acetaminophen rectal (OTC)

Brand and Other Names:Acephen, FeverAll, more...FeverAll Infants, FeverAll Junior Strength, Adults' FeverAll

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

suppository

  • 80mg
  • 120mg
  • 325mg
  • 650mg

Antipyretic/Analgesic

325-650 mg PR q4-6hr PRN

Not to exceed 4 g/day

Administration

Patient should lie on left side with knees bent

Remove protective wrap before inserting

Gently insert tip into rectum with slight side-to-side movement (tip of suppository pointing toward navel)

Dosage Forms & Strengths

suppository

  • 80mg
  • 120mg
  • 325mg
  • 650mg

Antipyretic/Analgesic

3 months to 1 year: 80 mg PR q6hr PRN

1-3 years: 80 mg PR q4hr PRN

3-6 years: 120 mg PR q4-6hrPRN

6-12 years: 325 mg PR q4-6hr PRN

>12 years: As adults; 325-650 mg PR q4-6hr PRN

Maximum daily dose

  • <12 years: Not to exceed 5 doses/24 hr
  • ≥12 years: Not to exceed 4 g/day

Administration

Patient should lie on left side with knees bent

Remove protective wrap before inserting

Gently insert tip into rectum with slight side-to-side movement (tip of suppository pointing toward navel)

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Interactions

Interaction Checker

and acetaminophen rectal

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            Contraindicated (0)

              Serious - Use Alternative (1)

              • lonafarnib

                acetaminophen rectal will increase the level or effect of lonafarnib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Avoid or Use Alternate Drug. If coadministration of lonafarnib (a sensitive CYP3A substrate) with weak CYP3A inhibitors is unavoidable, reduce to, or continue lonafarnib at starting dose. Closely monitor for arrhythmias and events (eg, syncope, heart palpitations) since lonafarnib effect on QT interval is unknown.

              Monitor Closely (18)

              • avapritinib

                acetaminophen rectal will increase the level or effect of avapritinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • axitinib

                acetaminophen rectal increases levels of axitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • eltrombopