acetaminophen 80mg Chewable Tablet (00536-3233) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Chewable tablet

Children's Genapap Chewable Tablet (Grape) (00182-2147) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Chewable tablet

Children's Pain and Fever 80mg Chewable Tablet (00536-3234) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Chewable tablet

GoodSense Acetaminophen 80mg Chewable Tablet (00113-0481) (Goodsense a Division of Perrigo) null

Acetaminophen Chewable tablet

Leader Children's Pain Reliever Chewable Tablet (Grape) (37205-0055) (Cardinal Health, Inc.) (off market)Leader Children's Pain Reliever Chewable Tablet (Grape) package photo

Acetaminophen Chewable tablet

Mapap Children's 80mg Chewable Tablet (00904-1974) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Chewable tablet

Mapap Children's 80mg Chewable Tablet (00904-5256) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Chewable tablet

Pain & Fever 80mg Chewable Tablet (00536-1014) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Chewable tablet

Premier Value Children's Non-Aspirin 80mg Chewable Tablet (Fruit) (null) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Chewable tablet

Select Brand Children's Pain Reliever 80mg Chewable Tablet (15127-0830) (Select Brand) nullSelect Brand Children's Pain Reliever 80mg Chewable Tablet package photo

Acetaminophen Chewable tablet

Tylenol Children's 80mg Chewable Tablet (50580-0486) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Chewable tablet

Tylenol Children's 80mg Chewable Tablet (Bubblegum) (50580-0430) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Chewable tablet

Tylenol Children's 80mg Soft Chew (Fruit Burst) (50580-0102) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Chewable tablet

Tylenol Children's 80mg Soft Chew (Grape) (50580-0104) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Chewable tablet

Acetaminophen 160mg Chewable Tablet (52735-0754) (Family Pharmacy) null

Acetaminophen Chewable tablet

Acetaminophen 160mg Tablet (00536-3284) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Chewable tablet

CVS Children's Pain Relief 160mg Chewable Tablet (Bubblegum) (null) (CVS Health) null

Acetaminophen Chewable tablet

GNP Children's Pain Relief 160mg Chewable Tablet (Bubblegum) (46122-0424) (AmerisourceBergen Corporation) null

Acetaminophen Chewable tablet

Health Mart Children's 160mg Chewable Tablet (Bubblegum) (62011-0339) (McKesson Corporation) null

Acetaminophen Chewable tablet

Leader Children's Acetaminophen 160mg Chewable Tablet (Bubblegum) (70000-0310) (Cardinal Health, Inc.) null

Acetaminophen Chewable tablet

Leader Children's Acetaminophen 160mg Chewable Tablet (Grape) (70000-0309) (Cardinal Health, Inc.) null

Acetaminophen Chewable tablet

Mapap Children's 160mg Chewable Tablet (Bubblegum) (00904-6645) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Chewable tablet

PediaCare Children's Smooth Melts Fever Reducer/Pain Reliever 160mg Chewable Tablet (Cherry) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Chewable tablet

RITE AID Junior Acetaminophen 160mg Chewable Tablet (Bubble Gum) (null) (Rite Aid Corp) nullRITE AID Junior Acetaminophen 160mg Chewable Tablet (Bubble Gum) package photo

Acetaminophen Chewable tablet

Tylenol Children's 160mg Chewable Tablet (Bubblegum) (00045-0519) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Chewable tablet

Tylenol Children's 160mg Chewable Tablet (Grape) (00045-0518) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Chewable tablet

Walgreens Children's Pain & Fever 160mg Chewable Tablet (Bubblegum) (00363-4501) (Walgreens Co) null

Acetaminophen Chewable tablet

Walgreens Children's Pain & Fever 160mg Chewable Tablet (Grape) (00363-9440) (Walgreens Co) null

Acetaminophen Chewable tablet, Acetaminophen Oral solution

TYLENOL Children's Be Ready At Home Or On-The-Go Convenience Kit (00045-0296) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Effervescent tablet

CVS Pain Relief Extra Strength Effervescent Tablet (Orange) (59779-0179) (CVS Health) null

Acetaminophen Elixir

Apra 160mg/5ml Elixir (59390-0074) (Altaire Pharmaceuticals Inc) (off market)

Acetaminophen Elixir

Apra 160mg/5ml Elixir (59390-0002) (Altaire Pharmaceuticals Inc) (off market)

Acetaminophen Elixir

Mapap 160mg/5mL Elixir (Cherry) (00904-1985) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)Mapap 160mg/5mL Elixir (Cherry) package photo

Acetaminophen Oral capsule

Aceta 500mg Capsule (00436-0958) (Century Pharmaceuticals Inc) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (52735-0723) (Family Pharmacy) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (00820-0191) (Logen Pharmaceuticals Inc.) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (10135-0225) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (null) (Mason Vitamins) null

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (17236-0601) (R&S Northeast, LLC, formerly Dixon-Shane Drug Company) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (60814-0148) (Rexall Group) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (00536-3230) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (00677-0678) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral capsule

Acetaminophen 500mg Capsule (11383-0012) (Weeks and Leo) null

Acetaminophen Oral capsule

Mapap 500mg Capsule (00904-1987) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral capsule

Mapap 500mg Gelcap (00904-1989) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral capsule

Walgreens Acetaminophen Extra Strength 500mg Gelcap (00363-0325) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Gelcap package photo

Acetaminophen Oral capsule

XS No Aspirin Pain Reliever Capsule (00084-0050) (Natural Nutritionals Company) (off market)

Acetaminophen Oral capsule, liquid filled

CVS Acetaminophen 325mg Liquid Gel Capsule (null) (CVS Health) null

Acetaminophen Oral capsule, liquid filled

CVS Pain Relief 325mg Liquid Gel Capsule (51013-0176) (CVS Health) (off market)

Acetaminophen Oral capsule, liquid filled

GNP Pain Relief 325mg Liquid Gel Capsule (46122-0372) (AmerisourceBergen Corporation) null

Acetaminophen Oral capsule, liquid filled

Tylenol 325mg Liquid Gel Capsule (00045-0487) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral capsule, liquid filled

CVS Pain Relief Extra Strength 500mg Liquid Gel (51013-0107) (CVS Health) null

Acetaminophen Oral capsule, liquid filled

GNP Acetaminophen Extra Strength 500mg Liquid Capsule (46122-0388) (AmerisourceBergen Corporation) null

Acetaminophen Oral capsule, liquid filled

Walgreens Pain Reliever Extra Strength 500mg Softgel (00363-0711) (Walgreens Co) null

Acetaminophen Oral disintegrating tablet

CVS Children's Pain Relief 80mg Rapid Tab (Bubblegum) (null) (CVS Health) (off market)CVS Children's Pain Relief 80mg Rapid Tab (Bubblegum) package photo

Acetaminophen Oral disintegrating tablet

CVS Children's Pain Relief 80mg Rapid Tab (Bubblegum) (59779-0447) (CVS Health) null

Acetaminophen Oral disintegrating tablet

CVS Children's Pain Relief 80mg Rapid Tab (Grape) (null) (CVS Health) (off market)CVS Children's Pain Relief 80mg Rapid Tab (Grape) package photo

Acetaminophen Oral disintegrating tablet

CVS Children's Pain Relief 80mg Rapid Tab (Grape) (59779-0452) (CVS Health) null

Acetaminophen Oral disintegrating tablet

GNP Children's Easy-Melts 80mg Tablet (Bubblegum) (46122-0131) (AmerisourceBergen Corporation) null

Acetaminophen Oral disintegrating tablet

GNP Children's Easy-Melts 80mg Tablet (Grape) (46122-0133) (AmerisourceBergen Corporation) null

Acetaminophen Oral disintegrating tablet

Leader Children's Pain Reliever 80mg Rapid Melts Tablet (Bubblegum) (37205-0516) (Cardinal Health, Inc.) null

Acetaminophen Oral disintegrating tablet

Mapap Children's 80mg Rapid Orally Disintegrating Tablet (Bubble Gum) (00904-5751) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral disintegrating tablet

Mapap Children's 80mg Rapid Orally Disintegrating Tablet (Grape) (00904-5791) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral disintegrating tablet

Premier Value Children's Non-Aspirin 80mg Quick Melt Tab (Grape) (68016-0019) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral disintegrating tablet

Premier Value Children's Pain Reliever 80mg Quick Melt Tablet (Grape) (68016-0196) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral disintegrating tablet

RITE AID Children's Pain Reliever Rapid Melt 80mg Dissolving Tablet (Bubblegum) (null) (Rite Aid Corp) nullRITE AID Children's Pain Reliever Rapid Melt 80mg Dissolving Tablet (Bubblegum) package photo

Acetaminophen Oral disintegrating tablet

Tylenol Children's 80mg Meltaways (Bubblegum Burst) (00045-0519) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral disintegrating tablet

Tylenol Children's 80mg Meltaways (Grape Punch) (00045-0518) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral disintegrating tablet

Tylenol Children's 80mg Meltaways (Wacky Watermelon) (50580-0516) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral disintegrating tablet

Walgreens Children's Acetaminophen 80mg Rapid Tab (Bubble Gum) (00363-0447) (Walgreens Co) nullWalgreens Children's Acetaminophen 80mg Rapid Tab (Bubble Gum) package photo

Acetaminophen Oral disintegrating tablet

Walgreens Children's Acetaminophen 80mg Rapid Tab (Grape) (00363-0452) (Walgreens Co) nullWalgreens Children's Acetaminophen 80mg Rapid Tab (Grape) package photo

Acetaminophen Oral disintegrating tablet

CVS Junior Pain Relief 160mg Rapid Tab (Bubblegum) (null) (CVS Health) nullCVS Junior Pain Relief 160mg Rapid Tab (Bubblegum) package photo

Acetaminophen Oral disintegrating tablet

CVS Junior Pain Relief 160mg Rapid Tab (Grape) (null) (CVS Health) nullCVS Junior Pain Relief 160mg Rapid Tab (Grape) package photo

Acetaminophen Oral disintegrating tablet

Junior Mapap 160mg Rapid Orally Disintegrating Tablet (Bubble Gum) (00904-5754) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral disintegrating tablet

Junior Mapap 160mg Rapid Tab (Bubble Gum) (00904-5754) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral disintegrating tablet

Premier Value Jr. Non-Aspirin 160mg Quick Melt (Grape) (68016-0019) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral disintegrating tablet

Premier Value Junior Pain Reliever 160mg Quick Melt Tablet (Grape) (68016-0198) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral disintegrating tablet

RITE AID Junior Acetaminophen 160mg Rapid Melts Tablet (Bubble Gum) (null) (Rite Aid Corp) null

Acetaminophen Oral disintegrating tablet

RITE AID Junior Acetaminophen 160mg Rapid Melts Tablet (Grape) (null) (Rite Aid Corp) nullRITE AID Junior Acetaminophen 160mg Rapid Melts Tablet (Grape) package photo

Acetaminophen Oral disintegrating tablet

Sunmark Junior Pain Reliever Fever Reducer 160mg Rapid Melt (Bubblegum) (49348-0063) (McKesson Corporation) null

Acetaminophen Oral disintegrating tablet

Tylenol Junior 160mg Meltaways (Bubblegum Burst) (50580-0513) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral disintegrating tablet

Tylenol Junior 160mg Meltaways (Grape Punch) (00045-0514) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral disintegrating tablet

Walgreens Junior Acetaminophen 160mg Rapid Tab (Bubble Gum) (00363-0450) (Walgreens Co) nullWalgreens Junior Acetaminophen 160mg Rapid Tab (Bubble Gum) package photo

Acetaminophen Oral disintegrating tablet

Walgreens Junior Acetaminophen 160mg Rapid Tab (Grape) (00363-0449) (Walgreens Co) null

Acetaminophen Oral disintegrating tablet

Walgreens Junior Pain & Fever 160mg Fast Dissolving Tablet (Bubblegum) (00363-4500) (Walgreens Co) null

Acetaminophen Oral drops, solution

Infant Q-Pap 80mg/0.8ml Drops (Fruit) (00603-0838) (Par Pharmaceuticals, an Endo Company) nullInfant Q-Pap 80mg/0.8ml Drops (Fruit) package photo

Acetaminophen Oral drops, solution

Infantaire 80mg/0.8ml Drops (59390-0001) (Altaire Pharmaceuticals Inc) (off market)

Acetaminophen Oral drops, solution

Infants' Acetaminophen 80mg/0.8ml Drops (00182-6009) (Teva Pharmaceuticals USA) (off market)Infants' Acetaminophen 80mg/0.8ml Drops package photo

Acetaminophen Oral drops, solution

Infants' Genapap 80mg/0.8ml Drops (00182-1477) (Teva Pharmaceuticals USA) (off market)Infants' Genapap 80mg/0.8ml Drops package photo

Acetaminophen Oral drops, solution

Infants' Mapap 80mg/0.8ml Drops (00904-5901) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral drops, solution

Infants' Mapap 80mg/0.8ml Drops (00904-6158) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral drops, solution

Infants' Silapap Drops (54838-0145) (Silarx Pharmaceuticals Inc) (off market)

Acetaminophen Oral drops, solution

Mapap 80mg/0.8ml Drops (00904-5255) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral drops, solution

Nortemp 80mg/0.8ml Drops (Cherry) (63162-0518) (Ballay Pharmaceuticals) (off market)

Acetaminophen Oral drops, solution

Pain and Fever 80mg/0.8ml Drops (00536-1936) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Pain and Fever 80mg/0.8ml Drops package photo

Acetaminophen Oral drops, solution

Pediaphen 80mg/0.8ml Concentrated Drops (Cherry) (42192-0504) (Acella Pharmaceuticals, LLC, formerly BrookstonePharma, Inc) (off market)

Acetaminophen Oral drops, solution

Top Care Infants' Pain Relief 80mg/0.8ml Drops (Cherry) (36800-0008) (Topco Associates LLC) null

Acetaminophen Oral drops, solution

Tylenol Infants' 80mg/0.8ml Concentrated Drops (Cherry) (00045-0167) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral drops, solution

Tylenol Infants' 80mg/0.8ml Concentrated Drops (Cherry) (00045-0186) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral drops, solution

Tylenol Infants' 80mg/0.8ml Concentrated Drops (Grape) (50580-0122) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral drops, solution

Tylenol Infants' 80mg/0.8ml Concentrated Drops (Grape) (00045-0122) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral drops, suspension

Equaline Infants' Pain Relief 80mg/0.8ml Drops (41163-0008) (Albertson's, Inc) (off market)

Acetaminophen Oral drops, suspension

GNP Infants' Pain Relief 80mg/0.8ml Concentrated Drops (Cherry) (24385-0313) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral drops, suspension

GoodSense Infants' Pain Relief 80mg/0.8mL Concentrated Drops (Cherry) (00113-0008) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral drops, suspension

GoodSense Infants' Pain Relief 80mg/0.8mL Concentrated Drops (Grape) (00113-0289) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral drops, suspension

Leader Infants' Pain Reliever Concentrated Suspension Drops (37205-0008) (Cardinal Health, Inc.) (off market)Leader Infants' Pain Reliever Concentrated Suspension Drops package photo

Acetaminophen Oral drops, suspension

Publix Infants' Pain Relief 80mg/0.8ml Concentrated Drops (Cherry) (56062-0008) (Publix Super Markets, Inc) null

Acetaminophen Oral drops, suspension

RITE AID Infants' Pain Relief 80mg/0.8ml Concentrated Drops (Cherry) (null) (Rite Aid Corp) null

Acetaminophen Oral drops, suspension

Top Care Infants' Pain Relief 80mg/0.8ml Concentrated Drops (Grape) (null) (Topco Associates LLC) null

Acetaminophen Oral drops, suspension

Top Care Infants' Pain Relief 80mg/0.8ml Concentrated Drops (Grape) (null) (Topco Associates LLC) null

Acetaminophen Oral drops, suspension

Walgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Cherry) (00363-0008) (Walgreens Co) nullWalgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Cherry) package photo

Acetaminophen Oral drops, suspension

Walgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Grape) (00363-0289) (Walgreens Co) nullWalgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Grape) package photo

Acetaminophen Oral drops, suspension

Walgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Grape) (00363-0289) (Walgreens Co) nullWalgreens Infants' Non-Aspirin 80mg/0.8mL Drops (Grape) package photo

Acetaminophen Oral drops, suspension

Equaline Infants' Pain Relief Drops (Grape) (41163-0289) (Albertson's, Inc) (off market)

Acetaminophen Oral powder

Tylenol Children's Pain+Fever 160mg Powder (00045-0416) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (57896-0883) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (57896-0882) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (50383-0095) (Hi-Tech Pharmacal, a subsidiary of Akorn) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (50383-0101) (Hi-Tech Pharmacal, a subsidiary of Akorn) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00536-0133) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00536-0123) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00182-7029) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00182-7030) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00472-1417) (Teva/Actavis US) (off market)Acetaminophen 80mg/0.8ml Drops package photo

Acetaminophen Oral solution

Acetaminophen 80mg/0.8ml Drops (00364-0730) (Teva/Actavis US) (off market)

Acetaminophen Oral solution

Children's ED-APAP 80mg/2.5mL Solution (00485-0057) (ITF Pharma formerly Edwards Pharmaceuticals Inc) null

Acetaminophen Oral solution

Infants' Acetaminophen 80mg/0.8ml Drops (00472-1417) (Teva/Actavis US) (off market)

Acetaminophen Oral solution

Acetaminophen 120mg/5ml Solution (00121-0259) (Pharmaceutical Associates Inc Div Beach Products) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Liquid (58657-0520) (Method Pharmaceuticals) null

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Liquid (69367-0323) (Westminster Pharmaceuticals, LLC) null

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (60432-0120) (Morton Grove Pharmaceuticals Inc, a subsidiary of Wockhardt, Ltd.) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (00426-8610) (Morton Grove Pharmaceuticals Inc, a subsidiary of Wockhardt, Ltd.) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (60432-0610) (Morton Grove Pharmaceuticals Inc, a subsidiary of Wockhardt, Ltd.) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (60432-0081) (Morton Grove Pharmaceuticals Inc, a subsidiary of Wockhardt, Ltd.) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (00121-0657) (Pharmaceutical Associates Inc Div Beach Products) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (81033-0002) (Kesin Pharma Corporation) null

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00904-6738) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00121-0657) (Pharmaceutical Associates Inc Div Beach Products) null

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (68094-0231) (Precision Dose, Inc.) null

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00536-0124) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00781-6377) (Sandoz Inc. a Novartis Company) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00677-1839) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00182-1473) (Teva Pharmaceuticals USA) (off market)Acetaminophen 160mg/5mL Solution package photo

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00182-6177) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00472-0647) (Teva/Actavis US) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (66689-0054) (Vistapharm Inc) null

Acetaminophen Oral solution

Acetaminophen 325mg/10.15mL Solution (60687-0571) (American Health Packaging) null

Acetaminophen Oral solution

Acetaminophen 325mg/10.15mL Solution (81033-0002) (Kesin Pharma Corporation) null

Acetaminophen Oral solution

Acetaminophen 325mg/10.15mL Solution (00904-6739) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral solution

Acetaminophen 325mg/10.15mL Solution (00121-1314) (Pharmaceutical Associates Inc Div Beach Products) null

Acetaminophen Oral solution

Acetaminophen 325mg/10.15mL Solution (66689-0055) (Vistapharm Inc) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (60687-0571) (American Health Packaging) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (81033-0002) (Kesin Pharma Corporation) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (00904-6820) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (00121-1971) (Pharmaceutical Associates Inc Div Beach Products) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (68094-0030) (Precision Dose, Inc.) null

Acetaminophen Oral solution

Acetaminophen 650mg/20.3mL Solution (66689-0056) (Vistapharm Inc) null

Acetaminophen Oral solution

Children's Acetaminophen 160mg/5mL Solution (Cherry) (00904-7014) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral solution

Children's Pain and Fever 160mg/5ml Solution (00536-0122) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Children's Pain and Fever 160mg/5ml Solution package photo

Acetaminophen Oral solution

Children's Pain and Fever 160mg/5ml Solution (00536-0122) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Children's Pain and Fever 160mg/5ml Solution package photo

Acetaminophen Oral solution

Children's Silapap 160mg/5ml Liquid (Cherry) (54838-0144) (Silarx Pharmaceuticals Inc) nullChildren's Silapap 160mg/5ml Liquid (Cherry) package photo

Acetaminophen Oral solution

Children's Silapap 160mg/5ml Liquid (Grape) (54838-0118) (Silarx Pharmaceuticals Inc) (off market)

Acetaminophen Oral solution

ElixSure Fever/Pain 160mg/5ml Solution (Bubblegum) (51672-2500) (TaroPharma ) (off market)

Acetaminophen Oral solution

ElixSure Fever/Pain 160mg/5ml Solution (Cherry) (null) (Moberg Pharma NA formerly Alterna LLC) null

Acetaminophen Oral solution

ElixSure Fever/Pain 160mg/5ml Solution (Cherry) (51672-2501) (TaroPharma ) (off market)

Acetaminophen Oral solution

ElixSure Fever/Pain 160mg/5ml Solution (Grape) (51672-2502) (TaroPharma ) (off market)

Acetaminophen Oral solution

GNP Children's Acetaminophen Pain Reliever & Fever Reducer 160mg/5mL Oral Suspension (46122-0212) (AmerisourceBergen Corporation) null

Acetaminophen Oral solution

LIQUID PAIN RELIEF 160mg/5ml Solution (Cherry) (57896-0180) (Geri-Care Pharmaceuticals) (off market)LIQUID PAIN RELIEF 160mg/5ml Solution (Cherry) package photo

Acetaminophen Oral solution

LIQUID PAIN RELIEF 160mg/5ml Solution (Cherry) (57896-0160) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral solution

LIQUID PAIN RELIEF 160mg/5mL Solution (Cherry) (57896-0180) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral solution

Mapap Children's 160mg/5mL Liquid (Cherry) (00904-1985) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)Mapap Children's 160mg/5mL Liquid (Cherry) package photo

Acetaminophen Oral solution

M-PAP 160mg/5mL Solution (58657-0525) (Method Pharmaceuticals) null

Acetaminophen Oral solution

Q-Pap 160mg/5ml Liquid (Cherry) (00603-0839) (Par Pharmaceuticals, an Endo Company) (off market)Q-Pap 160mg/5ml Liquid (Cherry) package photo

Acetaminophen Oral solution

Q-Pap 160mg/5mL Liquid (Grape) (00603-0840) (Par Pharmaceuticals, an Endo Company) (off market)Q-Pap 160mg/5mL Liquid (Grape) package photo

Acetaminophen Oral solution

Triaminic Fever Reducer and Pain Reliever Solution (Bubble gum) (00067-6432) (GlaxoSmithKline Consumer Healthcare ) null

Acetaminophen Oral solution

Triaminic Fever Reducer and Pain Reliever Solution (Grape) (00067-6431) (GlaxoSmithKline Consumer Healthcare ) null

Acetaminophen Oral solution

Triaminic Infants' Fever Reducer and Pain Reliever Solution (Bubble gum) (00067-6441) (GlaxoSmithKline Consumer Healthcare ) nullTriaminic Infants' Fever Reducer and Pain Reliever Solution (Bubble gum) package photo

Acetaminophen Oral solution

Triaminic Infants' Fever Reducer and Pain Reliever Solution (Grape) (00067-6440) (GlaxoSmithKline Consumer Healthcare ) nullTriaminic Infants' Fever Reducer and Pain Reliever Solution (Grape) package photo

Acetaminophen Oral solution

Acetaminophen 160mg/5ml Solution (50383-0099) (Hi-Tech Pharmacal, a subsidiary of Akorn) (off market)

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00472-1410) (Teva/Actavis US) (off market)Acetaminophen 160mg/5mL Solution package photo

Acetaminophen Oral solution

Acetaminophen 160mg/5mL Solution (00364-0731) (Teva/Actavis US) (off market)

Acetaminophen Oral solution

Acetaminophen 500mg/5ml Solution (00121-0538) (Pharmaceutical Associates Inc Div Beach Products) (off market)

Acetaminophen Oral solution

APAP 500 Adult 500mg/5ml Liquid (60258-0050) (Cypress Pharmaceutical Inc. a wholly-owned subsidiary of Currax Pharmaceuticals, LLC) (off market)

Acetaminophen Oral solution

Comtrex Maximum Strength Sore Throat Relief 500mg/15ml Solution (null) (Bristol Myers Squibb Co) null

Acetaminophen Oral solution

CVS Acetaminophen 500mg/15mL Extra Strength Rapid Burst Liquid (Cherry) (69842-0878) (CVS Health) null

Acetaminophen Oral solution

CVS Acetaminophen Extra Strength 500mg/15mL Liquid (Cherry) (69842-0945) (CVS Health) null

Acetaminophen Oral solution

CVS Pain Relief 500mg/15mL Extra Strength Rapid Burst Liquid (Cherry) (59779-0166) (CVS Health) (off market)

Acetaminophen Oral solution

CVS Pain Relief 500mg/15mL Extra Strength Rapid Burst Liquid (Cherry) (null) (CVS Health) (off market)

Acetaminophen Oral solution

GNP Pain Relief 500mg/15mL Extra Strength Rapid Burst Liquid (Cherry) (46122-0357) (AmerisourceBergen Corporation) null

Acetaminophen Oral solution

Mapap 500mg/15ml Extra Strength Rapid Burst Liquid (Cherry) (00904-5847) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral solution

Mapap 500mg/15ml Extra Strength Rapid Burst Liquid (Cherry) (00904-5847) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral solution

Premier Value Rapid Burst Acetaminophen Extra Strength 500mg/15ml Liquid (Cherry) (68016-0166) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral solution

Tylenol Extra Strength 500mg/15ml Liquid (Cherry) (00045-0500) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral solution

Walgreens Adult Pain Reliever 500mg/15mL Extra Strength Liquid (00363-0278) (Walgreens Co) nullWalgreens Adult Pain Reliever 500mg/15mL Extra Strength Liquid package photo

Acetaminophen Oral solution

Walgreens Pain Reliever 500mg/15mL Extra Strength Liquid (11917-0157) (Walgreens Co) (off market)

Acetaminophen Oral solution

Comtrex Sore Throat 1000mg/30ml Liquid (Honey Lemon) (null) (Bristol Myers Squibb Co) null

Acetaminophen Oral solution

Goody's Back & Body Pain Relief Liquid (Orange) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) null

Acetaminophen Oral solution

Goody's Back & Body Pain Relief Liquid (Orange) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral solution

Tylenol Sore Throat 1000mg/30ml Liquid (cherry) (50580-0913) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral solution

Tylenol Sore Throat 1000mg/30ml Liquid (honey lemon) (50580-0914) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral solution

Tylenol Sore Throat Daytime 1000mg/30ml Cool Burst Liquid (00045-0813) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen 80mg/2.5mL Suspension (Grape) (68094-0586) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Acetaminophen 80mg/2.5mL Suspension (Grape) (68094-0583) (Precision Dose, Inc.) (off market)

Acetaminophen Oral suspension

Infants' Acetaminophen 80mg/0.8ml Concentrated Suspension (68094-0692) (Precision Dose, Inc.) (off market)

Acetaminophen Oral suspension

Acetaminophen 160mg/5ml Suspension (00121-4781) (Pharmaceutical Associates Inc Div Beach Products) (off market)

Acetaminophen Oral suspension

Acetaminophen 160mg/5mL Suspension (00121-0939) (Pharmaceutical Associates Inc Div Beach Products) nullAcetaminophen 160mg/5mL Suspension package photo

Acetaminophen Oral suspension

Acetaminophen 325mg/10.15mL Suspension (68094-0330) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Apra 160mg/5mL Suspension (59390-0040) (Altaire Pharmaceuticals Inc) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5mL Suspension (00121-1781) (Pharmaceutical Associates Inc Div Beach Products) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5mL Suspension (00121-1781) (Pharmaceutical Associates Inc Div Beach Products) null

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5mL Suspension (Cherry) (00904-6766) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) nullChildren's Acetaminophen 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5mL Suspension (Cherry) (45802-0203) (Perrigo Pharmaceuticals Company) nullChildren's Acetaminophen 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5ml Suspension (Grape) (68094-0594) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5ml Suspension (Grape) (68094-0605) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5ml Suspension (Grape) (68094-0587) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5ml Suspension (Grape) (68094-0593) (Precision Dose, Inc.) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5ml Suspension (Grape) (00536-1321) (Rugby Laboratories a Division of The Harvard Drug Group, LLC ) null

Acetaminophen Oral suspension

Children's Acetaminophen 160mg/5mL Suspension (Grape) (45802-0201) (Perrigo Pharmaceuticals Company) null

Acetaminophen Oral suspension

Children's Acetaminophen 325mg/10.15ml Suspension (Grape) (68094-0614) (Precision Dose, Inc.) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen 325mg/10.15ml Suspension (Grape) (68094-0588) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Acetaminophen 650mg/20.3ml Suspension (Grape) (68094-0650) (Precision Dose, Inc.) (off market)

Acetaminophen Oral suspension

Children's Acetaminophen Dye-Free 160mg/5mL Suspension (Grape) (68094-0015) (Precision Dose, Inc.) null

Acetaminophen Oral suspension

Children's Pain & Fever 160mg/5mL Suspension (Cherry) (58602-0221) (Aurohealth LLC, an Aurobindo Company) null

Acetaminophen Oral suspension

Children's Pain and Fever 160mg/5ml Suspension (Cherry) (00536-3606) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Children's Pain and Fever 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

Children's Q-Pap 160mg/5ml Suspension (Bubble Gum) (00603-0841) (Par Pharmaceuticals, an Endo Company) (off market)Children's Q-Pap 160mg/5ml Suspension (Bubble Gum) package photo

Acetaminophen Oral suspension

Children's Q-Pap 160mg/5ml Suspension (Cherry) (00603-0842) (Par Pharmaceuticals, an Endo Company) (off market)

Acetaminophen Oral suspension

Children's Q-Pap 160mg/5ml Suspension (Grape) (00603-0843) (Par Pharmaceuticals, an Endo Company) (off market)

Acetaminophen Oral suspension

CVS Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) (59779-0126) (CVS Health) nullCVS Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) package photo

Acetaminophen Oral suspension

CVS Children's Pain & Fever 160mg/5mL Suspension (Grape) (59779-0263) (CVS Health) nullCVS Children's Pain & Fever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

CVS Children's Pain & Fever 160mg/5ml Suspension (Strawberry) (null) (CVS Health) (off market)

Acetaminophen Oral suspension

CVS Children's Pain & Fever 160mg/5mL Suspension (Strawberry) (59779-0754) (CVS Health) nullCVS Children's Pain & Fever 160mg/5mL Suspension (Strawberry) package photo

Acetaminophen Oral suspension

CVS Children's Pain and Fever 160mg/5mL Suspension (Cherry) (null) (CVS Health) null

Acetaminophen Oral suspension

CVS Children's Pain and Fever 160mg/5mL Suspension (Grape) (59779-0785) (CVS Health) nullCVS Children's Pain and Fever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

CVS Children's Pain and Fever 160mg/5mL Suspension (Grape) (null) (CVS Health) (off market)

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5ml Suspension (Bubble Gum) (59779-0105) (CVS Health) (off market)

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5ml Suspension (Cherry) (59779-0175) (CVS Health) nullCVS Children's Pain Relief 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5ml Suspension (Cherry) (null) (CVS Health) (off market)CVS Children's Pain Relief 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5mL Suspension (Cherry) (null) (CVS Health) nullCVS Children's Pain Relief 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5ml Suspension (Grape) (59779-0130) (CVS Health) (off market)CVS Children's Pain Relief 160mg/5ml Suspension (Grape) package photo

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5ml Suspension (Grape) (null) (CVS Health) (off market)

Acetaminophen Oral suspension

CVS Children's Pain Relief 160mg/5mL Suspension (Tropical Punch) (59779-0104) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain & Fever 160mg/5mL Dye Free Suspension (Cherry) (59779-0590) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain & Fever 160mg/5mL Dye Free Suspension (Cherry) (59779-0590) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain & Fever 160mg/5ml Suspension (Cherry) (59779-0590) (CVS Health) (off market)CVS Infants' Pain & Fever 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (59779-0590) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5ml Suspension (Cherry) (59779-0161) (CVS Health) (off market)CVS Infants' Pain and Fever 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5ml Suspension (Cherry) (59779-0161) (CVS Health) (off market)CVS Infants' Pain and Fever 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5ml Suspension (Cherry) (59779-0161) (CVS Health) (off market)

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5mL Suspension (Cherry) (null) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5mL Suspension (Cherry) (59779-0161) (CVS Health) nullCVS Infants' Pain and Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5mL Suspension (Cherry) (59779-0161) (CVS Health) nullCVS Infants' Pain and Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5ml Suspension (Grape) (59779-0946) (CVS Health) (off market)CVS Infants' Pain and Fever 160mg/5ml Suspension (Grape) package photo

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5mL Suspension (Grape) (59779-0946) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain and Fever 160mg/5mL Suspension (Grape) (59779-0946) (CVS Health) nullCVS Infants' Pain and Fever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

CVS Infants' Pain Relief 160mg/5mL Suspension (Bubble Gum) (59779-0178) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain Relief 160mg/5mL Suspension (Bubble Gum) (null) (CVS Health) null

Acetaminophen Oral suspension

CVS Infants' Pain Relief 160mg/5mL Suspension Drops (Grape) (null) (CVS Health) null

Acetaminophen Oral suspension

Equaline Children's Pain Relief Suspension (Bubble Gum) (41163-0105) (Albertson's, Inc) (off market)

Acetaminophen Oral suspension

Equaline Children's Pain Relief Suspension (Cherry) (41163-0175) (Albertson's, Inc) (off market)

Acetaminophen Oral suspension

GNP Children's Pain & Fever 160mg/5mL Suspension (Cherry) (46122-0322) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain & Fever 160mg/5mL Suspension (Grape) (46122-0323) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain and Fever 160mg/5mL Suspension (Cherry) (46122-0105) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral suspension

GNP Children's Pain and Fever 160mg/5mL Suspension (Cherry) (46122-0210) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5ml Suspension (Bubble Gum) (24385-0105) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5mL Suspension (Bubble Gum) (46122-0209) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5mL Suspension (Cherry) (24385-0146) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5mL Suspension (Cherry) (46122-0019) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5mL Suspension (Grape) (24385-0130) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Children's Pain Relief 160mg/5mL Suspension (Grape) (46122-0106) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Infants' Pain & Fever Relief 160mg/5mL Suspension (Grape) (46122-0552) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Infants' Pain and Fever 160mg/5ml Suspension (46122-0056) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Infants' Pain and Fever 160mg/5ml Suspension (Grape) (46122-0042) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Infants' Pain Relief 160mg/5ml Suspension (Cherry) (46122-0050) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral suspension

GNP Infants' Pain Relief 160mg/5mL Suspension (Cherry) (46122-0340) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GNP Infants' Pain Relief 160mg/5ml Suspension (Grape) (46122-0042) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral suspension

GNP Infants' Pain Relief 160mg/5mL Suspension (Grape) (46122-0313) (AmerisourceBergen Corporation) null

Acetaminophen Oral suspension

GoodSense Children's Pain & Fever 160mg/5mL Suspension (Cherry) (00113-0608) (Goodsense a Division of Perrigo) null

Acetaminophen Oral suspension

GoodSense Children's Pain Relief 160mg/5mL Suspension (Bubblegum) (00113-0105) (Goodsense a Division of Perrigo) null

Acetaminophen Oral suspension

GoodSense Children's Pain Relief 160mg/5mL Suspension (Cherry) (00113-0175) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral suspension

GoodSense Children's Pain Relief 160mg/5mL Suspension (Grape) (00113-0130) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral suspension

GoodSense Children's Pain Relief 160mg/5mL Suspension (Grape) (00113-0212) (Goodsense a Division of Perrigo) null

Acetaminophen Oral suspension

GoodSense Infants' Pain and Fever 160mg/5mL Suspension (Cherry) (00113-0590) (Goodsense a Division of Perrigo) null

Acetaminophen Oral suspension

Health Mart Children's Pain & Fever 160mg/5mL Suspension (Grape) (62011-0246) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Children's Pain and Fever 160mg/5ml Suspension (Cherry) (62011-0022) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Children's Pain and Fever 160mg/5ml Suspension (Cherry) (62011-0247) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Children's Pain and Fever 160mg/5ml Suspension (Grape) (62011-0183) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Children's Pain and Fever 160mg/5ml Suspension (Grape) (62011-0029) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Infants' Pain and Fever 160mg/5ml Suspension (Cherry) (62011-0002) (McKesson Corporation) null

Acetaminophen Oral suspension

Health Mart Infants' Pain and Fever 160mg/5ml Suspension (Grape) (62011-0001) (McKesson Corporation) null

Acetaminophen Oral suspension

Infants' Acetaminophen 160mg/5mL Suspension (Cherry) (00536-1212) (Rugby Laboratories a Division of The Harvard Drug Group, LLC ) nullInfants' Acetaminophen 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Infants' Mapap 160mg/5ml Suspension (Cherry) (00904-6244) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)Infants' Mapap 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

Infants' Mapap 160mg/5ml Suspension (Cherry) (00904-6307) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral suspension

Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (00536-1111) (Rugby Laboratories a Division of The Harvard Drug Group, LLC ) (off market)

Acetaminophen Oral suspension

Leader Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) (70000-0028) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain & Fever 160mg/5ml Suspension (Cherry) (37205-0676) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain & Fever 160mg/5mL Suspension (Cherry) (70000-0481) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain & Fever 160mg/5mL Suspension (Grape) (70000-0496) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain & Fever 160mg/5ml Suspension (Strawberry) (49781-0010) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain Reliever 160mg/5ml Suspension (Bubblegum) (37205-0717) (Cardinal Health, Inc.) nullLeader Children's Pain Reliever 160mg/5ml Suspension (Bubblegum) package photo

Acetaminophen Oral suspension

Leader Children's Pain Reliever 160mg/5ml Suspension (Strawberry) (37205-0627) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain Reliever Suspension (Cherry) (37205-0508) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Children's Pain Reliever Suspension (Grape) (37205-0518) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Infants' Pain & Fever 160mg/5ml Suspension (Cherry) (37205-0575) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral suspension

Leader Infants' Pain & Fever 160mg/5ml Suspension (Cherry) (37205-0577) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral suspension

Leader Infants' Pain & Fever 160mg/5ml Suspension (Grape) (37205-0576) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Leader Infants' Pain & Fever 160mg/5mL Suspension (Grape) (70000-0472) (Cardinal Health, Inc.) null

Acetaminophen Oral suspension

Little Fevers Children's 160mg/5ml Suspension (Cherry) (null) (Prestige Brands Holdings, Inc.) (off market)

Acetaminophen Oral suspension

Little Fevers Children's Fever/Pain Reliever 160mg/5ml Suspension (Grape) (null) (Prestige Brands Holdings, Inc.) null

Acetaminophen Oral suspension

Little Fevers Infants' 160mg/5ml Suspension (Berry) (null) (Prestige Brands Holdings, Inc.) null

Acetaminophen Oral suspension

Little Fevers Infants' 160mg/5ml Suspension (Grape) (null) (Prestige Brands Holdings, Inc.) null

Acetaminophen Oral suspension

Little Remedies Infant Fever + Pain Reliever 160mg/5mL Suspension (Berry) (2 Pack) (null) (Prestige Brands Holdings, Inc.) null

Acetaminophen Oral suspension

Mapap Children's 160mg/5ml Suspension (Cherry) (00904-6308) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral suspension

Mapap Children's 160mg/5ml Suspension (Cherry) (00904-5116) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral suspension

Mapap Children's 160mg/5mL Suspension (Cherry) (00904-6536) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)Mapap Children's 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Nortemp Children's 160mg/5ml Oral Suspension (Cotton Candy) (63162-0510) (Ballay Pharmaceuticals) (off market)

Acetaminophen Oral suspension

PediaCare Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Bubble Gum) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Grape) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Infants' Fever Reducer/Pain Reliever 160mg/5ml Suspension (Bubble Gum) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Infants' Fever Reducer/Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Infants' Fever Reducer/Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

PediaCare Infants' Fever Reducer/Pain Reliever 160mg/5ml Suspension (Grape) (null) (Medtech Products, Inc a Prestige Consumer Healthcare Company) (off market)

Acetaminophen Oral suspension

Premier Value Children's Non-Aspirin Pain Relief 160mg/5ml Suspension (Bubble Gum) (68016-0178) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Children's Non-Aspirin Pain Relief 160mg/5ml Suspension (Cherry) (68016-0103) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Children's Pain Relief 160mg/5ml Suspension (Cherry) (68016-0103) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral suspension

Premier Value Children's Pain Relief 160mg/5ml Suspension (Cherry) (68016-0725) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Children's Pain Relief 160mg/5ml Suspension (Grape) (68016-0699) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Bubble Gum) (68016-0178) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Bubble Gum) (68016-0702) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Cherry) (68016-0160) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Cherry) (68016-0703) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Grape) (68016-0704) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Premier Value Infants' Pain Relief 160mg/5ml Suspension (Grape) (68016-0141) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral suspension

Publix Children's Pain Relief 160mg/5ml Suspension (Cherry) (56062-0175) (Publix Super Markets, Inc) null

Acetaminophen Oral suspension

RITE AID Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Bubblegum) (null) (Rite Aid Corp) nullRITE AID Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Bubblegum) package photo

Acetaminophen Oral suspension

RITE AID Children's Fever Reducer/Pain Reliever 160mg/5mL Suspension (Cherry) (null) (Rite Aid Corp) nullRITE AID Children's Fever Reducer/Pain Reliever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

RITE AID Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Grape) (null) (Rite Aid Corp) nullRITE AID Children's Fever Reducer/Pain Reliever 160mg/5ml Suspension (Grape) package photo

Acetaminophen Oral suspension

RITE AID Infants' Fever Reducer & Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Rite Aid Corp) null

Acetaminophen Oral suspension

RITE AID Infants' Fever Reducer & Pain Reliever 160mg/5ml Suspension (Cherry) (null) (Rite Aid Corp) null

Acetaminophen Oral suspension

RITE AID Infants' Fever Reducer & Pain Reliever 160mg/5mL Suspension (Cherry) (null) (Rite Aid Corp) nullRITE AID Infants' Fever Reducer & Pain Reliever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

RITE AID Infants' Fever Reducer & Pain Reliever 160mg/5ml Suspension (Grape) (null) (Rite Aid Corp) nullRITE AID Infants' Fever Reducer & Pain Reliever 160mg/5ml Suspension (Grape) package photo

Acetaminophen Oral suspension

RITE AID Infants' Fever Reducer & Pain Reliever 160mg/5mL Suspension (Grape) (null) (Rite Aid Corp) nullRITE AID Infants' Fever Reducer & Pain Reliever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

Select Brand Children's Pain Reliever Suspension (Bubble Gum) (15127-0510) (Select Brand) null

Acetaminophen Oral suspension

Select Brand Children's Pain Reliever Suspension (Grape) (15127-0509) (Select Brand) nullSelect Brand Children's Pain Reliever Suspension (Grape) package photo

Acetaminophen Oral suspension

Sunmark Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) (49348-0093) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain & Fever 160mg/5ml Suspension (Cherry) (49348-0123) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain & Fever 160mg/5ml Suspension (Grape) (49348-0325) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain & Fever 160mg/5ml Suspension (Grape) (49348-0119) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain Reliever Suspension (Bubble Gum) (49348-0888) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain Reliever Suspension (Cherry) (49348-0797) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Children's Pain Reliever Suspension (Grape) (49348-0266) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Infants' Pain & Fever 160mg/5ml Suspension (Cherry) (49348-0081) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Infants' Pain Relief 160mg/5ml Suspension (Grape) (49348-0430) (McKesson Corporation) null

Acetaminophen Oral suspension

Sunmark Infants' Pain Relief 160mg/5ml Suspension (Grape) (49348-0309) (McKesson Corporation) null

Acetaminophen Oral suspension

Today's Health Children's Pain Reliever Suspension (Bubble Gum) (null) (Today's Health, Inc.) null

Acetaminophen Oral suspension

Today's Health Children's Pain Reliever Suspension (Cherry) (null) (Today's Health, Inc.) null

Acetaminophen Oral suspension

Today's Health Children's Pain Reliever Suspension (Grape) (null) (Today's Health, Inc.) null

Acetaminophen Oral suspension

Top Care Children's Pain Relief 160mg/5ml Suspension (Bubblegum) (36800-0105) (Topco Associates LLC) null

Acetaminophen Oral suspension

Top Care Children's Pain Relief 160mg/5ml Suspension (Cherry) (36800-0175) (Topco Associates LLC) null

Acetaminophen Oral suspension

Top Care Children's Pain Relief 160mg/5ml Suspension (Grape) (36800-0130) (Topco Associates LLC) null

Acetaminophen Oral suspension

Top Care Children's Pain Relief 160mg/5ml Suspension (Strawberry) (null) (Topco Associates LLC) null

Acetaminophen Oral suspension

Top Care Infants' Pain and Fever 160mg/5mL Suspension (Cherry) (null) (Topco Associates LLC) null

Acetaminophen Oral suspension

Top Care Infants' Pain and Fever 160mg/5mL Suspension (Grape) (null) (Topco Associates LLC) null

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Bubblegum) (00045-0407) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

TYLENOL Children's 160mg/5mL Suspension (Bubblegum) (00045-0407) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Cherry Blast) (00045-0123) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Cherry) (00045-0166) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

Tylenol Children's 160mg/5mL Suspension (Cherry) (00045-0123) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

TYLENOL Children's 160mg/5mL Suspension (Cherry) (00045-0166) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Grape Splash) (00045-0296) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Grape Splash) (00045-0296) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

TYLENOL Children's 160mg/5mL Suspension (Grape) (00045-0296) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

TYLENOL Children's 160mg/5mL Suspension (Strawberry) (00045-0493) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Children's 160mg/5ml Suspension (Very Berry Strawberry) (00045-0493) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

Tylenol Children's Pain + Fever 160mg/5mL Suspension (Cherry) (50580-0170) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral suspension

Tylenol Children's160mg/5ml Suspension with Flavor Creators (50580-0454) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral suspension

Tylenol Infants' 160mg/5mL Suspension (Cherry) (00045-0186) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

TYLENOL Infants' 160mg/5mL Suspension (Cherry) (00045-0186) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Infants' 160mg/5mL Suspension (Grape) (00045-0122) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral suspension

TYLENOL Infants' 160mg/5mL Suspension (Grape) (00045-0122) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Infants' Pain + Fever 160mg/5mL Suspension (Cherry) (00045-0167) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Infants' Pain + Fever 160mg/5mL Suspension (Cherry) (50580-0599) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral suspension

Tylenol Pain + Fever 160mg/5mL Suspension (Cherry) (50580-0177) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Bubble Gum) (00363-0283) (Walgreens Co) nullWalgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Bubble Gum) package photo

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5ml Suspension (Cherry) (11917-0120) (Walgreens Co) (off market)

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0284) (Walgreens Co) nullWalgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0959) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0959) (Walgreens Co) nullWalgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) (00363-1397) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) (00363-0285) (Walgreens Co) nullWalgreens Children's Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

Walgreens Children's Non-Aspirin 160mg/5ml Suspension (Bubble Gum) (00363-0105) (Walgreens Co) nullWalgreens Children's Non-Aspirin 160mg/5ml Suspension (Bubble Gum) package photo

Acetaminophen Oral suspension

Walgreens Children's Non-Aspirin 160mg/5ml Suspension (Cherry) (00363-0175) (Walgreens Co) nullWalgreens Children's Non-Aspirin 160mg/5ml Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Children's Non-Aspirin 160mg/5mL Suspension (Grape) (00363-0130) (Walgreens Co) nullWalgreens Children's Non-Aspirin 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

Walgreens Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) (00363-0281) (Walgreens Co) nullWalgreens Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) package photo

Acetaminophen Oral suspension

Walgreens Children's Pain & Fever 160mg/5mL Suspension (Bubble Gum) (00363-0105) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Children's Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0800) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0590) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0590) (Walgreens Co) nullWalgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) (00363-0330) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) (00363-0330) (Walgreens Co) nullWalgreens Infants' Dye-Free Pain & Fever 160mg/5mL Suspension (Grape) package photo

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0161) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0132) (Walgreens Co) nullWalgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0132) (Walgreens Co) nullWalgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) package photo

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Cherry) (00363-0161) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Grape) (00363-0946) (Walgreens Co) null

Acetaminophen Oral suspension

Walgreens Infants' Pain & Fever 160mg/5mL Suspension (Grape) (00363-0946) (Walgreens Co) null

Acetaminophen Oral suspension

Infants' Acetaminophen 200mg/2ml Concentrated Suspension (68094-0703) (Precision Dose, Inc.) (off market)Infants' Acetaminophen 200mg/2ml Concentrated Suspension package photo

Acetaminophen Oral suspension

Adult Pain Relief Extra Strength 500mg/15mL Liquid (57896-0202) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral suspension

Adult Pain Relief Extra Strength 500mg/15mL Liquid (57896-0202) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral suspension

Adult Pain Relief Extra Strength 500mg/15ml Liquid (Cherry) (57896-0206) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Aceta 325mg Tablet (00436-0410) (Century Pharmaceuticals Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (65162-0350) (Akyma Pharmaceuticals, a subsidiary of Amneal Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (65162-0350) (Amneal Pharmaceuticals LLC) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (20254-0200) (Concord Laboratories Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (58865-0005) (Dawn Pharmaceutical) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (52735-0709) (Family Pharmacy) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (52569-0851) (Generamed Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57896-0881) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57896-0100) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57896-0102) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57896-0104) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57896-0101) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (60809-0100) (Glasgow Pharmaceutical Corporation) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (53746-0011) (Interpharm Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (51111-0488) (J. B. Williams Co., Inc, a subsidiary of Combe, Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00820-0135) (Logen Pharmaceuticals Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00904-6719) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)Acetaminophen 325mg Tablet package photo

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00904-6773) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) nullAcetaminophen 325mg Tablet package photo

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (10135-0163) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (10135-0123) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (49348-0009) (McKesson Corporation) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (63739-0087) (McKesson Packaging) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (63739-0002) (McKesson Packaging Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (63739-0440) (McKesson Packaging Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (57480-0100) (Medirex Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (51079-0002) (Mylan Institutional LLC ) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00084-0047) (Natural Nutritionals Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (66267-0999) (NuCare Pharmaceuticals Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (66267-0003) (NuCare Pharmaceuticals Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00574-0007) (Paddock Laboratories Inc, a Perrigo Family) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (55966-0000) (PDK Labs Inc) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (55289-0563) (PD-Rx Pharmaceuticals, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (55289-0563) (PD-Rx Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (55289-0563) (PD-Rx Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (58864-0002) (PD-Rx Pharmaceuticals, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (17236-0350) (R&S Northeast, LLC, formerly Dixon-Shane Drug Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (69618-0010) (Reliable 1 Laboratories LLC) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00122-0825) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (60814-0143) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (60814-0142) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00122-0882) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00536-1164) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00536-1327) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) nullAcetaminophen 325mg Tablet package photo

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00781-1294) (Sandoz Inc. a Novartis Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00677-1781) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00677-1974) (Sun Pharmaceutical Industries, Inc.) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00093-0855) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00093-0893) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00182-8447) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00182-1000) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (52152-0030) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00364-0022) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (00228-1103) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (49483-0340) (Time Cap Laboratories Inc) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (47682-0145) (UniFirst First-Aid Corporation) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (47682-0803) (UniFirst First-Aid Corporation) null

Acetaminophen Oral tablet

Acetaminophen 325mg Tablet (11383-0139) (Weeks and Leo) null

Acetaminophen Oral tablet

Actamin 325mg Tablet (10244-0565) (Otis Clapp and Son) (off market)

Acetaminophen Oral tablet

BeneHealth Acetaminophen 325mg Tablet (65155-0101) (BeneHealth) null

Acetaminophen Oral tablet

CVS Acetaminophen 325mg Rapid Release Gelcap (69842-0876) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief 325mg Tablet (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief 325mg Tablet (59779-0766) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief 325mg Tablet (59779-0766) (CVS Health) null

Acetaminophen Oral tablet

Equaline Regular Strength Pain Relief 325mg Tablet (41163-0403) (Albertson's, Inc) (off market)

Acetaminophen Oral tablet

Genapap 325mg Tablet (00182-1410) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Genebs 325mg Tablet (00182-0141) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

GNP Acetaminophen 325mg Gelcap (46122-0430) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief 325mg Tablet (24385-0403) (AmerisourceBergen Corporation) nullGNP Pain Relief 325mg Tablet package photo

Acetaminophen Oral tablet

GNP Pain Relief 325mg Tablet (46122-0390) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GoodSense Pain Relief 325mg Tablet (00113-0403) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral tablet

GoodSense Pain Relief 325mg Tablet (00113-0403) (Goodsense a Division of Perrigo) null

Acetaminophen Oral tablet

Health Mart Pain Reliever 325mg Tablet (62011-0032) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Mart Pain Reliever 325mg Tablet (62011-0032) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Star Acetaminophen 325mg Tablet (57896-0101) (Geri-Care Pharmaceuticals) (off market)Health Star Acetaminophen 325mg Tablet package photo

Acetaminophen Oral tablet

Leader Acetaminophen 325mg Tablet (70000-0374) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen 325mg Tablet (70000-0092) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Tablet (37205-0031) (Cardinal Health, Inc.) (off market)Leader Pain Reliever Tablet package photo

Acetaminophen Oral tablet

Mapap 325mg Tablet (00904-1982) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral tablet

Mapap 325mg Tablet (00904-1982) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral tablet

Pain & Fever 325mg Tablet (00536-3222) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Pain & Fever 325mg Tablet (00536-3222) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Pain Relief 325mg Tablet (00761-0173) (Basic Vitamins) (off market)

Acetaminophen Oral tablet

PHARBETOL 325mg Tablet (16103-0353) (Pharbest Pharmaceuticals) null

Acetaminophen Oral tablet

Plus PHARMA Acetaminophen 325mg Regular Strength Tablet (51645-0703) (Gemini Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Premier Value Non-Aspirin 325mg Tablet (68016-0012) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral tablet

Premier Value Non-Aspirin 325mg Tablet (68016-0246) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Q-Pap 325mg Tablet (00603-0263) (Par Pharmaceuticals, an Endo Company) null

Acetaminophen Oral tablet

RITE AID Pain Relief 325mg Tablet (null) (Rite Aid Corp) nullRITE AID Pain Relief 325mg Tablet package photo

Acetaminophen Oral tablet

Select Brand Pain Reliever 325mg Tablet (15127-0072) (Select Brand) nullSelect Brand Pain Reliever 325mg Tablet package photo

Acetaminophen Oral tablet

Sunmark Pain Reliever 325mg Tablet (49348-0973) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever 325mg Tablet (49348-0973) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever 325mg Tablet (49348-0973) (McKesson Corporation) (off market)

Acetaminophen Oral tablet

Top Care Pain Relief 325mg Tablet (36800-0403) (Topco Associates LLC) null

Acetaminophen Oral tablet

Tylenol 325mg Caplet (50580-0501) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol 325mg Caplet (50580-0501) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol 325mg Tablet (00045-0496) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Regular Strength 325mg Caplet (50580-0458) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet

Tylenol Regular Strength 325mg Caplet (50580-0600) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet

Tylenol Regular Strength 325mg Tablet (50580-0496) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet

Walgreens Acetaminophen 325mg Tablet (00363-0104) (Walgreens Co) nullWalgreens Acetaminophen 325mg Tablet package photo

Acetaminophen Oral tablet

Acetaminophen 500mg Caplet (53746-0018) (Interpharm Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Caplet (63739-0439) (McKesson Packaging Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Caplet (43063-0224) (PD-Rx Pharmaceuticals, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Caplet (45802-0484) (Perrigo Pharmaceuticals Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Caplet (00677-1975) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Extra Strength Tablet (00904-6730) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral tablet

Acetaminophen 500mg Extra Strength Tablet (00904-6730) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral tablet

Acetaminophen 500mg Extra Strength Tablet (00536-1172) (Rugby Laboratories a Division of The Harvard Drug Group, LLC ) null

Acetaminophen Oral tablet

Acetaminophen 500mg Extra-Strength Tablet (57896-0200) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (65162-0607) (Akyma Pharmaceuticals, a subsidiary of Amneal Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (65162-0602) (Akyma Pharmaceuticals, a subsidiary of Amneal Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (65162-0602) (Amneal Pharmaceuticals LLC) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (65162-0607) (Amneal Pharmaceuticals LLC) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (20254-0202) (Concord Laboratories Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (20254-0201) (Concord Laboratories Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (20254-0203) (Concord Laboratories Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (58865-0006) (Dawn Pharmaceutical) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (52735-0712) (Family Pharmacy) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (52735-0710) (Family Pharmacy) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (52569-0854) (Generamed Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (57896-0200) (Geri-Care Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (60809-0101) (Glasgow Pharmaceutical Corporation) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00143-1339) (Hikma Pharmaceuticals USA Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (53746-0001) (Interpharm Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (51111-0489) (J. B. Williams Co., Inc, a subsidiary of Combe, Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00820-0136) (Logen Pharmaceuticals Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00820-0138) (Logen Pharmaceuticals Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (10135-0164) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (10135-0152) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (10135-0144) (Marlex Pharmaceuticals) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (null) (Mason Vitamins) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (49348-0871) (McKesson Corporation) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (49348-0286) (McKesson Corporation) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (49348-0023) (McKesson Corporation) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (63739-0001) (McKesson Packaging Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (57480-0102) (Medirex Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (51079-0396) (Mylan Institutional LLC ) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00084-0049) (Natural Nutritionals Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (66267-0005) (NuCare Pharmaceuticals Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (66267-0998) (NuCare Pharmaceuticals Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (55289-0880) (PD-Rx Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (55289-0880) (PD-Rx Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (17236-0602) (R&S Northeast, LLC, formerly Dixon-Shane Drug Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (17236-0607) (R&S Northeast, LLC, formerly Dixon-Shane Drug Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (69618-0011) (Reliable 1 Laboratories LLC) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00122-0863) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00122-0883) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00122-0805) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (60814-0147) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00122-0845) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (60814-0149) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00122-0806) (Rexall Group) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00781-1834) (Sandoz Inc. a Novartis Company) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00677-1784) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00677-1782) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00677-1976) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00093-0856) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00093-0894) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00182-8453) (Teva Pharmaceuticals USA) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00364-0553) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (52152-0044) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (00364-0837) (Teva/Actavis US) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (null) (The Nature's Bounty Co.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (null) (The Nature's Bounty Co.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (null) (The Nature's Bounty Co.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (null) (The Nature's Bounty Co.) (off market)

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (47682-0864) (UniFirst First-Aid Corporation) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (47682-0804) (UniFirst First-Aid Corporation) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (11383-0011) (Weeks and Leo) null

Acetaminophen Oral tablet

Acetaminophen 500mg Tablet (11383-0138) (Weeks and Leo) null

Acetaminophen Oral tablet

Acetaminophen Extra Strength 500mg Caplet (57896-0222) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Acetaminophen Extra Strength 500mg Caplet (00904-6720) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral tablet

Acetaminophen Extra Strength 500mg Caplet (49483-0341) (Time Cap Laboratories Inc) null

Acetaminophen Oral tablet

Acetaminophen Extra Strength 500mg Rapid Release Gelcap (00904-6749) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral tablet

Acetaminophen Extra Strength 500mg Rapid Release Gelcap (00536-1292) (Rugby Laboratories a Division of The Harvard Drug Group, LLC ) null

Acetaminophen Oral tablet

Acetaminophen Extra-Strength 500mg Tablet (null) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Actamin 500mg Tablet (10244-0584) (Otis Clapp and Son) (off market)

Acetaminophen Oral tablet

Actamin 500mg Tablet (10244-0575) (Otis Clapp and Son) (off market)

Acetaminophen Oral tablet

Anacin Aspirin Free 500mg Tablet (00573-0310) (Medtech Products, Inc a Prestige Brands Company formerly Insight Pharmaceuticals) (off market)

Acetaminophen Oral tablet

BeneHealth Acetaminophen 500mg Tablet (65155-0201) (BeneHealth) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Caplet (69842-0484) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Caplet (69842-0168) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Caplet (69842-0484) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Caplet (69842-0484) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Easy Swallow Tablet (69842-0931) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) nullCVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) nullCVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

CVS Acetaminophen Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0975) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (69842-0484) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) nullCVS Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) nullCVS Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0975) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Caplet (59779-0484) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Easy Swallow Tablet (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Easy Swallow Tablet (59779-0531) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Geltab (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Geltab (59779-0187) (CVS Health) nullCVS Pain Relief Extra Strength 500mg Geltab package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Tablet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Tablet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (59779-0405) (CVS Health) (off market)CVS Pain Relief Extra Strength 500mg Tablet package photo

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (59779-0101) (CVS Health) null

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (null) (CVS Health) (off market)

Acetaminophen Oral tablet

CVS Pain Relief Extra Strength 500mg Tablet (59779-0101) (CVS Health) null

Acetaminophen Oral tablet

Equaline Extra Strength Pain Relief Caplet (41163-0484) (Albertson's, Inc) (off market)

Acetaminophen Oral tablet

Equaline Extra Strength Pain Relief Gelcap (41163-0976) (Albertson's, Inc) (off market)

Acetaminophen Oral tablet

Equaline Extra Strength Pain Relief Geltab (41163-0187) (Albertson's, Inc) (off market)

Acetaminophen Oral tablet

Equaline Extra Strength Pain Relief Tablet (41163-0405) (Albertson's, Inc) (off market)

Acetaminophen Oral tablet

Genapap 500mg Caplet (00182-2152) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Genapap 500mg Gelcap (00182-2154) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Genapap 500mg Tablet (00182-1457) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Genebs 500mg Caplet (00182-1832) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

Genebs 500mg Tablet (00182-1453) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Caplet (24385-0484) (AmerisourceBergen Corporation) nullGNP Pain Relief Extra Strength 500mg Caplet package photo

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Caplet (46122-0312) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Caplet (24385-0484) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Easy Tab Tablet (24385-0145) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Rapid Release Gelcap (46122-0003) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Tablet (24385-0405) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet

GNP Pain Relief Extra Strength 500mg Tablet (24385-0087) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet

GNP Pain Relief Rapid Release Extra Strength 500mg Caplet (46122-0312) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Relief Rapid Release Extra Strength 500mg Caplet (46122-0543) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Reliever Extra Strength 500mg Caplet (46122-0297) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet

GNP Pain Reliever Extra Strength 500mg Caplet (46122-0297) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet

GNP Pain Reliever Extra Strength 500mg Caplet (46122-0257) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet

GNP Pain Reliever Extra Strength 500mg Caplet (46122-0370) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet

GoodSense Extra Strength Pain Relief 500mg Tablet (00113-0405) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral tablet

GoodSense Pain Relief 500mg Caplet (00113-0484) (Goodsense a Division of Perrigo) null

Acetaminophen Oral tablet

GoodSense Pain Relief Extra Strength 500mg Cool Ice Caplet (00113-0010) (Goodsense a Division of Perrigo) (off market)

Acetaminophen Oral tablet

GoodSense Pain Relief Extra Strength 500mg Tablet (00113-0227) (Goodsense a Division of Perrigo) null

Acetaminophen Oral tablet

Health Mart Pain Relief Extra Strength 500mg Caplet (62011-0034) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Mart Pain Relief Extra Strength 500mg Caplet (62011-0023) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Mart Pain Relief Extra Strength 500mg Caplet (62011-0023) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Mart Pain Relief Extra Strength 500mg Caplet (62011-0023) (McKesson Corporation) null

Acetaminophen Oral tablet

Health Mart Pain Relief Extra Strength 500mg Easy To Swallow Tablet (62011-0027) (McKesson Corporation) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Caplet (70000-0373) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Caplet (70000-0373) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Caplet (70000-0373) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Caplet (70000-0373) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Caplet (70000-0373) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0312) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0312) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0312) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0446) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0446) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Rapid Release Gelcap (70000-0446) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Tablet (70000-0410) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Tablet (70000-0036) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Acetaminophen Extra Strength 500mg Tablet (70000-0410) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever 500mg Gelcap (37205-0025) (Cardinal Health, Inc.) (off market)Leader Pain Reliever 500mg Gelcap package photo

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Caplet (37205-0594) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Caplet (37205-0594) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Caplet (37205-0594) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Geltab (37205-0187) (Cardinal Health, Inc.) (off market)Leader Pain Reliever Extra Strength 500mg Geltab package photo

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Rapid Release Gelcap (37205-0980) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Rapid Release Gelcap (37205-0980) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Tablet (37205-0593) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Tablet (37205-0659) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Tablet (37205-0593) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength 500mg Tablet (37205-0659) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength Caplet (37205-0020) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Leader Pain Reliever Extra Strength Tablet (37205-0035) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet

Mapap 500mg Caplet (00904-1983) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) nullMapap 500mg Caplet package photo

Acetaminophen Oral tablet

Mapap 500mg Tablet (00904-1988) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral tablet

Mapap Extra Strength 500mg Rapid Release Gelcap (00904-5816) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Oral tablet

Non-Aspirin Acetaminophen 500mg Tablet (59606-0020) (Leiner Health Products, a subsidiary of Nature's Bounty) (off market)

Acetaminophen Oral tablet

Pain and Fever 500mg Tablet (00536-3231) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Pain and Fever 500mg Tablet (00536-3218) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Pain and Fever 500mg Tablet (00536-3231) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)

Acetaminophen Oral tablet

Pain Relief 500mg Tablet (00761-0113) (Basic Vitamins) (off market)

Acetaminophen Oral tablet

Pain Relief 500mg Tablet (00761-0904) (Basic Vitamins) (off market)

Acetaminophen Oral tablet

PAIN RELIEF Extra-Strength 500mg Caplet (57896-0221) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

PAIN RELIEF Extra-Strength 500mg Gelcap (57896-0251) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

PAIN RELIEF Extra-Strength 500mg Tablet (57896-0201) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet

Panadol 500mg Extra Strength Caplet (null) (GlaxoSmithKline Consumer Healthcare) (off market)

Acetaminophen Oral tablet

PHARBETOL 500mg Caplet (16103-0350) (Pharbest Pharmaceuticals) null

Acetaminophen Oral tablet

PHARBETOL 500mg Tablet (16103-0376) (Pharbest Pharmaceuticals) null

Acetaminophen Oral tablet

Plus PHARMA Acetaminophen 500mg Extra-Strength Tablet (51645-0706) (Gemini Pharmaceuticals, Inc.) null

Acetaminophen Oral tablet

Premier Value Non-Aspirin Extra Strength 500mg Caplet (68016-0138) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Non-Aspirin Extra Strength 500mg Tablet (68016-0139) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Cool Caplet (68016-0027) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Cool Caplet (68016-0027) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Cool Caplet (68016-0027) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Rapid Release Gelcap (68016-0029) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Rapid Release Gelcap (68016-0029) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Relief Extra Strength 500mg Tablet (68016-0021) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Reliever Extra Strength 500mg Caplet (68016-0656) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Reliever Extra Strength 500mg Caplet (68016-0656) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Reliever Extra Strength 500mg Caplet (68016-0656) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Premier Value Pain Reliever Extra Strength 500mg Caplet (68016-0656) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet

Publix Pain Relief Extra Strength 500mg Caplet (56062-0484) (Publix Super Markets, Inc) null

Acetaminophen Oral tablet

Publix Pain Relief Extra Strength 500mg Caplet (56062-0010) (Publix Super Markets, Inc) null

Acetaminophen Oral tablet

Publix Pain Relief Extra Strength 500mg Tablet (56062-0227) (Publix Super Markets, Inc) null

Acetaminophen Oral tablet

Publix Pain Relief Extra Strength Geltab (56062-0187) (Publix Super Markets, Inc) null

Acetaminophen Oral tablet

Q-Pap Extra Strength 500mg Caplet (00603-0265) (Par Pharmaceuticals, an Endo Company) (off market)

Acetaminophen Oral tablet

Q-Pap Extra Strength 500mg Tablet (00603-0268) (Par Pharmaceuticals, an Endo Company) (off market)Q-Pap Extra Strength 500mg Tablet package photo

Acetaminophen Oral tablet

Quality Choice Extra Strength Pain Relief 500mg Cool Taste Caplet (63868-0503) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet

Quality Choice Pain Relief Extra Strength 500mg Easy Tab Tablet (63868-0507) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet

Quality Choice Pain Relief Extra Strength 500mg Rapid Release Gelcap (63868-0987) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet

Quality Choice Pain Relief Extra Strength 500mg Rapid Release Gelcap (63868-0987) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet

RITE AID Acetaminophen Extra Strength 500mg Easy Tab Tablet (null) (Rite Aid Corp) null

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet (null) (Rite Aid Corp) null

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet (null) (Rite Aid Corp) nullRITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet (null) (Rite Aid Corp) null

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet (null) (Rite Aid Corp) nullRITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet (null) (Rite Aid Corp) nullRITE AID Pain Relief Acetaminophen 500mg Extra Strength Caplet package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Acetaminophen 500mg Extra Strength Tablet (null) (Rite Aid Corp) null

Acetaminophen Oral tablet

RITE AID Pain Relief Extra Strength 500mg Easy Tab Tablet (null) (Rite Aid Corp) nullRITE AID Pain Relief Extra Strength 500mg Easy Tab Tablet package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (Rite Aid Corp) nullRITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (Rite Aid Corp) nullRITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (Rite Aid Corp) nullRITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

RITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap (null) (Rite Aid Corp) nullRITE AID Pain Relief Extra Strength 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

Select Brand Pain Reliever 500mg Caplet (15127-0735) (Select Brand) nullSelect Brand Pain Reliever 500mg Caplet package photo

Acetaminophen Oral tablet

Select Brand Pain Reliever 500mg Rapid Release Gelcap (15127-0994) (Select Brand) nullSelect Brand Pain Reliever 500mg Rapid Release Gelcap package photo

Acetaminophen Oral tablet

Select Brand Pain Reliever 500mg Tablet (15127-0730) (Select Brand) nullSelect Brand Pain Reliever 500mg Tablet package photo

Acetaminophen Oral tablet

Sunmark Pain Relief Extra Strength 500mg Rapid Release Gelcap (49348-0892) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever Extra Strength 500mg Caplet (49348-0042) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever Extra Strength 500mg Rapid Release Gelcap (49348-0116) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever Extra Strength 500mg Tablet (49348-0730) (McKesson Corporation) null

Acetaminophen Oral tablet

Sunmark Pain Reliever Extra Strength 500mg Tablet (49348-0998) (McKesson Corporation) null

Acetaminophen Oral tablet

Today's Health Acetaminophen Extra Strength 500mg Caplet (null) (Today's Health, Inc.) null

Acetaminophen Oral tablet

Today's Health Acetaminophen Extra Strength 500mg Caplet (null) (Today's Health, Inc.) null

Acetaminophen Oral tablet

Today's Health Acetaminophen Extra Strength 500mg Cool Taste Caplet (null) (Today's Health, Inc.) null

Acetaminophen Oral tablet

Today's Health Acetaminophen Extra Strength 500mg Easy Tab Tablet (null) (Today's Health, Inc.) null

Acetaminophen Oral tablet

Top Care Extra Strength Pain Relief 500mg Tablet (36800-0405) (Topco Associates LLC) null

Acetaminophen Oral tablet

Top Care Pain Relief 500mg Caplet (36800-0484) (Topco Associates LLC) null

Acetaminophen Oral tablet

Top Care Pain Relief Extra Strength 500mg Cool Ice Caplet (36800-0010) (Topco Associates LLC) null

Acetaminophen Oral tablet

Top Care Pain Relief Extra Strength 500mg Rapid Release Gelcap (36800-0046) (Topco Associates LLC) null

Acetaminophen Oral tablet

Top Care Pain Relief Extra Strength 500mg Tablet (36800-0227) (Topco Associates LLC) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (50580-0451) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (50580-0412) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00450-0449) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0444) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

TYLENOL Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

TYLENOL Extra Strength 500mg Caplet (00045-0449) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Cool Caplet (00045-0444) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Crushable Tablet (00045-0499) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg EZ Tab (00045-0422) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Gelcap (50580-0468) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Geltab (50580-0124) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)Tylenol Extra Strength 500mg Geltab package photo

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Rapid Release Gels (00045-0488) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Rapid Release Gels (00045-0488) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Tablet (50580-0499) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Tablet (00045-0499) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Tablet (00045-0499) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Tylenol Extra Strength 500mg Tablet (00045-0499) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet

Walgreens Acetaminophen 500mg Caplet (00363-0175) (Walgreens Co) nullWalgreens Acetaminophen 500mg Caplet package photo

Acetaminophen Oral tablet

Walgreens Acetaminophen 500mg Caplet (00363-0175) (Walgreens Co) null

Acetaminophen Oral tablet

Walgreens Acetaminophen Extra Strength 500mg Cool Ice Caplet (00363-0010) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Cool Ice Caplet package photo

Acetaminophen Oral tablet

Walgreens Acetaminophen Extra Strength 500mg Easy Tab Tablet (00363-0531) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Easy Tab Tablet package photo

Acetaminophen Oral tablet

Walgreens Acetaminophen Extra Strength 500mg Fast Release QuickGels Gelcap (00363-0519) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Fast Release QuickGels Gelcap package photo

Acetaminophen Oral tablet

Walgreens Acetaminophen Extra Strength 500mg Geltab (00363-0187) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Geltab package photo

Acetaminophen Oral tablet

Walgreens Acetaminophen Extra Strength 500mg Tablet (00363-0148) (Walgreens Co) nullWalgreens Acetaminophen Extra Strength 500mg Tablet package photo

Acetaminophen Oral tablet

Walgreens Pain Reliever Extra Strength 500mg Caplet (00363-0175) (Walgreens Co) null

Acetaminophen Oral tablet

XS Pain Reliever 500mg Tablet (54629-0915) (National Vitamin Company Inc) (off market)

Acetaminophen Oral tablet

XS Pain Reliever 500mg Tablet (54629-0966) (National Vitamin Company Inc) (off market)

Acetaminophen Oral tablet

XS Pain Reliever 500mg Tablet (54629-0965) (National Vitamin Company Inc) (off market)

Acetaminophen Oral tablet

Acetaminophen 650mg Tablet (51079-0050) (Mylan Institutional LLC ) (off market)

Acetaminophen Oral tablet, biphasic release

Acetaminophen 8HR Arthritis Pain 650mg Extended-Release Caplet (51660-0333) (OHM Laboratories Inc, a Sun Pharma Company) null

Acetaminophen Oral tablet, biphasic release

Quality Choice Arthritis Pain Relief Acetaminophen 8HR 650mg Extended-Release Tablet (63868-0089) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet, biphasic release

RITE AID Acetaminophen 8 Hour 650mg Extended-Release Caplet (null) (Rite Aid Corp) nullRITE AID Acetaminophen 8 Hour 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, biphasic release

RITE AID Acetaminophen 8 Hour 650mg Extended-Release Caplet (null) (Rite Aid Corp) nullRITE AID Acetaminophen 8 Hour 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, biphasic release

Tylenol 8 Hour 650mg Extended Relief Caplet (00045-0297) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet, biphasic release

Tylenol 8 Hour 650mg Extended Relief Caplet (00045-0297) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet, biphasic release

Tylenol 8 Hour 650mg Extended Relief Geltab (50580-0505) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet, biphasic release

Tylenol 8HR Arthritis Pain 650mg Extended-Release Caplet (00045-0838) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) null

Acetaminophen Oral tablet, biphasic release

Tylenol 8HR Muscle Aches & Pain 650mg Extended-Release Caplet (50580-0309) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) null

Acetaminophen Oral tablet, biphasic release

Tylenol Arthritis Pain 650mg Extended-Relief Caplet (00045-0838) (McNeil Consumer Healthcare Division of McNEIL-PPC, Inc.) (off market)

Acetaminophen Oral tablet, extended release

Acetaminophen 650mg Arthritis Pain Relief Extended-Release Caplet (57896-0268) (Geri-Care Pharmaceuticals) null

Acetaminophen Oral tablet, extended release

Acetaminophen 650mg Arthritis Pain Relief Extended-Release Caplet (69848-0015) (Granules USA, Inc.) null

Acetaminophen Oral tablet, extended release

Acetaminophen 650mg Extended-Release Tablet (68084-0777) (American Health Packaging) null

Acetaminophen Oral tablet, extended release

Acetaminophen 650mg Extended-Release Tablet (00904-6883) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) null

Acetaminophen Oral tablet, extended release

Acetaminophen 8HR 650mg Arthritis Pain Relief Extended-Release Tablet (68001-0495) (BluePoint Laboratories) null

Acetaminophen Oral tablet, extended release

CVS 8 Hour Pain Relief 650mg Extended-Release Caplet (null) (CVS Health) (off market)CVS 8 Hour Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS 8 Hour Pain Relief 650mg Extended-Release Caplet (null) (CVS Health) (off market)

Acetaminophen Oral tablet, extended release

CVS 8HR Arthritis Pain Relief 650mg Extended-Release Caplet (69842-0544) (CVS Health) null

Acetaminophen Oral tablet, extended release

CVS 8HR Arthritis Pain Relief 650mg Extended-Release Caplet (69842-0544) (CVS Health) nullCVS 8HR Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS 8HR Arthritis Pain Relief 650mg Extended-Release Caplet (69842-0544) (CVS Health) null

Acetaminophen Oral tablet, extended release

CVS 8HR Muscle Aches & Pain 650mg Extended-Release Caplet (69842-0764) (CVS Health) null

Acetaminophen Oral tablet, extended release

CVS 8HR Muscle Aches & Pain 650mg Extended-Release Caplet (69842-0312) (CVS Health) null

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (null) (CVS Health) (off market)

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (59779-0544) (CVS Health) (off market)CVS Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (null) (CVS Health) (off market)CVS Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (59779-0544) (CVS Health) nullCVS Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (59779-0544) (CVS Health) (off market)

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Caplet (59779-0544) (CVS Health) nullCVS Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Geltab (null) (CVS Health) null

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Geltab (null) (CVS Health) nullCVS Arthritis Pain Relief 650mg Extended-Release Geltab package photo

Acetaminophen Oral tablet, extended release

CVS Arthritis Pain Relief 650mg Extended-Release Geltab (null) (CVS Health) (off market)CVS Arthritis Pain Relief 650mg Extended-Release Geltab package photo

Acetaminophen Oral tablet, extended release

CVS Pain Relief 650mg Extended-Release Caplet (59779-0217) (CVS Health) (off market)CVS Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

GNP 8HR Muscle Aches & Pain 650mg Extended-Release Caplet (46122-0630) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet, extended release

GNP Acetaminophen 8 Hour 650mg Extended-Release Caplet (46122-0062) (AmerisourceBergen Corporation) nullGNP Acetaminophen 8 Hour 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

GNP Acetaminophen 8 Hour Arthritis Pain 650mg Extended-Release Tablet (46122-0629) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet, extended release

GNP Arthritis Pain Relief 650mg Extended-Release Caplet (24385-0629) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet, extended release

GNP Arthritis Pain Relief 650mg Extended-Release Caplet (46122-0170) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet, extended release

GNP Arthritis Pain Relief Extended-Release Caplet (24385-0629) (AmerisourceBergen Corporation) null

Acetaminophen Oral tablet, extended release

GNP Pain Relief 650mg Extended-Release Caplet (24385-0629) (AmerisourceBergen Corporation) (off market)

Acetaminophen Oral tablet, extended release

GoodSense 8 Hour Pain Relief 650mg Extended-Release Caplet (00113-0217) (Goodsense a Division of Perrigo) nullGoodSense 8 Hour Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

GoodSense Arthritis Pain Relief 650mg Extended-Release Caplet (00113-0544) (Goodsense a Division of Perrigo) null

Acetaminophen Oral tablet, extended release

GoodSense Arthritis Pain Relief 650mg Extended-Release Caplet (00113-0544) (Goodsense a Division of Perrigo) null

Acetaminophen Oral tablet, extended release

Health Mart Arthritis Pain Relief 650mg Extended-Release Caplet (62011-0026) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Health Mart Arthritis Pain Relief 650mg Extended-Release Caplet (62011-0337) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Health Mart Arthritis Pain Relief 650mg Extended-Release Caplet (62011-0338) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Health Mart Pain Relief 650mg Extended-Release Caplet (62011-0336) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Leader 8 Hour Pain Reliever 650mg Extended-Release Caplet (37205-0477) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader 8HR Arthritis Pain Extended-Release Caplet (70000-0180) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader 8HR Arthritis Pain Extended-Release Caplet (70000-0180) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet, extended release

Leader 8HR Arthritis Pain Extended-Release Caplet (70000-0180) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet, extended release

Leader 8HR Arthritis Pain Extended-Release Caplet (70000-0180) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader Arthritis Pain Reliever 650mg Extended-Release Geltab (37205-0662) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader Arthritis Pain Reliever 650mg Extended-Release Geltab (37205-0662) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader Arthritis Pain Reliever Extended-Release Caplet (37205-0034) (Cardinal Health, Inc.) null

Acetaminophen Oral tablet, extended release

Leader Arthritis Pain Reliever Extended-Release Caplet (37205-0034) (Cardinal Health, Inc.) (off market)

Acetaminophen Oral tablet, extended release

Mapap Arthritis Pain 650mg Extended-Release Caplet (00904-5769) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) nullMapap Arthritis Pain 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Midol Long Lasting Relief 650mg Extended-Release Caplet (12843-0571) (Bayer Corp Consumer Care Div) null

Acetaminophen Oral tablet, extended release

Premier Value Acetaminophen 8 Hour 650mg Extended-Release Caplet (68016-0336) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet, extended release

Premier Value Arthritis Pain Relief 650mg Extended-Release Caplet (68016-0019) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) (off market)

Acetaminophen Oral tablet, extended release

Premier Value Arthritis Pain Relief 650mg Extended-Release Caplet (68016-0333) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet, extended release

Premier Value Arthritis Pain Relief 650mg Extended-Release Geltab (68016-0340) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet, extended release

Premier Value Arthritis Pain Relief 650mg Extended-Release Geltab (68016-0340) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet, extended release

Premier Value Non-Aspirin 8 Hour 650mg Extended-Release Caplet (68016-0019) (Pharmacy Value Alliance LLC formerly Chain Drug Consortium , LLC) null

Acetaminophen Oral tablet, extended release

Publix Arthritis Pain Relief 650mg Extended-Release Caplet (56062-0544) (Publix Super Markets, Inc) null

Acetaminophen Oral tablet, extended release

Quality Choice Acetaminophen 8 Hour 650mg Extended-Release Caplet (63868-0091) (Chain Drug Marketing Association) null

Acetaminophen Oral tablet, extended release

RITE AID Arthritis Pain Relief 650mg Extended-Release Caplet (null) (Rite Aid Corp) nullRITE AID Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

RITE AID Arthritis Pain Relief 650mg Extended-Release Caplet (null) (Rite Aid Corp) nullRITE AID Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

RITE AID Arthritis Pain Relief 650mg Extended-Release Caplet (null) (Rite Aid Corp) nullRITE AID Arthritis Pain Relief 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Select Brand Arthritis Pain Relief Extended-Release Caplet (15127-0332) (Select Brand) nullSelect Brand Arthritis Pain Relief Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Sunmark 8 Hour Pain Relief 650mg Extended-Release Caplet (49348-0924) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Sunmark Arthritis Pain Relief 650mg Extended-Release Caplet (49348-0921) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Sunmark Arthritis Pain Relief 650mg Extended-Release Caplet (70677-0019) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Sunmark Arthritis Pain Relief 650mg Extended-Release Caplet (70677-0018) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Sunmark Pain Reliever 650mg Extended-Release Caplet (70677-0017) (McKesson Corporation) null

Acetaminophen Oral tablet, extended release

Today's Health Arthritis Pain Relief 650mg Extended-Release Caplet (null) (Today's Health, Inc.) null

Acetaminophen Oral tablet, extended release

Top Care 8 Hour Pain Relief 650mg Extended-Release Caplet (36800-0217) (Topco Associates LLC) null

Acetaminophen Oral tablet, extended release

Top Care Arthritis Pain Relief 650mg Extended-Release Caplet (36800-0966) (Topco Associates LLC) null

Acetaminophen Oral tablet, extended release

Top Care Arthritis Pain Relief 650mg Extended-Release Caplet (36800-0544) (Topco Associates LLC) null

Acetaminophen Oral tablet, extended release

Tylenol Arthritis Pain 650mg Extended Relief Geltab (50580-0292) (Johnson & Johnson Consumer Inc., McNeil Consumer Healthcare Division) (off market)

Acetaminophen Oral tablet, extended release

Walgreens 8-Hour Pain Reliever 650mg Extended-Release Caplet (00363-9992) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens 8-Hour Pain Reliever 650mg Extended-Release Caplet (00363-9992) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens 8-Hour Pain Reliever 650mg Extended-Release Caplet (00363-9992) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Acetaminophen 8 Hour 650mg Extended-Release Caplet (00363-0336) (Walgreens Co) nullWalgreens Acetaminophen 8 Hour 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Walgreens Acetaminophen 8 Hour 650mg Extended-Release Caplet (00363-0336) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Acetaminophen 8 Hour 650mg Extended-Release Caplet (00363-0336) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Acetaminophen 8-Hour 650mg Extended-Release Caplet (00363-0336) (Walgreens Co) nullWalgreens Acetaminophen 8-Hour 650mg Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Relief 650mg Extended-Release Caplet (00363-0334) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Relief 650mg Extended-Release Caplet (00363-0334) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Relief 650mg Extended-Release Caplet (00363-0544) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Relief Extended-Release Caplet (00363-0333) (Walgreens Co) nullWalgreens Arthritis Pain Relief Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Relief Extended-Release Caplet (00363-0333) (Walgreens Co) nullWalgreens Arthritis Pain Relief Extended-Release Caplet package photo

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-0544) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-0334) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-9993) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-0544) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-0544) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Caplet (00363-9993) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Geltab (11917-0187) (Walgreens Co) (off market)

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Geltab (00363-0340) (Walgreens Co) null

Acetaminophen Oral tablet, extended release

Walgreens Arthritis Pain Reliever 650mg Extended-Release Geltab (11917-0148) (Walgreens Co) (off market)

Acetaminophen Rectal suppository

FeverAll Infants' 80mg Rectal Suppository (51672-2114) (Taro Pharmaceuticals USA Inc) null

Acetaminophen Rectal suppository

FeverAll Infants' 80mg Rectal Suppository (00472-1200) (Teva/Actavis US) (off market)FeverAll Infants' 80mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acephen 120mg Rectal Suppository (00713-0118) (Cosette Pharmaceuticals, Inc.) nullAcephen 120mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (59439-0121) (Ascent Pediatrics, Inc. a Subsidiary of Medicis Corporation) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (52297-0118) (Cardinal Health, Inc.) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (52735-0717) (Family Pharmacy) null

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00839-7838) (HL Moore Drug Exchange) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00839-5999) (HL Moore Drug Exchange) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (49348-0796) (McKesson Corporation) null

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00603-8042) (Par Pharmaceuticals, an Endo Company) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (45802-0732) (Perrigo Pharmaceuticals Company) nullAcetaminophen 120mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00536-1255) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Acetaminophen 120mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00677-0700) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00182-1662) (Teva Pharmaceuticals USA) (off market)Acetaminophen 120mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 120mg Rectal Suppository (00364-7247) (Teva/Actavis US) (off market)

Acetaminophen Rectal suppository

CVS Children's Fever Reducing 120mg Rectal Suppository (59779-0579) (CVS Health) null

Acetaminophen Rectal suppository

CVS Children's Fever Reducing 120mg Rectal Suppository (59779-0579) (CVS Health) (off market)CVS Children's Fever Reducing 120mg Rectal Suppository package photo

Acetaminophen Rectal suppository

FeverAll Children's 120mg Rectal Suppository (51672-2115) (Taro Pharmaceuticals USA Inc) null

Acetaminophen Rectal suppository

FeverAll Children's 120mg Rectal Suppository (00472-1201) (Teva/Actavis US) (off market)

Acetaminophen Rectal suppository

Mapap 120mg Rectal Suppository (00904-7692) (Major Pharmaceuticals Inc, a Harvard Drug Group Company) (off market)

Acetaminophen Rectal suppository

Top Care Children's Fever Reducer 120mg Rectal Suppository (null) (Topco Associates LLC) null

Acetaminophen Rectal suppository

Walgreens Children's Fever Reducer 120mg Rectal Suppository (00363-0706) (Walgreens Co) null

Acetaminophen Rectal suppository

Acephen 325mg Rectal Suppository (00713-0164) (Cosette Pharmaceuticals, Inc.) nullAcephen 325mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 325mg Rectal Suppository (00536-1320) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Acetaminophen 325mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 325mg Rectal Suppository (00182-7001) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Rectal suppository

FeverAll Jr.Strength 325mg Rectal Suppository (51672-2116) (Taro Pharmaceuticals USA Inc) null

Acetaminophen Rectal suppository

FeverAll Jr.Strength 325mg Rectal Suppository (00472-1202) (Teva/Actavis US) (off market)

Acetaminophen Rectal suppository

Acephen 650mg Rectal Suppository (00713-0165) (Cosette Pharmaceuticals, Inc.) nullAcephen 650mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (24385-0147) (AmerisourceBergen Corporation) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (59439-0122) (Ascent Pediatrics, Inc. a Subsidiary of Medicis Corporation) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00839-6001) (HL Moore Drug Exchange) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00839-7839) (HL Moore Drug Exchange) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00603-8045) (Par Pharmaceuticals, an Endo Company) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (45802-0730) (Perrigo Pharmaceuticals Company) nullAcetaminophen 650mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00536-1260) (Rugby Laboratories a Division of The Harvard Drug Group, LLC) (off market)Acetaminophen 650mg Rectal Suppository package photo

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00677-1016) (Sun Pharmaceutical Industries, Inc.) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00182-1095) (Teva Pharmaceuticals USA) (off market)

Acetaminophen Rectal suppository

Acetaminophen 650mg Rectal Suppository (00364-2581) (Teva/Actavis US) (off market)

Acetaminophen Rectal suppository

FeverAll 650mg Rectal Suppository (51672-2117) (Taro Pharmaceuticals USA Inc) null

Acetaminophen Rectal suppository

FeverAll 650mg Rectal Suppository (00472-1203) (Teva/Actavis US) (off market)

Acetaminophen Soft chew

Acetaminophen 160mg Chewable Gel (50488-4160) (Alexso Inc) null

Acetaminophen Soft chew

Acetaminophen 325mg Chewable Gel (50488-4325) (Alexso Inc) null

Acetaminophen Soft chew

7T Gummy ES 500mg Chewable Gel (70645-0500) (7T Pharma LLC) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (55150-0307) (AuroMedics Pharma LLC) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (00264-4100) (B Braun Medical Inc) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (36000-0306) (Baxter Healthcare Corporation) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (63323-0434) (Fresenius Kabi USA, LLC) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (24201-0100) (Leucadia Pharmaceuticals) nullAcetaminophen 1000mg/100mL Solution for Injection package photo

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (67457-0940) (Mylan Institutional LLC ) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (00781-3156) (Sandoz Inc. a Novartis Company) null

Acetaminophen Solution for injection

Acetaminophen 1000mg/100mL Solution for Injection (PREMIER ProRx) (00781-9274) (Sandoz Inc. a Novartis Company) null

Acetaminophen Solution for injection

Acetaminophen 500mg/50mL Solution for Injection (00264-4500) (B Braun Medical Inc) null

Acetaminophen Solution for injection

OFIRMEV 1000mg/100mL Solution for Injection (43825-0102) (Cadence Pharmaceuticals Inc, a subsidiary of Mallinckrodt plc) null

Description/Classification

Description

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.[23977] In addition, acetaminophen has been recommended by the American Lung Association as the first line treatment for aches and pains associated with the flu, by the American Geriatrics Society for both minor and persistent pain in elderly patients, and by the American College of Rheumatology as first-line therapy for osteoarthritis of the hip or knee.[35614][35976] The drug has a history of safe and effective use; however, unintentional or intentional misuse of acetaminophen is the number one cause of acute hepatic failure in the U.S.[32202] Acetaminophen was first approved by the FDA in 1950. Intravenous acetaminophen was approved by the FDA in November 2010 for the treatment of pain and fever in adults, adolescents, and children over the age of 2 years. In 2017, the indication for fever was expanded to include patients as young as premature neonates born at 32 weeks gestation.[42289]

Classifications

  • Central Nervous System
    • Analgesics
      • Analgesics with Antipyretic Activity
Revision Date: 02/07/2017, 11:51:09 AM

References

23977 - Perneger TV, Whelton PK, Klag MJ. Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal antiinflammatory drugs. N Engl J Med 1994;331:1675-9.32202 - Larson AM, Polson J, Fontana RJ, et al, the Acute Liver Failure Study Group. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology 2005;42:1364-72.35614 - American Geriatrics Society (AGS) Panel on Pharmacological Management of Persistent Pain in Older Persons. Pharmacological management of persistent pain in older persons. J Am Geriatr Soc 2009;57:1331-46.35976 - American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum 2000;43:1905-15.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.

Administration Information

General Administration Information

For storage information, see the specific product information within the How Supplied section.

 

NOTE: Acetaminophen-induced hepatotoxicity often involves the use of more than 1 acetaminophen-containing product. Ensure dosing intervals and maximum daily dosage limits are based on all routes of administration (e.g., intravenous, oral, rectal) and all products containing acetaminophen, including both single-entity and combination products.[42289]

Route-Specific Administration

Oral Administration

  • May be taken without regard to meals.

Oral Solid Formulations

  • Chewable tablets: May be swallowed whole or chewed.[54020]
  • Chewable gel: Chew thoroughly before swallowing.[64629]
  • Oral granules: Mix with a small amount of soft food (i.e., applesauce, ice cream, or jam) immediately prior to administration.
  • Oral powders: Do not administer the capsules containing the powder whole. Open capsule and sprinkle over a small amount of water (less than 5 mL) or mix with a small amount of soft food (i.e., applesauce, ice cream, or jam) immediately prior to administration.
  • Dissolve packs: Tear packet and pour onto tongue.
  • Effervescent tablets: Dissolve tablet fully in 6 ounces of room temperature water. Do not chew or swallow whole tablets.
  • Immediate-release tablets: Administer with a sufficient amount of water.
  • Extended-release tablets: Do not crush, chew, split, or dissolve in liquid.[54020]

Oral Liquid Formulations

  • Liquid acetaminophen may be available in multiple concentrations. Always verify the concentration before administering each dose.
  • For home administration, advise caregivers to administer the amount of medicine listed on the specific drug product label for the patient's weight and age or provide written instructions that specify the dose in milligrams (mg) and/or the concentration and the dose in milliliters (mL).

 

Oral solution:

  • Administer using an oral calibrated measuring device to ensure accurate dosing.

 

Oral suspension:

  • Shake well prior to each use.
  • Administer using an oral calibrated measuring device to ensure accurate dosing.

Injectable Administration

  • Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.
  • To reduce the risk of dosing errors that can lead to accidental overdose, hepatotoxicity, and even death, use special care when preparing and administering acetaminophen intravenous injection. Specifically, ensure that:
    • the dose in milligrams (mg) and milliliters (mL) is not confused
    • weight-based dosing is used for patients weighing less than 50 kg
    • infusion pumps are properly programmed
    • the total daily acetaminophen dose from all sources does not exceed recommended daily maximum limits [42289]

Intravenous Administration

Intermittent IV Infusion Preparation

  • No further dilution of acetaminophen injectable solution is required.
  • Do not add other medications to the vial or infusion device.
  • For doses less than 1,000 mg, the appropriate dose must be withdrawn from the container using aseptic technique and placed in a separate empty, sterile container (e.g., glass bottle, plastic intravenous container, or syringe) prior to administration.
  • For patients (weighing 50 kg or more) requiring a 1,000 mg dose, administer the dose by inserting an intravenous set directly in the container; use a vented set for vials and a non-vented set for bags.
  • Storage: Acetaminophen containers are preservative free. FDA-approved labeling recommends administering the dose within 6 hours once the seal on the container has been penetrated or the dose transferred to another container. Discard any unused portion.[42289] Of note, acetaminophen has retained physical and chemical stability in a range of volumes (10 to 90 mL) for up to 84 hours in opened vials and polypropylene syringes at room temperature (23 to 25 degrees C). According to USP 797 guidelines, a single transfer of acetaminophen from the original vial to a syringe would be classified as a low-risk condition. The maximum exposure time of low-risk-level compounded sterile products (CSPs) is 48 hours at room temperature when the CSP is compounded aseptically within ISO class 5 or higher air quality.[56385]

 

Intermittent IV Infusion Administration

  • Infuse the dose over 15 minutes.[42289]

Rectal Administration

  • Instruct patient or caregiver on proper use of suppository.
  • Prior to insertion, carefully remove the wrapper. Avoid excessive handling as to avoid melting of the suppository.
  • If suppository is too soft to insert, chill in the refrigerator for 30 minutes or run cold water over it before removing the wrapper.
  • Moisten the suppository with cool water prior to insertion.
  • Have patient lie down on their side, usually in the Sim's lateral position to provide support and comfort.
  • Apply gentle pressure to insert the suppository completely into the rectum, pointed end first, using a gloved, lubricated index finger.
  • After insertion, keep the patient lying down to aid retention. May gently hold the buttock cheeks close together to keep the patient from immediately expelling the suppository. The suppository must be retained in rectum to ensure complete absorption.

Clinical Pharmaceutics Information

From Trissel's 2‚Ñ¢ Clinical Pharmaceutics Database

Acetaminophen

pH Range
Approximately pH 5.5.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
ReferencesKambia NK, Luyckx M, Dine T, et al. Stability and compatibility of paracetamol injection admixed with ketoprofen. Eur J Hosp Pharm Sci. 2006; 12
Sodium Content
Acetaminophen (paracetamol) injection contains 0.04 mg/mL of sodium.
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
Osmolality/Osmolarity
Acetaminophen (paracetamol) injection is isotonic having an osmolality of 290 mOsm/kg.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
Stability
Intact containers of acetaminophen (paracetamol) injection stored at controlled room temperature and kept in the outer packaging are stable for 2 years from the date of manufacturing. The product contains no antimicrobial preservative, and each vial is for use on only one occasion. The product should be used immediately after opening and any unused solution should be discarded. In the U.S., the manufacturer states that once the vacuum seal of the glass vial has been penetrated, or the contents have been transferred to another container, the dose should be administered within 6 hours. However, Kwiatkowski et al. evaluated the extended stability of undiluted acetaminophen 10-mg/mL (Cadence) as 25 and 90 mL of drug solution remaining in opened original vials stored at room temperature of 23 to 25 degree C. No visible haze or particulate formation, color change, or gas evolution and no change in solution pH occurred. In addition, stability-indicating HPLC analysis found no loss of acetaminophen occurred in 84 hours. Infusion Solutions: In some countries, the labeling states that if acetaminophen (paracetamol) injection is to be diluted for intravenous infusion, the manufacturer recommends dilution in dextrose 5% or sodium chloride 0.9% up to a volume of 1 in 10. The manufacturer recommends administering the diluted solution immediately after preparation. However, if the diluted solution is not used immediately, it should be stored for no longer than 1 hour after preparation including the administration period. Repackaged in Syringes: Kwiatkowski et al. evaluated the extended stability of undiluted acetaminophen 10-mg/mL (Cadence) repackaged in polypropylene plastic syringes (Becton Dickinson) as 10-mL of drug in a 10-mL syringe, 25-mL of drug in a 30-mL syringe, and 50 mL of drug in a 60-mL syringe. No visible haze or particulate formation, color change, or gas evolution and no change in solution pH occurred. In addition, stability-indicating HPLC analysis found no loss of acetaminophen occurred in 84 hours.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
ReferencesAnon. NZ; Information for health professionals, New Zealand Medicines and Medical Devices Safety Authority, Wellington, New Zealand. Accessed at: http://www.medsafe.govt.nz.
ReferencesKwiatkowski JL, Johnson CE, Wagner DS. Extended stability of intravenous acetaminophen in syringes and opened vials. Am J Health-Syst Pharm. 2012; 69
Light Exposure
The manufacturer does not require light protection during storage of acetaminophen (paracetamol) injection. Troitzky et al. reported a stability study of acetaminophen (paracetamol) with other drugs both exposed to and protected from exposure to light for 24 hours. No difference in the stability of acetaminophen (paracetamol) due to exposure to light was found.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
ReferencesTroitzky A, Tirault M, Lefeuvre S, et al. Stabilite physicochimique et bacteriologique d'associations d'antalgiques de classe I en solution. [Physico-chemical stability and sterility of non-opioid analgesics in solution.]. Ann Fr Anesth Reanim. 2008; 27
Freezing
Acetaminophen (paracetamol) injection should be protected from freezing.
ReferencesAnon. NZ; Information for health professionals, New Zealand Medicines and Medical Devices Safety Authority, Wellington, New Zealand. Accessed at: http://www.medsafe.govt.nz.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
Sorption Leaching
Bernard et al. reported no loss of acetaminophen when two acetaminophen 10-mg/mL products, Perfalgan (Bristol Myers Squibb) and paracetamol (PanPharma) were tested in contact for 24 hours with Intrafix SafeSet (B. Braun) composed of polyvinyl chloride (PVC) plasticized with a new plasticizer, di(2-ethylhexyl) terephthalate (DEHT; DOTP). Kwiatkowski et al. reported no loss of acetaminophen due to sorption when repackaged in polypropylene syringes.
ReferencesBernard L, Sautou V, Bourdeaux D, et al. Stabilite et compatibilite du paracetamol, du ketoprofen et de l'amoxicilline administres avec un perfuser de securite [Stability and compatiblity of acetaminophen, ketoprofen and amoxicillin in a fail-safe intravenous administration set]. Ann Fr Anesth Reanim. 2012; 31
ReferencesKwiatkowski JL, Johnson CE, Wagner DS. Extended stability of intravenous acetaminophen in syringes and opened vials. Am J Health-Syst Pharm. 2012; 69
Other Information
Other Drugs: The manufacturer states that acetaminophen (paracetamol) infusion solution should not be mixed with other drugs. The manufacturer notes that both diazepam and chlorpromazine hydrochloride are physically incompatible with acetaminophen (paracetamol) injection.
ReferencesAnon. Manufacturer's information and labeling. (Package insert).
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
ReferencesAnon. NZ; Information for health professionals, New Zealand Medicines and Medical Devices Safety Authority, Wellington, New Zealand. Accessed at: http://www.medsafe.govt.nz.
Stability Max
Maximum reported stability periods: Repackaged- 84 hours at room temperature In D5W- 1 hour at room temperature In NS- 1 hour at room temperature
ReferencesAnon. eMC, electronic medicines compendium, Datapharm Communications Ltd., London, England. Accessed at: http://www.medicines.org.uk.
ReferencesAnon. NZ; Information for health professionals, New Zealand Medicines and Medical Devices Safety Authority, Wellington, New Zealand. Accessed at: http://www.medsafe.govt.nz.
ReferencesKwiatkowski JL, Johnson CE, Wagner DS. Extended stability of intravenous acetaminophen in syringes and opened vials. Am J Health-Syst Pharm. 2012; 69
Revision Date: 09/10/2019, 01:43:37 PMCopyright 2004-2021 by Lawrence A. Trissel. All Rights Reserved.

References

42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf56385 - Kwiatkowski JL, Johnson CE, Wagner DS. Extended stability of intravenous acetaminophen in syringes and opened vials. Am J Health Syst Pharm 2012;15:1999-2001.64629 - 7T Gummy ES (acetaminophen chewable gels) package insert. Las Vegas, NV: 7T Pharma, LLC: 2019 Sept.

Adverse Reactions

Mild

  • agitation
  • anorexia
  • anxiety
  • diarrhea
  • fatigue
  • fever
  • headache
  • injection site reaction
  • insomnia
  • maculopapular rash
  • malaise
  • muscle cramps
  • nausea
  • pruritus
  • purpura
  • urticaria
  • vomiting

Moderate

  • anemia
  • constipation
  • contact dermatitis
  • dyspnea
  • elevated hepatic enzymes
  • erythema
  • hemolysis
  • hypertension
  • hypoalbuminemia
  • hypokalemia
  • hypomagnesemia
  • hypophosphatemia
  • hypoprothrombinemia
  • hypotension
  • jaundice
  • medication overuse headache
  • neutropenia
  • peripheral edema
  • thrombocytopenia
  • thrombocytosis
  • trismus
  • wheezing
  • withdrawal

Severe

  • acute generalized exanthematous pustulosis (AGEP)
  • agranulocytosis
  • anaphylactic shock
  • anaphylactoid reactions
  • angioedema
  • exfoliative dermatitis
  • hearing loss
  • heart failure
  • hemolytic anemia
  • hepatic encephalopathy
  • hepatic failure
  • hepatic necrosis
  • hepatotoxicity
  • interstitial nephritis
  • myocarditis
  • oliguria
  • pancytopenia
  • pleural effusion
  • pulmonary edema
  • renal failure (unspecified)
  • renal papillary necrosis
  • renal tubular necrosis
  • rhabdomyolysis
  • Stevens-Johnson syndrome
  • toxic epidermal necrolysis

In clinical trials of adults receiving IV acetaminophen, headache occurred in 10% of patients compared to 9% of those receiving placebo. Headache (1% or more) was also reported in clinical trials of IV acetaminophen in pediatric patients.[42289] Overuse of drugs for treating acute headaches, including acetaminophen, may lead to medication overuse headache. Patients may experience migraine-like daily headaches or a significant increase in migraine attack frequency. Discontinuation of the overused drug and treatment of withdrawal symptoms (e.g., transient worsening of headache) may be necessary. Advise patients about the risks of medication overuse (e.g., use of acetaminophen for at least 15 days/month or any combination of therapy for at least 10 days/month) and encourage them to keep a written record of headache frequency and drug use.[66767] [66803] Pediatric guidelines recommend no more than 14 days/month of over-the-counter medication and no more than 9 days/month of any combination of therapy to avoid medication overuse headache.[64587]

The most common gastrointestinal side effects reported in clinical trials of IV acetaminophen in adults were nausea, occurring in 34% of patients who received acetaminophen vs. 31% of those who received placebo, and vomiting, occurring in 15% of the acetaminophen group vs. 11% of those who received placebo. Nausea, vomiting, and constipation were among the most commonly reported adverse reactions (5% or more) in pediatric patients treated with IV acetaminophen during clinical trials. Additionally, diarrhea was reported in 1% or more of pediatric patients.[42289] Oral therapy is not usually associated with significant adverse reactions in recommended doses. If a patient who has taken oral acetaminophen presents with significant gastrointestinal symptoms (e.g., nausea, vomiting, and/or abdominal pain), acetaminophen-induced liver toxicity should be considered.[54020]

The hepatic effects of acetaminophen are well-known. In a study of combined data collected over a 5-year period (1998 to 2003) from 22 specialty medical centers in the United States, acetaminophen-induced liver injury was the leading cause of acute hepatic failure. Unintentional overdose accounted for almost half of the reported cases; acetaminophen toxicity may occur as the result of acute overdose or chronic excessive dosing.[32202] [44683] Young children appear to be at less risk of developing hepatotoxicity, possibly because of an age-related difference in the metabolism of the drug.[32202] Acetaminophen-induced hepatotoxicity is manifested as hepatic necrosis, jaundice, and hepatic encephalopathy. Early nonspecific symptoms include nausea/vomiting, anorexia, abdominal pain, and malaise.[42289] [54184] After acute overdose, elevated hepatic enzymes occur within 12 to 36 hours and maximal liver damage and hepatic impairment peak 3 to 5 days after ingestion.[54184] GI bleeding can occur secondary to hypoprothrombinemia. Administration of intravenous vitamin K is recommended for hypoprothrombinemia due to acetaminophen overdosage. If more than 150 to 200 mg/kg, 10 g, or an unknown amount of acetaminophen is ingested, obtain a serum acetaminophen concentration 4 hours after ingestion or as soon as possible thereafter.[42289] [54020] [54184] Promptly administer N-acetylcysteine (NAC), which serves as a substitute sulfhydryl donor for glutathione, if the acetaminophen concentration plots above the treatment line on the Rumack-Matthew nomogram. NAC treatment should begin immediately if the estimated time after ingestion approaches 8 hours.[54020] [54184] Avoid acetaminophen misuse; do not exceed recommended doses and account for intake from all sources (e.g., single-entity products and combination products). Excessive acetaminophen exposure, malnutrition, concurrent ethanol consumption (acute and chronic), and/or concurrent use of enzyme-inducing drugs (e.g., isoniazid) may lead to greater exposure of the toxic metabolite, N-acetyl-para-benzoquinoneimine (NAPQI), and increase the risk for toxicity.[54020] [54184] [54187]

Acetaminophen has been associated with chronic analgesic nephropathy, a condition characterized by interstitial nephritis and renal papillary necrosis in patients receiving large doses of analgesics for an extended period of time. Though the National Kidney Foundation states there is negligible evidence to suggest chronic acetaminophen use causes analgesic nephropathy, they have recognized a weak association between chronic use and the prevalence of chronic renal failure (unspecified) and end-stage renal disease.[54096] In addition, acetaminophen overdose can result in acute renal failure and renal tubular necrosis, though such toxicity rarely occurs without severe hepatic toxicity.[54183] [54184] [54185] Oliguria (1% or more) has been reported in pediatric clinical trials of IV acetaminophen.[42289] The risk of renal complications appears to be higher in patients with poor nutrition, chronic alcohol consumption, or concurrent use of enzyme-inducing drugs (e.g., isoniazid).[54024] [54183]

Hypokalemia and peripheral edema occurred in at least 1% of patients in clinical trials. Other metabolic disturbances reported in at least 1% of pediatric patients after administration of IV acetaminophen included hypoalbuminemia, hypomagnesemia, and hypophosphatemia.[42289]

Cardiovascular adverse events reported in clinical trials of IV acetaminophen in at least 1% of adult and pediatric patients include both hypertension and hypotension.[42289]

Anemia (1% or more) and fever (1% or more) have been reported during pediatric clinical trials of IV acetaminophen.[42289] In addition, sporadic case reports of agranulocytosis, thrombocytopenia, thrombocytosis, neutropenia, and pancytopenia have been described in patients taking acetaminophen.[31419] [31420] [54020] Investigate symptoms such as unusual tiredness or weakness, unusual bleeding or bruising, and unexplained sore throat or fever promptly.

Drug-induced hemolysis and hemolytic anemia have been associated with acetaminophen overdose in patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Though several case reports of hemolytic anemia in G6PD-deficient patients receiving therapeutic doses of acetaminophen exist, a direct cause and effect relationship has not been well established. Monitor G6PD-deficient patients presenting with acetaminophen toxicity closely for signs and symptoms of hemolysis.[54061] [54063]

Acetaminophen has been associated with a risk of rare but serious and sometimes fatal skin reactions, including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP).[42289] [55541] These reactions can occur at any time during acetaminophen use, even after the first dose.[55541] Toxic epidermal necrolysis (TEN) occurred in a 7-year-old girl after she took 3 doses of oral acetaminophen to treat a fever and sore throat. Twelve hours after the last dose, an erythematous rash appeared, which became generalized and vesicular over the next few hours. The patient developed a fever, low blood pressure, and an elevated erythrocyte sedimentation rate and liver function tests. Skin biopsy was positive for subepidermal blister formation with full-thickness necrolysis of the epidermis. Acetaminophen rechallenge, performed 6 months later in an allergy clinic, produced similar symptoms within 30 minutes of administration and confirmed the initial diagnosis.[27732] SJS and TEN usually begin with flu-like symptoms followed by rash, blistering, and sloughing, all of which spread from the face downwards to the entire body (including palms of hands and soles of feet); recovery ranges from weeks to months and complications include corneal ulcerations, blindness, and internal organ damage.[55542] [55543] [55544] AGEP is typically a less severe reaction, characterized by acute onset, fever, and nonfollicular pustules on an erythematous rash; it usually resolves within 2 weeks of drug discontinuation.[27736] [55543] [55544] In addition to the aforementioned skin reactions, multiple cases of allergic contact dermatitis (delayed hypersensitivity type) have been reported in the literature. Various reactions, including generalized pruriginous micropapular eruption, facial edema, generalized pruriginous exanthem, exfoliative dermatitis, and generalized exanthema occurred within several hours after acetaminophen ingestion.[27734] [27735] Pruritus was one of the most common adverse reactions reported in pediatric clinical trials of IV acetaminophen, occurring in 5% or more of patients. Hypersensitivity reactions to acetaminophen may be manifested by urticaria, erythema, rash, maculopapular rash, and fever. Though rare, anaphylactic shock, angioedema, and anaphylactoid reactions have been reported.[42289] [54020] Discontinue acetaminophen immediately and seek medical attention for symptomatic treatment in patients who develop dermatologic or hypersensitivity reactions.[42289]

A case of acquired purpura fulminans developed in a 32-year-old woman who was instructed to take acetaminophen 1,000 mg every 4 to 6 hours as needed for pain. The patient noted rapidly spreading purpuric lesions and associated edema. Her lesions were nonblanchable and enlarging, and she had multiple purplish-black hemorrhagic and necrotic areas. Purpura fulminans is usually associated with disseminated intravascular coagulation and can occur in patients with inherited or acquired deficiencies of the protein C anticoagulant pathway. Based on the patient's history of alcohol use and poor nutritional status, the authors concluded that reduced hepatic glutathione stores were further reduced by the introduction of acetaminophen, leading to impaired protein C and S synthesis and propagation of the disseminated intravascular coagulation cascade. Discontinuation of alcohol and acetaminophen and administration of vitamin K, heparin, and a systemic antibiotic led to almost complete purpuric lesion and hepatotoxicity resolution in 6 days.[27733]

Insomnia occurred in 7% of adult patients who received IV acetaminophen in clinical trials vs. 5% of those who received placebo. Anxiety and fatigue also occurred in adult patients treated with IV acetaminophen. In clinical trials of pediatric patients receiving IV acetaminophen, agitation occurred in 1% or more of patients.[42289]

Atelectasis, pleural effusion, pulmonary edema, stridor, and wheezing were reported in 1% or more of pediatric patients, while dyspnea and abnormal breath sounds were reported in 1% or more of adult patients.[42289] There is epidemiological evidence in children and adults associating acetaminophen use with asthma symptoms. In addition, evidence suggests in utero and early infancy exposure may be associated with an increased risk of childhood asthma. Researchers hypothesize that acetaminophen may contribute to asthma through depletion of airway mucosal glutathione, increasing oxidative stress, epithelial damage, and airway inflammation.[54102] [54104] [54107]

Muscle cramps or spasms occurred in 1% or more of adult and pediatric patients treated with IV acetaminophen in clinical trials. Other musculoskeletal events included trismus in adult patients.[42289] Acetaminophen-induced rhabdomyolysis has been described in a single case report. A 17-year-old male with a past medical history of drug-induced reactions (hepatitis, agranulocytosis, desquamative dermatitis, and pyrexia) after receiving acetaminophen with or without concurrent antibiotics, was rechallenged with oral acetaminophen 400 mg. Within 5 hours of administration, the adolescent presented with febrile exanthema, neutropenia, and increased C-reactive protein, creatine phosphokinase, tumor necrosis factor-alpha, interleukin-6, and interleukin-10; the skin eruption and fever lasted 36 hours. Investigate symptoms such as unusual tiredness, weakness or unusual pain and swelling of the extremities, nausea and vomiting, and dark-colored urine promptly.[31420]

Toxic myocarditis was reported in a 15-year-old female after an intentional overdose of an unspecified amount of acetaminophen. The patient expired as a result of acute heart failure.[31421]

Prospective studies have shown there to be a slight but consistent association between regular analgesic use and hearing loss. Acetaminophen-related ototoxicity may result from depletion of glutathione, which protects the cochlea from noise damage.[53720] As a true long-term association may exist, counsel patients to minimize long-term treatment with acetaminophen as much as possible. A prospective analysis examining the association between analgesic use and the risk of hearing loss was conducted in 62,261 women 31 to 48 years of age at study enrollment who were originally enrolled in the Nurses' Health Study II. The association between self-reported hearing loss and analgesic use (including acetaminophen, aspirin, and NSAIDs) was examined over 14 years. During 764,247 person-years of follow-up, 10,012 cases of hearing loss were reported. After adjustment for confounders, acetaminophen use 2 or more days per week was independently associated with an increased risk of hearing loss, with the relative risk of hearing loss increasing with increasing frequency of use. Acetaminophen use 2 to 3, 4 to 5, or 6 or more days per week was associated with relative risks of 1.11 (95% CI 1.02 to 1.19), 1.21 (95% CI 1.07 to 1.37), and 1.08 (95% CI 0.95 to 1.22), respectively (p = 0.0007). Of note, those with more frequent use of acetaminophen had higher body mass indices; were more likely to smoke, have hypertension, or have diabetes; and were less physically active.[53720] In a similar study in male patients, the association between professionally diagnosed hearing loss and analgesic use (including acetaminophen, aspirin, and NSAIDs) was prospectively analyzed in 26,917 patients 40 to 74 years of age at study enrollment over 18 years. During 369,079 person-years of follow-up, 3,488 cases of hearing loss were reported. After adjustment for confounders, the hazard ratio (HR) for acetaminophen-associated hearing loss was 1.22 (95% CI 1.07 to 1.39, p = 0.09) in patients who were regular users of the drug (at least 2 times weekly) compared to those with less use. Men who regularly used acetaminophen for 4 years or more were 33% (14% to 56%) more likely to develop hearing loss than those with shorter use. In men younger than 50 years, the HR of hearing loss was 1.99 (95% CI 1.34 to 2.95); the degree of association generally decreased with aging.[53719] These studies do suggest association; however, data are based on patient reporting of the outcomes. Information regarding noise exposure and analgesic doses was not provided.[53719] [53720]

An injection site reaction, described as infusion site pain, occurred in 1% or more of patients receiving IV acetaminophen during clinical trials.[42289]

Revision Date: 09/02/2021, 04:38:54 PM

References

27732 - Halevi A, Ben-Amitai D, Garty BZ. Toxic epidermal necrolysis associated with acetaminophen ingestion. Ann Pharmacother 2000;34:32-4.27733 - Guccione JL, Zemtsov A, Cobos E, et al. Acquired purpura fulminans induced by alcohol and acetaminophen Successful treatment with heparin and vitamin K. Arch Dermatol 1993;129:1267-9.27734 - Irion R, Gall, H, Werful T, et al. Delayed-type hypersensitivity rash from paracetamol. Contact Dermatitis 2000;43:60-1.27735 - Ibanez MD, Alonso E, Munoz MC, et al. Delayed hypersensitivity reaction to paracetamol. Allergy 1996;51:121-3.27736 - Beylot C, Doutre M, Beylot-Barry M. Acute generalized exanthematous pustulosis. Semin Cutan Med Surg 1996;15(4):244-249.31419 - Bougie D, Aster R. Immune thrombocytopenia resulting from sensitivity to metabolites of naproxen and acetaminophen. Blood 2001;97:3846-50.31420 - Moneret-Vautrin DA, Morisset M, Humbert JC, et al. Acetaminophen-induced rhabdomyolysis. Allergy 1999;54:1115-6.31421 - Wakeel RA, Davies HT, Williams JD. Toxic myocarditis in paracetamol poisoning. Br Med J 1987;295:1097.32202 - Larson AM, Polson J, Fontana RJ, et al, the Acute Liver Failure Study Group. Acetaminophen-induced acute liver failure: results of a United States multicenter, prospective study. Hepatology 2005;42:1364-72.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.44683 - US Food and Drug Administration. Public health problem of liver injury related to the use of acetaminophen in both over-the-counter (OTC) and prescription (RX) products. June 29-30, 2009. Available at http://www.fda.gov/AdvisoryCommittees/Calendar/ucm143083.htm. Accessed June 16, 2011.53719 - Curhan SG, Eavey R, Shargorodsky J, et al. Analgesic use and the risk of hearing loss in men. Am J Med 2010;123:231-237.53720 - Curhan SG, Shargorodsky J, Eavey R, et al. Analgesic use and the risk of hearing loss in women. Am J Epidemiol 2012;176:544-554.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf54024 - Blakely P, McDonald BR. Acute renal failure due to acetaminophen ingestion: a case report and review of the literature. J Am Soc Nephrol 1995;6:48-53.54061 - Sklar GE. Hemolysis as a potential complication of acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency. Pharmacotherapy 2002;22:656-658.54063 - Wright RO, Perry HE, Woolf AD. Hemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency. J Toxicol Clin Toxicol 1996;34:731-734.54096 - Henrich WL, Agodoa LE, Barrett B. Analgesics and the kidney: summary and recommendations to the scientific advisory board of the National Kidney Foundation form an ad hoc committee of the National Kidney Foundation. Am J Kidney Dis 1996;27:162-165.54102 - Henderson AJ, Shaheen SO. Acetaminophen and asthma. Paediatr Respir Rev 2013;14:9-16.54104 - McBride JT. The association of acetaminophen and asthma prevalence and severity. Pediatrics 2011;128:1181-1185.54107 - Settipane RA, Schrank PJ, Simon RA. Prevalence of cross-sensitivity with acetaminophen in aspirin-sensitive asthmatic subjects. J Allergy Clin Immunol 1995;96:480-485.54183 - Fruchter LL, Alexopoulou I, Lau KK. Acute interstitial nephritis with acetaminophen and alcohol intoxication. Ital J Pediatr 2011;37:17-20.54184 - Hodgman MJ, Garrard AR. A review of acetaminophen poisoning. Crit Care Clin 2012;28:499-516.54185 - Perneger TV, Whelton PK, Klag MJ. Risk of kidney failure associated with the use of acetaminophen, aspirin, and nonsteroidal antiiflammatory drugs. N Engl J Med 1994;331:1675-1679.54187 - Whitcomb DC, Block GD. Association of acetaminophen hepatotoxicity with fasting and ethanol use. JAMA 1994;272:1845-1850.55541 - US Food and Drug Administration (FDA). Acetaminophen: Drug Safety Communication - Association with Risk of Serious Skin Reactions. Retrieved August 2, 2013. Available on the World Wide Web at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm363519.htm?source=govdelivery55542 - Usatine RP, Sandy N. Dermatologic emergencies. Am Fam Physician 2010;82:773-780.55543 - Peermohamed S, Haber RM. Acute generalized exanthematous pustulosis simulating toxic epidermal necrolysis: a case resport and review of the literature. Arch Dermatol 2011;147:697-701.55544 - US Food and Drug Administration. FDA Warns of Rare Acetaminophen Risk. Retrieved August 2, 2013. Available on the World Wide Web at: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm363010.htm.64587 - Oskoui M, Pringsheim T, Holler-Managan Y, et al. Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology 2019 [Epub ahead of print]66767 - Diener HC, Antonaci F, Braschinsky M, et al. European Academy of Neurology guideline on the management of medication overuse headache. Eur J Neurol 2020;27:1102-1116.66803 - Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 2018;38:1-211.

Contraindications/Precautions

Absolute contraindications are italicized.

  • 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

Acetaminophen is contraindicated in patients with a known acetaminophen hypersensitivity or hypersensitivity to any of the excipients of the formulation to be used. Acetaminophen hypersensitivity reactions are rare, but severe sensitivity reactions are possible. Patients who have experienced a serious skin reaction with acetaminophen should not take the drug again; discuss alternative pain relievers/fever reducers with these patients and/or their caregivers.[42289] [54020] [55541]

Intravenous (IV) acetaminophen is contraindicated in patients with severe hepatic impairment or severe active hepatic disease. Acetaminophen has the potential for overdose or poisoning causing hepatotoxicity and acute liver failure, at times resulting in liver transplantation and death. Most cases of liver injury are associated with the use of acetaminophen at doses exceeding 4 grams per day and often involve the use of more than one acetaminophen-containing product. Caution must be used during the preparation and administration of IV acetaminophen, as well as the measurement of oral liquid dosage forms to minimize the risk of dosing errors that can result in accidental overdose. Advise patients receiving acetaminophen to carefully read OTC and prescription labels, to avoid excessive and/or duplicate medications, and to seek medical help immediately if more than 4 grams of acetaminophen is ingested in 1 day, even if they feel well. It is important to note that the risk of acetaminophen-induced hepatotoxicity is increased in patients with pre-existing hepatic disease (e.g., hepatitis), those who ingest alcohol (e.g., ethanol intoxication, alcoholism), those with chronic malnutrition, and those with severe hypovolemia. In patients with chronic hepatic disease, acetaminophen can be used safely in recommended doses and is often preferred to nonsteroidal anti-inflammatory drugs (NSAIDs) due to the absence of platelet impairment, gastrointestinal toxicity, and nephrotoxicity. Though the half-life of acetaminophen may be prolonged, repeated dosing does not result in drug or metabolite accumulation. In addition, cytochrome P450 activity is not increased and glutathione stores are not depleted in hepatically impaired patients taking therapeutic doses, therefore toxic metabolite formation and accumulation is not altered. Although it is always prudent to use the smallest dose of acetaminophen for the shortest duration necessary, courses less than 2 weeks in length have been administered safely to adult patients with stable chronic liver disease.[23562] [42289] [54020] [54066]

Use all forms of acetaminophen with caution in patients with severe renal impairment or renal failure. Intravenous acetaminophen requires dosage adjustment for those with a creatinine clearance (CrCl) of 30 mL/minute or less; do not administer any form of acetaminophen more frequently than every 8 hours in patients with a CrCl less than 10 mL/minute.[32569] [42289] Some studies have suggested an association between chronic use of acetaminophen and renal effects. The National Kidney Foundation states that there is negligible evidence to suggest chronic use of acetaminophen causes analgesic nephropathy; however, there is a weak association between chronic acetaminophen use and the prevalence of chronic renal failure and end-stage renal disease.[54096] In a case-controlled study of adult patients with early renal failure, the regular use of acetaminophen (without aspirin) was associated with a risk of chronic renal failure that was 2.5-times as high as that for non-acetaminophen users. The risk increased with an increasing cumulative acetaminophen lifetime dose. The average dose used during periods of regular acetaminophen use also correlated with risk, as those who took at least 1.4 grams/day during periods of regular use had an odds ratio for chronic renal failure of 5.3; duration of therapy was unrelated to risk.[27368] The National Kidney Foundation considers acetaminophen as the non-narcotic analgesic of choice for episodic pain in patients with chronic renal disease but discourages habitual consumption.[54096]

Patients with G6PD deficiency who overdose with acetaminophen may be at increased risk for drug-induced hemolysis. Practitioners should be aware of this potential complication and monitor at-risk patients for signs and symptoms of hemolysis. Conflicting data exists on whether therapeutic doses of acetaminophen can cause hemolysis in G6PD deficient patients. However, a direct cause and effect relationship has not been well established and therefore, therapeutic doses are generally considered safe in this population.[54061] [54063]

Symptoms of acute infection (e.g., fever, pain) can be masked during treatment with acetaminophen in patients with bone marrow suppression, especially neutropenia, or immunosuppression.[42289]

Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen's hepatotoxic metabolite, N-acetyl-p-benzoquinoneimine (NAPQI). In a retrospective chart review of 602 patients (13 to 86 years of age) admitted for acetaminophen toxicity, current daily tobacco use was registered in 70% of patients. Multivariant analyses found tobacco smoking to be an independent risk factor for hepatotoxicity, hepatic encephalopathy, and death.[28001] [28215]

Caution must be taken when administering acetaminophen to pediatric patients to ensure appropriate dosing. Liquid acetaminophen is available in multiple concentrations; verify the concentration before administering each dose. Other factors that can lead to inadvertent overdoses include substituting adult acetaminophen formulations for pediatric formulations for convenience, misreading or interpreting instructions, or administering more acetaminophen due to persistent fever.[25461] Repeated overdoses of acetaminophen in infants or children in combination with decreased nutrition may lead to changes in the metabolism of acetaminophen leading to hepatotoxicity. This combination leads to decreases in sulfation, glucuronidation, and glutathione production. Efficacy of IV acetaminophen for the treatment of acute pain has not been established in neonates, infants, and children younger than 2 years. In clinical trials, there was no difference in analgesic effect, measured by the reduced need for additional opioid treatment for pain control, in patients younger than 2 years receiving opioid plus acetaminophen vs. opioid plus placebo. Intravenous acetaminophen is indicated for the treatment of fever in patients as young as 32 weeks gestation.[42289]

The federal Omnibus Budget Reconciliation Act (OBRA) regulates medication use in residents (e.g., geriatric adults) of long-term care facilities (LTCFs). According to OBRA, daily doses of acetaminophen greater than 4 grams/day from all sources (alone or as part of combination products) may increase the risk of hepatotoxicity. For acetaminophen doses greater than the maximum recommended daily dose, OBRA guidelines recommend a documented assessment reflecting periodic monitoring of liver function and an indication that the benefits of therapy outweigh the risks.[60742]

Some, but not all, acetaminophen products (particularly certain chewable tablets) contain aspartame and should be used with caution in patients with phenylketonuria, since aspartame is a source of phenylalanine. Consult specific product labeling for inactive ingredient content.

Use of acetaminophen chewable gels in patients with diabetes mellitus requires the supervision of a physician due to the sugar content in each chewable gel.[64629]

Use of acetaminophen chewable gels in patients with hypertension requires the supervision of a physician due to the sodium content in each chewable gel.[64629]

Published epidemiological studies have not reported a clear association with acetaminophen use during pregnancy and birth defects, miscarriage, or adverse maternal or fetal outcomes. Large observational studies of newborns exposed to oral acetaminophen during the first trimester have not shown an increased risk for congenital malformations or major birth defects; however, these studies cannot definitely establish the absence of risk because of methodological limitations.[42289] Acetaminophen does cross the placenta and should be used during pregnancy only if the benefits to the mother outweigh the potential risks to the fetus or infant. No overall increase in fetal mortality, determined by pregnancy outcomes of mothers that overdosed on various amounts of oral acetaminophen, was apparent amongst 300 women.[27731] Treatment with acetylcysteine or methionine did not appear to affect fetal or neonatal toxicity. Of 235 infants exposed to an overdose of only acetaminophen, 168 were normal, 8 had malformations, 16 were spontaneously aborted, and 43 were electively terminated. None of the infants with malformations were exposed during the first trimester, but all of the spontaneous abortions were subsequent to first trimester exposure.

There is no information regarding the presence of intravenous acetaminophen in human milk, the effects on the breast-fed infant, or the effects on milk production. However, limited published studies report acetaminophen passes rapidly into human milk with similar concentrations in the milk and plasma. Average and maximum neonatal doses of 1% and 2%, respectively, of the weight-adjusted maternal dose are reported after a single oral dose of 1,000 mg. There is a well-documented report of rash occurring in a breast-fed infant that resolved with drug discontinuation and recurred with resumption.[42289] According to previous recommendations from the American Academy of Pediatrics (AAP), acetaminophen has not been associated with any observable changes in nursing infants of mothers that took acetaminophen while breast-feeding. The AAP and other experts regard acetaminophen as a maternal medicine that is usually compatible with breast-feeding.[27500]

Revision Date: 04/03/2021, 06:50:30 PM

References

23562 - Benson GD. Acetaminophen in chronic liver disease. Clin Pharmacol Ther 1983;33:95-101.25461 - Heubi JE, Barbacci MB, Zimmerman HJ. Therapeutic misadventures with acetaminophen: hepatotoxicity after multiple doses in children. J Pediatr 1998:132:22-7.27368 - Fored CM, Ejerblad E, Lindblad P, et al. Acetaminophen, aspirin, and chronic renal failure. N Engl J Med 2001;345:1801-8.27500 - American Academy of Pediatrics (AAP) Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics 2001;108(3):776-789.27731 - McElhatton PR, Sullivan FM, Volans GN. Paracetamol overdose in pregnancy analysis of the outcomes of 300 cases referred to the Teratology Information Service. Reprod Toxicol 1997;11:85-94.28001 - Hansten PD, Horn JR. Cytochrome P450 Enzymes and Drug Interactions, Table of Cytochrome P450 Substrates, Inhibitors, Inducers and P-glycoprotein, with Footnotes. In: The Top 100 Drug Interactions - A guide to Patient Management. 2008 Edition. Freeland, WA: H&H Publications; 2008:142-157.28215 - Schmidt LE, Dalhoff K. The impact of current tobacco use on the outcome of paracetamol poisoning. Aliment Pharmacol Ther 2003;18:979-85.32569 - Aronoff GR, Bennett WM, Berns JS, et al. Drug prescribing in renal failure: dosing guidelines for adults and children, 5th ed. Philadelphia: American College of Physicians; 2007.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf54061 - Sklar GE. Hemolysis as a potential complication of acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency. Pharmacotherapy 2002;22:656-658.54063 - Wright RO, Perry HE, Woolf AD. Hemolysis after acetaminophen overdose in a patient with glucose-6-phosphate dehydrogenase deficiency. J Toxicol Clin Toxicol 1996;34:731-734.54066 - Benson GD, Koff RS, Tolman KG. The therapeutic use of acetaminophen in patients with liver disease. Am J Ther 2005;12:133-141.54096 - Henrich WL, Agodoa LE, Barrett B. Analgesics and the kidney: summary and recommendations to the scientific advisory board of the National Kidney Foundation form an ad hoc committee of the National Kidney Foundation. Am J Kidney Dis 1996;27:162-165.55541 - US Food and Drug Administration (FDA). Acetaminophen: Drug Safety Communication - Association with Risk of Serious Skin Reactions. Retrieved August 2, 2013. Available on the World Wide Web at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm363519.htm?source=govdelivery60742 - Health Care Financing Administration. Interpretive Guidelines for Long-term Care Facilities. Title 42 CFR 483.25(l) F329: Unnecessary Drugs. Revised 2015.64629 - 7T Gummy ES (acetaminophen chewable gels) package insert. Las Vegas, NV: 7T Pharma, LLC: 2019 Sept.

Mechanism of Action

Acetaminophen acts within the CNS to increase the pain threshold by inhibiting central cyclooxygenase, an enzyme involved in prostaglandin (PG) synthesis. Acetaminophen inhibits both isoforms of central cyclooxygenase, COX-1 and COX-2. Acetaminophen does not inhibit PG synthesis in peripheral tissues, which is the reason for its lack of peripheral anti-inflammatory effects.[54019][54020]

Revision Date: 08/09/2021, 02:21:49 PM

References

54019 - Anderson BJ. Paracetamol (acetaminophen): mechanisms of action. Pediatr Anaesth 2008;18:915-921.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf

Pharmacokinetics

Acetaminophen is administered orally, rectally, or intravenously. At therapeutic concentrations, protein binding is about 10% to 25%. Acetaminophen is widely distributed throughout most body tissues except fat; low protein binding and molecular weight allow blood-brain barrier penetration. Vd is approximately 1 L/kg in children and adults.[42289][54020]

 

Acetaminophen is primarily metabolized in the liver by first-order kinetics and involves 3 separate pathways: glucuronidation, sulfate conjugation, and cytochrome P450 (CYP450) oxidation. Glucuronidation and sulfate conjugation are the major routes of metabolism, while a small amount of drug undergoes oxidative metabolism via CYP2E1 producing the hepatotoxic metabolite, N-acetyl-p-benzoquinoneimine (NAPQI). At therapeutic doses, NAPQI is rapidly conjugated with glutathione to form inert cysteine and mercapturic acid metabolites.[42289][54020] The P450 isoenzymes 1A2 and 3A4 appear to have a minor role in the metabolism of acetaminophen.[28100][54020] Supratherapeutic or repeated therapeutic doses of acetaminophen, fasting, and alcoholism may deplete glutathione stores, leading to increased concentrations of NAPQI and hepatotoxicity.[25460][54020] The elimination half-life of acetaminophen is 2 to 3 hours in healthy adult patients.[54020] Acetaminophen is renally excreted primarily as the glucuronide conjugate (40% to 65%) and sulfate metabolite (25% to 35%). Mercapturic acid and cysteine metabolites account for 5% to 12% of the urinary metabolites; less than 5% is excreted as unchanged drug.[28100][42289][54020]

 

Affected cytochrome P450 isoenzymes and drug transporters: CYP2E1

Although acetaminophen is primarily metabolized via glucuronidation and sulfate conjugation, it is also a substrate of CYP2E1. Drugs that induce CYP2E1 may increase the metabolism of acetaminophen to its toxic metabolite and therefore increase the risk of hepatotoxicity. Because CYP1A2 and CYP3A4 have negligible contribution to acetaminophen metabolism, the enzymes are unlikely to affect toxic metabolite formation.[25460][42289][54020]

Route-Specific Pharmacokinetics

Oral Route

Immediate-release acetaminophen is rapidly and almost completely absorbed from the gastrointestinal (GI) tract, primarily the small intestine. Bioavailability ranges from 85% to 98%. Peak plasma concentrations occur within 30 to 60 minutes and range from 7.7 to 17.6 mcg/mL after a single 1,000 mg dose and 7.9 to 27 mcg/mL at steady state after 1,000 mg every 6 hours in adult patients.[54020] In a study of febrile children 2 to 7 years of age, acetaminophen 12 mg/kg achieved maximum concentration (14.6 +/- 2.6 mcg/mL) within 0.55 +/- 0.08 hours.[54026] Maximum concentrations of acetaminophen are delayed with concurrent food administration, however the extent of absorption is not affected.[54020]

Intravenous Route

The maximum concentration after administration of an IV dose of acetaminophen is up to 70% higher than that seen after the same dose is given orally; however, the overall exposure, described by area under the concentration time curve (AUC), is similar. The pharmacokinetic profile of IV acetaminophen in adults is dose proportional after administration of single doses of 500, 650, and 1,000 mg.[42289]

Other Route(s)

Rectal Route

Rectal absorption of acetaminophen is prolonged and highly variable compared to other routes of administration; reported bioavailability ranges from 6.5% to 98%. Several factors may influence absorption, including lipophilicity of the vehicle, placement of the suppository, rectal contents, premature defecation of the suppository, suppository size, number of suppositories administered, and/or rectal pH. Compared to adult patients, pediatric patients appear to absorb acetaminophen from suppositories to a greater extent.[54111][54112][54115][54116]

Special Populations

Hepatic Impairment

The half-life of acetaminophen may be prolonged in patients with hepatic disease.[54020][54066]

Renal Impairment

In severe renal impairment (CrCl 10 to 30 mL/minute), the elimination of acetaminophen is slightly delayed, with an elimination half-life of 2 to 5.3 hours. In addition, the elimination of sulfate and glucuronide conjugates is 3 times slower in patients with severe renal impairment than in healthy subjects, leading to potential accumulation.[54126][54127][54131]

Pediatrics

Neonates and Infants

Slow and erratic gastric emptying in the neonate leads to a slower rate of oral acetaminophen absorption (0.21 hours); adult rates are reached by 6 to 8 months of age. Rectal absorption of an acetaminophen suppository decreases with increasing age; perhaps attributable to rectal insertion height and consequent rectal venous drainage patterns. Because of fetal body composition and water distribution, premature neonates and young infants have a slightly larger Vd compared to older pediatric patients and adults. At 28 weeks postconceptual age (PCA), Vd is 1.47 L/kg, whereas at 60 weeks PCA Vd is 1.04 L/kg.[54144] Observed concentrations of IV acetaminophen are similar in neonates older than 32 weeks gestation at birth treated with 12.5 mg/kg/dose; infants, children, and adolescents treated with 15 mg/kg/dose; and adults treated with 1,000 mg/dose.[42289] Neonates and infants have a lower risk of acetaminophen-induced hepatotoxicity compared to older children and adults because of hepatic enzyme immaturity (specifically CYP2E1, which is responsible for producing the hepatotoxic metabolite NAPQI).[56547] However, immature hepatic pathways also result in a delayed drug clearance. In neonates, sulfate conjugation is pronounced, while glucuronide conjugation is deficient. The relative contribution of sulfate and glucuronide conjugation changes with age and normal adult ratios (2:1 glucuronide to sulfate conjugates) are reached by late childhood. Acetaminophen clearance also has great interpatient variability and appears to increase with patient weight and age. Clearance increases from 28 weeks PCA (0.01 L/kg/hour) with a maturation half-life of 11.3 weeks to reach 0.15 L/kg/hour by early infancy (60 weeks PCA); clearance approaches adult values by 1 year of age. Additionally, clearance may be reduced in the presence of high unconjugated bilirubin concentrations.[54114][54117][54118] Approximate half-life of acetaminophen is as follows: neonate 28 to 32 weeks gestation = 11 hours, neonate 32 to 36 weeks gestation = 5 hours, term neonate = 3 to 3.5 hours, infant = 4 hours.[54119][54120][54121]

 

Children and Adolescents

Acetaminophen is excreted primarily as the sulfate conjugate in children, due to a deficiency in glucuronide formation in younger pediatric patients. The relative contribution of sulfate and glucuronide conjugation changes with age and normal adult ratios (2:1 glucuronide to sulfate conjugates) are reached by 12 years of age.[25459][54114] The AUC of acetaminophen in children and adolescents after a single IV dose of 15 mg/kg (38 and 41 mcg x hour/mL, respectively) is similar to that in adults after a single IV dose of 1,000 mg (43 mcg x hour/mL). In addition, the mean half-life of IV acetaminophen in pediatric patients is longer than the half-life in adults, with younger patients having the slowest clearance (children = 3 hours, adolescents = 2.9 hours, adults = 2.4 hours). Observed concentrations of IV acetaminophen are similar in infants, children, and adolescents treated with 15 mg/kg/dose; adults treated with 1,000 mg/dose, and neonates at least 32 weeks gestation at birth treated with 12.5 mg/kg/dose.[42289]

Revision Date: 04/19/2021, 08:46:53 AM

References

25459 - Miller RP, Roberts RJ, Fischer LJ. Acetaminophen elimination kinetics in neonates, children, and adults. Clin Pharmacol Ther 1976;19:284-94.25460 - Tolman KG. Hepatotoxicity of non-narcotic analgesics. Am J Med 1998;105:13S-19S.28100 - Manyike PT, Kharasch ED, Kalhorn TF, et al. Contribution of CYP2E1 and CYP3A to acetaminophen reactive metabolite formation. Clin Pharmacol Ther 2000;67:275-282.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.54020 - McNeil Consumer Healthcare. Tylenol Professional Product Information. 2010. Retrieved April 2, 2013. Available on the World Wide Web at: http://www.tylenolprofessional.com/assets/TYL_PPI.pdf54026 - Wilson JT, Brown RD, Bocchini JA. Efficacy, disposition and pharmacodynamics of aspirin, acetaminophen and choline salicylate in young febrile children. Ther Drug Monit 1982;4:147-180.54066 - Benson GD, Koff RS, Tolman KG. The therapeutic use of acetaminophen in patients with liver disease. Am J Ther 2005;12:133-141.54111 - Buck ML. Perioperative use of high-dose rectal acetaminophen. Pediatric Pharmacother 2001;7:1-354112 - Hahn TW, Henneberg SW, Holm-Knudsen RJ. Pharmacokinetics of rectal paracetamol after repeated dosing in children. Br J Anaesth 2000;85:512-519.54114 - Anderson BJ, van Lingen RA, Hansen TG. Acetaminophen developmental pharmacokinetics in premature neonates and infants. Anesthesiology 2002;96:1336-1345.54115 - Anderson BJ, Holford NH. Rectal acetaminophen pharmacokinetics. Anesthesiology 1998;88:1131.54116 - Birmingham PK, Tobin MJ, Fisher DM. Initial and subsequent dosing of rectal acetaminophen in children. Anesthesiology 2001;94:385-389.54117 - Anderson BJ, Allegaert K. Intravenous neonatal paracetamol dosing: the magic of 10 days. Pediatr Anesthesia 2009;19:289-295.54118 - Allegaert K, Palmer GM, Anderson BJ. The pharmacokinetics of intravenous paracetamol in neonates: size matters most. Arch Dis Child 2011;96:575-580.54119 - Levy G, Khanna NN, Soda DM. Pharmacokinetics of acetaminophen in the human neonate: formation of acetaminophen glucuronide and sulfate in relation to plasma bilirubin concentration and d-glucaric acid excretion. Pediatrics 1975;55:818-825.54120 - van Lingen RA, Deinum JT, Quak JM. Pharmacokinetics and metabolism of rectally administered paracetamol in preterm neonates. Arch Dis Child Fetal Neonatal Ed 1999;80:F59-63.54121 - van Lingen RA, Deinum HT, Quak CM. Multiple-dose pharmacokinetics of rectally administered acetaminophen in term infants. Clin Pharmacol Ther 1999;66:509-515.54126 - Martin U, Temple RM, Winney RJ. The disposition of paracetamol and the accumulation of its glucuronide and sulphate conjugates during multiple dosing in patients with chronic renal failure. Eur J Clin Pharmacol 1991;41:43-46.54127 - Prescott LF, Speirs GC, Critchley JA. Paracetamol disposition and metabolite kinetics in patients with chronic renal failure. Eur J Clin Pharmacol 1989;36:291-297.54131 - paracetamol 10 mg/ml solution for infusion European package insert. Iceland: Actavis Group PTC; 2011 Aug.54144 - Visscher H, Amstutz U, Sistonen J, et al. Pharmacogenomics of cardiovascular drugs and adverse effects in pediatrics. J Cardiovasc Pharmacol 2011;58:228-239.56547 - Ceelie I, de Wildt SN, van Dijk M. Effect of intravenous paracetamol on postoperative morphine requirements in neonates and infants undergoing major noncardiac surgery: a randomized controlled trial. JAMA 2013;309:149-154.

Pregnancy/Breast-feeding

pregnancy

Published epidemiological studies have not reported a clear association with acetaminophen use during pregnancy and birth defects, miscarriage, or adverse maternal or fetal outcomes. Large observational studies of newborns exposed to oral acetaminophen during the first trimester have not shown an increased risk for congenital malformations or major birth defects; however, these studies cannot definitely establish the absence of risk because of methodological limitations.[42289] Acetaminophen does cross the placenta and should be used during pregnancy only if the benefits to the mother outweigh the potential risks to the fetus or infant. No overall increase in fetal mortality, determined by pregnancy outcomes of mothers that overdosed on various amounts of oral acetaminophen, was apparent amongst 300 women.[27731] Treatment with acetylcysteine or methionine did not appear to affect fetal or neonatal toxicity. Of 235 infants exposed to an overdose of only acetaminophen, 168 were normal, 8 had malformations, 16 were spontaneously aborted, and 43 were electively terminated. None of the infants with malformations were exposed during the first trimester, but all of the spontaneous abortions were subsequent to first trimester exposure.

breast-feeding

There is no information regarding the presence of intravenous acetaminophen in human milk, the effects on the breast-fed infant, or the effects on milk production. However, limited published studies report acetaminophen passes rapidly into human milk with similar concentrations in the milk and plasma. Average and maximum neonatal doses of 1% and 2%, respectively, of the weight-adjusted maternal dose are reported after a single oral dose of 1,000 mg. There is a well-documented report of rash occurring in a breast-fed infant that resolved with drug discontinuation and recurred with resumption.[42289] According to previous recommendations from the American Academy of Pediatrics (AAP), acetaminophen has not been associated with any observable changes in nursing infants of mothers that took acetaminophen while breast-feeding. The AAP and other experts regard acetaminophen as a maternal medicine that is usually compatible with breast-feeding.[27500]

Revision Date: 09/23/2019, 04:44:33 PM

References

27500 - American Academy of Pediatrics (AAP) Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics 2001;108(3):776-789.27731 - McElhatton PR, Sullivan FM, Volans GN. Paracetamol overdose in pregnancy analysis of the outcomes of 300 cases referred to the Teratology Information Service. Reprod Toxicol 1997;11:85-94.42289 - Ofirmev (acetaminophen injection) package insert. Hazelwood, MO: Mallinckrodt Hospital Products Inc.; 2017 Jan.

Interactions

Level 2 (Major)

  • Ethanol
  • Imatinib
  • Isoniazid, INH
  • Isoniazid, INH; Pyrazinamide, PZA; Rifampin
  • Isoniazid, INH; Rifampin
  • Lamotrigine
  • Metyrapone

Level 3 (Moderate)

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Articaine; Epinephrine
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine
  • 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
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Boceprevir
  • Bupivacaine
  • Bupivacaine Liposomal
  • Bupivacaine; Lidocaine
  • Bupivacaine; Meloxicam
  • Busulfan
  • Chloroprocaine
  • Cholestyramine
  • Choline Salicylate; Magnesium Salicylate
  • Dapsone
  • Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
  • Desogestrel; Ethinyl Estradiol
  • Diflunisal
  • Drospirenone; Ethinyl Estradiol
  • Drospirenone; Ethinyl Estradiol; Levomefolate
  • Eltrombopag
  • Ethinyl Estradiol
  • Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate
  • Ethinyl Estradiol; Norelgestromin
  • Ethinyl Estradiol; Norethindrone Acetate
  • Ethinyl Estradiol; Norgestrel
  • Ethynodiol Diacetate; Ethinyl Estradiol
  • Etonogestrel; Ethinyl Estradiol
  • Isavuconazonium
  • Levonorgestrel; Ethinyl Estradiol
  • Levonorgestrel; Ethinyl Estradiol; Ferrous Bisglycinate
  • Lidocaine
  • Lidocaine; Prilocaine
  • Lomitapide
  • Lopinavir; Ritonavir
  • Magnesium Salicylate
  • Mepivacaine
  • Mepivacaine; Levonordefrin
  • Mipomersen
  • Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate
  • Norethindrone; Ethinyl Estradiol
  • Norethindrone; Ethinyl Estradiol; Ferrous fumarate
  • Norgestimate; Ethinyl Estradiol
  • Ombitasvir; Paritaprevir; Ritonavir
  • Omeprazole; Amoxicillin; Rifabutin
  • Penicillin G Benzathine; Penicillin G Procaine
  • Penicillin G Procaine
  • Pneumococcal Vaccine, Polyvalent
  • Posaconazole
  • Prilocaine
  • Prilocaine; Epinephrine
  • Rifabutin
  • Rifampin
  • Ritonavir
  • Ropivacaine
  • Salsalate
  • Segesterone Acetate; Ethinyl Estradiol
  • Telaprevir
  • Tetracaine
  • tobacco
  • Trimetrexate
  • Vemurafenib

Level 4 (Minor)

  • Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
  • Amobarbital
  • Antacids
  • Aprepitant, Fosaprepitant
  • Barbiturates
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Butabarbital
  • Butalbital; Acetaminophen
  • Butalbital; Acetaminophen; Caffeine
  • Butalbital; Acetaminophen; Caffeine; Codeine
  • Carbamazepine
  • Charcoal
  • Efavirenz
  • Efavirenz; Emtricitabine; Tenofovir
  • Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
  • Exenatide
  • Hydantoins
  • Insulin Glargine; Lixisenatide
  • Lamivudine, 3TC; Zidovudine, ZDV
  • Lanthanum Carbonate
  • Lixisenatide
  • Mephobarbital
  • Methohexital
  • Mitotane
  • Omeprazole; Sodium Bicarbonate
  • Pentobarbital
  • Phenobarbital
  • Phenobarbital; Hyoscyamine; Atropine; Scopolamine
  • Pramlintide
  • Primidone
  • Secobarbital
  • Sodium Bicarbonate
  • St. John's Wort, Hypericum perforatum
  • Sulfinpyrazone
  • Thiopental
  • Tizanidine
  • Warfarin
  • Zidovudine, ZDV
  • Zolmitriptan
Abacavir; Lamivudine, 3TC; Zidovudine, ZDV: (Minor) Both acetaminophen and zidovudine, ZDV undergo glucuronidation. Competition for the metabolic pathway is thought to have caused a case of acetaminophen-related hepatotoxicity. This interaction may be more clinically significant in patients with depleted glutathione stores, such as patients with acquired immunodeficiency syndrome, poor nutrition, or alcoholism. [4928] Acetaminophen; Aspirin, ASA; Caffeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Amobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Antacids: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. [6086] Aprepitant, Fosaprepitant: (Minor) Use caution if acetaminophen and aprepitant are used concurrently and monitor for an increase in acetaminophen-related adverse effects for several days after administration of a multi-day aprepitant regimen. Acetaminophen is a minor (10 to 15%) substrate of CYP3A4. Aprepitant, when administered as a 3-day oral regimen (125 mg/80 mg/80 mg), is a moderate CYP3A4 inhibitor and inducer and may increase plasma concentrations of acetaminophen. For example, a 5-day oral aprepitant regimen increased the AUC of another CYP3A4 substrate, midazolam (single dose), by 2.3-fold on day 1 and by 3.3-fold on day 5. After a 3-day oral aprepitant regimen, the AUC of midazolam (given on days 1, 4, 8, and 15) increased by 25% on day 4, and then decreased by 19% and 4% on days 8 and 15, respectively. As a single 125 mg or 40 mg oral dose, the inhibitory effect of aprepitant on CYP3A4 is weak, with the AUC of midazolam increased by 1.5-fold and 1.2-fold, respectively. After administration, fosaprepitant is rapidly converted to aprepitant and shares many of the same drug interactions. However, as a single 150 mg intravenous dose, fosaprepitant only weakly inhibits CYP3A4 for a duration of 2 days; there is no evidence of CYP3A4 induction. Fosaprepitant 150 mg IV as a single dose increased the AUC of midazolam (given on days 1 and 4) by approximately 1.8-fold on day 1; there was no effect on day 4. Less than a 2-fold increase in the midazolam AUC is not considered clinically important. [25460] [28100] [30676] [40027] Articaine; Epinephrine: (Moderate) Coadministration of articaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue articaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [28996] Aspirin, ASA: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Butalbital; Caffeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Aspirin, ASA; Butalbital; Caffeine; Codeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Aspirin, ASA; Caffeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Caffeine; Dihydrocodeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Caffeine; Orphenadrine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Carisoprodol: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Carisoprodol; Codeine: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Citric Acid; Sodium Bicarbonate: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. [6086] Aspirin, ASA; Dipyridamole: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Omeprazole: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Oxycodone: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Aspirin, ASA; Pravastatin: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. High-dose, chronic administration of the combined analgesics significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Barbiturates: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Belladonna Alkaloids; Ergotamine; Phenobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Bismuth Subsalicylate: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Bismuth Subsalicylate; Metronidazole; Tetracycline: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Boceprevir: (Moderate) Close clinical monitoring is advised when administering acetaminophen with boceprevir due to an increased potential for acetaminophen-related adverse events. If acetaminophen dose adjustments are made, re-adjust the dose upon completion of boceprevir treatment. Although this interaction has not been studied, predictions about the interaction can be made based on the metabolic pathway of acetaminophen. Acetaminophen is partially metabolized by the hepatic isoenzyme CYP3A4; boceprevir inhibits this isoenzyme. Coadministration may result in elevated acetaminophen plasma concentrations. [25460] [28100] [44314] Bupivacaine Liposomal: (Moderate) Coadministration of bupivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue bupivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [52331] Bupivacaine: (Moderate) Coadministration of bupivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue bupivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [52331] Bupivacaine; Lidocaine: (Moderate) Coadministration of bupivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue bupivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [52331] (Moderate) Coadministration of lidocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue lidocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [43383] Bupivacaine; Meloxicam: (Moderate) Coadministration of bupivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue bupivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [52331] Busulfan: (Moderate) Use busulfan and acetaminophen together with caution; concomitant use may result in increased busulfan levels and increased busulfan toxicity. Separating the administration of these drugs may mitigate this interaction; avoid giving acetaminophen within 72 hours prior to or concurrently with busulfan. Busulfan is metabolized in the liver through conjugation with glutathione; acetaminophen decreases glutathione levels in the blood and tissues and may reduce the clearance of busulfan. [60818] Butabarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Butalbital; Acetaminophen: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Butalbital; Acetaminophen; Caffeine: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Butalbital; Acetaminophen; Caffeine; Codeine: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Carbamazepine: (Minor) Carbamazepine may potentially accelerate the hepatic metabolism of acetaminophen. In addition, due to enzyme induction, carbamazepine may increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolite, NAPQI. Clinicians should be alert to decreased effect of acetaminophen. Dosage adjustments may be necessary, and closer monitoring of clinical and/or adverse effects is warranted. [4718] [4754] [4939] Charcoal: (Minor) Activated charcoal binds many drugs within the gut. Administering charcoal dietary supplements at the same time as a routine acetaminophen dosage would be expected to interfere with the analgesic and antipyretic efficacy of acetaminophen. Charcoal is mostly used in the setting of acetaminophen overdose; however, patients should never try to treat an acetaminophen overdose with charcoal dietary supplements. Advise patients to get immediate medical attention for an acetaminophen overdose. [219] [2744] [4944] Chloroprocaine: (Moderate) Coadministration of chloroprocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue chloroprocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29062] Cholestyramine: (Moderate) Cholestyramine has been shown to decrease the absorption of acetaminophen by roughly 60%. Experts have recommended that cholestyramine not be given within 1 hour of acetaminophen if analgesic or antipyretic effect is to be achieved. [4944] [4973] Choline Salicylate; Magnesium Salicylate: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Dapsone: (Moderate) Coadministration of dapsone with acetaminophen may increase the risk of developing methemoglobinemia. Advise patients to discontinue treatment and seek immediate medical attention with any signs or symptoms of methemoglobinemia. [60612] Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir: (Moderate) Concurrent administration of acetaminophen with ritonavir may result in elevated acetaminophen plasma concentrations and subsequent adverse events. Acetaminophen is metabolized by the hepatic isoenzyme CYP3A4; ritonavir is an inhibitor of this enzyme. Caution and close monitoring are advised if these drugs are administered together. [25460] [28100] [58664] Desogestrel; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Diflunisal: (Moderate) Acetaminophen plasma concentrations can increase by approximately 50% following administration of diflunisal. Acetaminophen has no effect on diflunisal concentrations. Acetaminophen in high doses has been associated with severe hepatotoxic reactions; therefore, caution should be exercised when using these agents concomitantly. [28370] Drospirenone; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Drospirenone; Ethinyl Estradiol; Levomefolate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Efavirenz: (Minor) Drugs that induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as efavirenz, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolite, NAPQI. Also, the analgesic activity of acetaminophen may be reduced. [4718] [4939] Efavirenz; Emtricitabine; Tenofovir: (Minor) Drugs that induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as efavirenz, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolite, NAPQI. Also, the analgesic activity of acetaminophen may be reduced. [4718] [4939] Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: (Minor) Drugs that induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as efavirenz, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolite, NAPQI. Also, the analgesic activity of acetaminophen may be reduced. [4718] [4939] Eltrombopag: (Moderate) Eltrombopag is a UDP-glucuronyltransferase inhibitor. Acetaminophen is a substrate of UDP-glucuronyltransferases. The significance or effect of this interaction is not known; however, elevated concentrations of acetaminophen are possible. Monitor patients for adverse reactions if these drugs are coadministered. [11579] Ethanol: (Major) The risk of developing hepatotoxicity from acetaminophen appears to be increased in patients who regularly consume alcohol. Patients who drink more than 3 alcohol-containing drinks a day and take acetaminophen are at increased risk of developing hepatotoxicity. Acute or chronic alcohol use increases acetaminophen-induced hepatotoxicity by inducing cytochrome P450 CYP 2E1 leading to increased formation of the hepatotoxic metabolite of acetaminophen. Also, chronic alcohol use can deplete liver glutathione stores. Administration of acetaminophen should be limited or avoided altogether in patients with alcoholism or patients who consume alcohol regularly. [24018] [25035] [28210] Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ethinyl Estradiol; Levonorgestrel; Folic Acid; Levomefolate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ethinyl Estradiol; Norelgestromin: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ethinyl Estradiol; Norethindrone Acetate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ethinyl Estradiol; Norgestrel: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ethynodiol Diacetate; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Etonogestrel; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Exenatide: (Minor) Although an interaction is possible, these drugs may be used together. To avoid potential pharmacokinetic interactions that might alter effectiveness of acetaminophen, it may be advisable for patients to take acetaminophen at least 1 hour prior to an exenatide injection. When 1,000 mg acetaminophen elixir was given with 10 mcg exenatide (at 0 hours) and at 1, 2 and 4 hours after exenatide injection, acetaminophen AUCs were decreased by 21%, 23%, 24%, and 14%, respectively; Cmax was decreased by 37%, 56%, 54%, and 41%, respectively. Additionally, acetaminophen Tmax was delayed from 0.6 hours in the control period to 0.9, 4.2, 3.3, and 1.6 hours, respectively. Acetaminophen AUC, Cmax, and Tmax were not significantly changed when acetaminophen was given 1 h before exenatide injection. The mechanism of this interaction is not available (although it may be due to delayed gastric emptying from exenatide use) and the clinical impact has not been assessed. [44456] [48491] Hydantoins: (Minor) Hydantoin anticonvulsants induce hepatic microsomal enzymes and may increase the metabolism of other drugs, leading to reduced efficacy of medications like acetaminophen. In addition, the risk of hepatotoxicity from acetaminophen may be increased with the chronic dosing of acetaminophen along with phenytoin. Adhere to recommended acetaminophen dosage limits. Acetaminophen-related hepatotoxicity has occurred clinically with the concurrent use of acetaminophen 1300 mg to 6200 mg daily and phenytoin. Acetaminophen cessation led to serum transaminase normalization within 2 weeks. [4718] [4927] Imatinib: (Major) Imatinib, STI-571 may affect the metabolism of acetaminophen. In vitro, imatinib was found to inhibit acetaminophen O-glucuronidation at therapeutic levels. Therefore, systemic exposure to acetaminophen is expected to be increased with coadministration of imatinib. Chronic acetaminophen therapy should be avoided in patients receiving imatinib. [4966] Insulin Glargine; Lixisenatide: (Minor) When 1,000 mg acetaminophen was given 1 or 4 hours after 10 mcg lixisenatide, the AUC was not significantly changed, but the acetaminophen Cmax was decreased by 29% and 31%, respectively and median Tmax was delayed by 2 and 1.75 hours, respectively. Acetaminophen AUC, Cmax, and Tmax were not significantly changed when acetaminophen was given 1 h before lixisenatide injection. The mechanism of this interaction is not available (although it may be due to delayed gastric emptying) and the clinical impact has not been assessed. To avoid potential pharmacokinetic interactions that might alter effectiveness of acetaminophen, it may be advisable for patients to take acetaminophen at least one hour prior to lixisenatide subcutaneous injection. [61024] Isavuconazonium: (Moderate) Concomitant use of isavuconazonium with acetaminophen may result in increased serum concentrations of acetaminophen. Acetaminophen is a substrate of the hepatic isoenzyme CYP3A4; isavuconazole, the active moiety of isavuconazonium, is a moderate inhibitor of this enzyme. Caution and close monitoring are advised if these drugs are used together. [25460] [28100] [59042] Isoniazid, INH: (Major) Agents which induce the hepatic isoenzyme CYP2E1, such as isoniazid, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. The combination of isoniazid and acetaminophen has caused severe hepatotoxicity in at least one patient; studies in rats have demonstrated that pre-treatment with isoniazid potentiates acetaminophen hepatotoxicity. [27050] [42734] Isoniazid, INH; Pyrazinamide, PZA; Rifampin: (Major) Agents which induce the hepatic isoenzyme CYP2E1, such as isoniazid, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. The combination of isoniazid and acetaminophen has caused severe hepatotoxicity in at least one patient; studies in rats have demonstrated that pre-treatment with isoniazid potentiates acetaminophen hepatotoxicity. [27050] [42734] (Moderate) Agents which induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as rifampin, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. [30314] Isoniazid, INH; Rifampin: (Major) Agents which induce the hepatic isoenzyme CYP2E1, such as isoniazid, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. The combination of isoniazid and acetaminophen has caused severe hepatotoxicity in at least one patient; studies in rats have demonstrated that pre-treatment with isoniazid potentiates acetaminophen hepatotoxicity. [27050] [42734] (Moderate) Agents which induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as rifampin, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. [30314] Lamivudine, 3TC; Zidovudine, ZDV: (Minor) Both acetaminophen and zidovudine, ZDV undergo glucuronidation. Competition for the metabolic pathway is thought to have caused a case of acetaminophen-related hepatotoxicity. This interaction may be more clinically significant in patients with depleted glutathione stores, such as patients with acquired immunodeficiency syndrome, poor nutrition, or alcoholism. [4928] Lamotrigine: (Major) Acetaminophen can be hepatotoxic, and lamotrigine appears to be a potential cause of progressive and fatal hepatotoxicity despite drug discontinuation. A 35 year-old developed fulminant liver failure possibly caused by lamotrigine. She was taking several other drugs including acetaminophen. In a randomized, single-dose study, the serum half-life of lamotrigine after a 300 mg dose decreased by 15% and the area under the plasma concentration-time curve decreased by 20% when given with acetaminophen 900 mg 3 times a day as compared with administration of lamotrigine with placebo. As the lamotrigine maximum serum concentration (Cmax) and time to Cmax was similar between the groups, and the lamotrigine renal clearance increased by 7%, acetaminophen appears to enhance removal of lamotrigine from the circulation. [5101] [5102] Lanthanum Carbonate: (Minor) The manufacturer recommends that oral compounds known to interact with antacids, such as acetaminophen, should not be taken within 2 hours of dosing with lanthanum carbonate. [9126] Levonorgestrel; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Levonorgestrel; Ethinyl Estradiol; Ferrous Bisglycinate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Lidocaine: (Moderate) Coadministration of lidocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue lidocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [43383] Lidocaine; Prilocaine: (Moderate) Coadministration of lidocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue lidocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [43383] (Moderate) Coadministration of prilocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue prilocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29064] Lixisenatide: (Minor) When 1,000 mg acetaminophen was given 1 or 4 hours after 10 mcg lixisenatide, the AUC was not significantly changed, but the acetaminophen Cmax was decreased by 29% and 31%, respectively and median Tmax was delayed by 2 and 1.75 hours, respectively. Acetaminophen AUC, Cmax, and Tmax were not significantly changed when acetaminophen was given 1 h before lixisenatide injection. The mechanism of this interaction is not available (although it may be due to delayed gastric emptying) and the clinical impact has not been assessed. To avoid potential pharmacokinetic interactions that might alter effectiveness of acetaminophen, it may be advisable for patients to take acetaminophen at least one hour prior to lixisenatide subcutaneous injection. [61024] Lomitapide: (Moderate) Caution should be exercised when lomitapide is used with other medications known to have potential for hepatotoxicity, such as acetaminophen (> 4 g/day PO for >= 3 days/week). The effect of concomitant administration of lomitapide with other hepatotoxic medications is unknown. More frequent monitoring of liver-related tests may be warranted. [52698] Lopinavir; Ritonavir: (Moderate) Concurrent administration of acetaminophen with ritonavir may result in elevated acetaminophen plasma concentrations and subsequent adverse events. Acetaminophen is metabolized by the hepatic isoenzyme CYP3A4; ritonavir is an inhibitor of this enzyme. Caution and close monitoring are advised if these drugs are administered together. [25460] [28100] [58664] Magnesium Salicylate: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Mephobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Mepivacaine: (Moderate) Coadministration of mepivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue mepivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29100] Mepivacaine; Levonordefrin: (Moderate) Coadministration of mepivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue mepivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29100] Methohexital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Metyrapone: (Major) Coadministration of metyrapone and acetaminophen may result in acetaminophen toxicity. Acetaminophen glucuronidation is inhibited by metyrapone. It may be advisable for patients to avoid acetaminophen while taking metyrapone. [10379] Mipomersen: (Moderate) Caution should be exercised when mipomersen is used with other medications known to have potential for hepatotoxicity, such as acetaminophen (> 4 g/day for >= 3 days/week). The effect of concomitant administration of mipomersen with other hepatotoxic medications is unknown. More frequent monitoring of liver-related tests may be warranted. [53015] Mitotane: (Minor) Use caution if mitotane and acetaminophen are used concomitantly, and monitor for decreased efficacy of acetaminophen. Mitotane is a strong CYP3A4 inducer and acetaminophen is a minor (10% to 15%) CYP3A4 substrate; coadministration may result in decreased plasma concentrations of acetaminophen. [25460] [28100] [41934] Norethindrone Acetate; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Norethindrone; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Norethindrone; Ethinyl Estradiol; Ferrous fumarate: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Norgestimate; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Ombitasvir; Paritaprevir; Ritonavir: (Moderate) Concurrent administration of acetaminophen with ritonavir may result in elevated acetaminophen plasma concentrations and subsequent adverse events. Acetaminophen is metabolized by the hepatic isoenzyme CYP3A4; ritonavir is an inhibitor of this enzyme. Caution and close monitoring are advised if these drugs are administered together. [25460] [28100] [58664] Omeprazole; Amoxicillin; Rifabutin: (Moderate) As a cytochrome P450 isoenzyme inducers, rifabutin could induce the metabolism of acetaminophen. An increase in acetaminophen-induced hepatotoxicity may be seen by increasing the metabolism of acetaminophen to its toxic metabolite, NAPQI. Also, the analgesic activity of acetaminophen may be reduced. [4718] Omeprazole; Sodium Bicarbonate: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. [6086] Penicillin G Benzathine; Penicillin G Procaine: (Moderate) Coadministration of penicillin G procaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue penicillin G procaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [31217] Penicillin G Procaine: (Moderate) Coadministration of penicillin G procaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue penicillin G procaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [31217] Pentobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Phenobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Phenobarbital; Hyoscyamine; Atropine; Scopolamine: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Pneumococcal Vaccine, Polyvalent: (Moderate) Concomitant administration of antipyretics, such as acetaminophen, may decrease an individual's immunological response to the pneumococcal vaccine. A post-marketing study conducted in Poland using a non-US vaccination schedule (2, 3, 4, and 12 months of age) evaluated the impact of prophylactic oral acetaminophen on antibody responses to Prevnar 13. Data show that acetaminophen, given at the time of vaccination and then dosed at 6 to 8 hour intervals for 3 doses on a scheduled basis, reduced the antibody response to some serotypes after the third dose of Prevnar 13 when compared to the antibody responses of infants who only received antipyretics 'as needed' for treatment. However, reduced antibody responses were not observed after the fourth dose of Prevnar 13 with prophylactic acetaminophen. [39165] Posaconazole: (Moderate) Posaconazole and acetaminophen should be coadministered with caution due to an increased potential for acetaminophen-related adverse events. Posaconazole is a potent inhibitor of CYP3A4, an isoenzyme partially responsible for the metabolism of acetaminophen. These drugs used in combination may result in elevated acetaminophen plasma concentrations, causing an increased risk for acetaminophen-related adverse events. [32723] [4718] Pramlintide: (Minor) Because pramlintide has the potential to delay the absorption of concomitantly administered medications, medications should be administered at least 1 hour before or 2 hours after pramlintide injection when the rapid onset of a concomitantly administered oral medication is a critical determinant of effectiveness (i.e., analgesics). [8010] Prilocaine: (Moderate) Coadministration of prilocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue prilocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29064] Prilocaine; Epinephrine: (Moderate) Coadministration of prilocaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue prilocaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [29064] Primidone: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Rifabutin: (Moderate) As a cytochrome P450 isoenzyme inducers, rifabutin could induce the metabolism of acetaminophen. An increase in acetaminophen-induced hepatotoxicity may be seen by increasing the metabolism of acetaminophen to its toxic metabolite, NAPQI. Also, the analgesic activity of acetaminophen may be reduced. [4718] Rifampin: (Moderate) Agents which induce the hepatic isoenzymes CYP2E1 and CYP1A2, such as rifampin, may potentially increase the risk for acetaminophen-induced hepatotoxicity via generation of a greater percentage of acetaminophen's hepatotoxic metabolites. [30314] Ritonavir: (Moderate) Concurrent administration of acetaminophen with ritonavir may result in elevated acetaminophen plasma concentrations and subsequent adverse events. Acetaminophen is metabolized by the hepatic isoenzyme CYP3A4; ritonavir is an inhibitor of this enzyme. Caution and close monitoring are advised if these drugs are administered together. [25460] [28100] [58664] Ropivacaine: (Moderate) Coadministration of ropivacaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue ropivacaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [52330] Salsalate: (Moderate) Prolonged concurrent use of acetaminophen and salicylates is not recommended. Although salicylates are rarely associated with nephrotoxicity, high-dose, chronic administration of salicylates combined other analgesics, including acetaminophen, significantly increases the risk of analgesic nephropathy, renal papillary necrosis, and end-stage renal disease. Additive hepatic toxicity may occur, especially in combined overdose situations. Do not exceed the recommended individual maximum doses when these agents are given concurrently for short-term therapy. [4064] Secobarbital: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Segesterone Acetate; Ethinyl Estradiol: (Moderate) Acetaminophen may increase plasma ethinyl estradiol levels, possibly by inhibition of conjugation. Patients taking acetaminophen concomitantly may experience an increase in estrogen related side effects. [41929] Sodium Bicarbonate: (Minor) Antacids can delay the oral absorption of acetaminophen, but the interactions are not likely to be clinically significant as the extent of acetaminophen absorption is not appreciably affected. [6086] St. John's Wort, Hypericum perforatum: (Minor) St. John's wort, Hypericum perforatum induces cytochrome P450 1A2. About 10 to 15% of the acetaminophen dose undergoes oxidative metabolism via cytochrome P450 isoenzymes CYP2E1, 3A4 and 1A2, which produces the hepatotoxic metabolite, N-acetyl-p-benzoquinonimine. Thus, theoretically St. John's wort might increase the risk of acetaminophen-induced hepatotoxicity by increasing the metabolism of acetaminophen to NAPQI. [2678] [4935] Sulfinpyrazone: (Minor) Sulfinpyrazone can induce hepatic oxidative microsomal enzymes and the drug has been shown to increase acetaminophen clearance by roughly 23%. Theoretically, it is thought that the induction of acetaminophen metabolism by sulfinpyrazone may increase the risk of acetaminophen hepatotoxicity due to the formation of increased amounts of toxic acetaminophen metabolites, but there is no confirmatory evidence. [4939] Telaprevir: (Moderate) Close clinical monitoring is advised when administering acetaminophen with telaprevir due to an increased potential for acetaminophen-related adverse events. If acetaminophen dose adjustments are made, re-adjust the dose upon completion of telaprevir treatment. Although this interaction has not been studied, predictions about the interaction can be made based on the metabolic pathway of acetaminophen. Acetaminophen is partially metabolized by the hepatic isoenzyme CYP3A4; telaprevir inhibits this isoenzyme. Coadministration may result in elevated acetaminophen plasma concentrations. [25460] [28100] [44393] Tetracaine: (Moderate) Coadministration of tetracaine with oxidizing agents, such as acetaminophen, may increase the risk of developing methemoglobinemia. Monitor patients closely for signs and symptoms of methemoglobinemia if coadministration is necessary. If methemoglobinemia occurs or is suspected, discontinue tetracaine and any other oxidizing agents. Depending on the severity of symptoms, patients may respond to supportive care; more severe symptoms may require treatment with methylene blue, exchange transfusion, or hyperbaric oxygen. [31353] Thiopental: (Minor) Chronic therapy with barbiturates can increase the metabolism and decrease the effectiveness of acetaminophen. During acute overdoses, barbiturates can enhance the formation of toxic acetaminophen metabolites. [4939] [6522] Tizanidine: (Minor) Tizanidine delays the time to attain peak concentrations of acetaminophen by about 16 minutes. The clinical significance of this interaction is unknown. [6899] Tobacco: (Moderate) Tobacco smoking induces the cytochrome P450 isoenzyme CYP1A2 and may potentially increase the risk for acetaminophen-induced hepatotoxicity during overdose via enhanced generation of acetaminophen's hepatotoxic metabolite, NAPQI. In one study, current tobacco smoking was found to be very frequent in patients admitted with acetaminophen poisoning. Tobacco smoking appears to be an independent risk factor of severe hepatotoxicity, acute liver failure and death following acetaminophen overdose. [4718] [4940] Trimetrexate: (Moderate) Acetaminophen can inhibit oxidative hepatic enzymes responsible for metabolizing trimetrexate. Concurrent use can decrease the clearance of trimetrexate and thus increase its plasma levels. [5221] [5224] Vemurafenib: (Moderate) Concomitant use of vemurafenib and acetaminophen may result in altered concentrations of acetaminophen. Vemurafenib is an inhibitor of CYP1A2 and CYP2A6, and an inducer of CYP3A4. Acetaminophen is a substrate of CYP1A2, CYP2A6, and CYP3A4. Use caution and monitor patients for toxicity and efficacy. [25460] [28100] [45335] Warfarin: (Minor) Although acetaminophen is routinely considered safer than aspirin and agent of choice when a mild analgesic/antipyretic is necessary for a patient receiving therapy with warfarin, acetaminophen has also been shown to augment the hypoprothrombinemic response to warfarin. Concomitant acetaminophen ingestion may result in increases in the INR in a dose-related fashion. Clinical bleeding has been reported. Single doses or short (i.e., several days) courses of treatment with acetaminophen are probably safe in most patients taking warfarin. Clinicians should be alert for an increased INR if acetaminophen is administered in large daily doses for longer than 10 to 14 days. [1628] Zidovudine, ZDV: (Minor) Both acetaminophen and zidovudine, ZDV undergo glucuronidation. Competition for the metabolic pathway is thought to have caused a case of acetaminophen-related hepatotoxicity. This interaction may be more clinically significant in patients with depleted glutathione stores, such as patients with acquired immunodeficiency syndrome, poor nutrition, or alcoholism. [4928] Zolmitriptan: (Minor) Zolmitriptan can delay the Tmax of acetaminophen by one hour. A single 1 g dose of acetaminophen does not alter the pharmacokinetics of zolmitriptan and its active metabolite. The interaction between zolmitriptan and acetaminophen is not likely to be clinically significant. [5175]
Revision Date: 10/19/2021, 02:27:00 AM

References

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Monitoring Parameters

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

US Drug 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
  • Plus PHARMA
  • 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 Muscle Aches & Pain
  • Tylenol Pain + Fever
  • Tylenol Regular Strength
  • Tylenol Sore Throat
  • XS No Aspirin
  • XS Pain Reliever
;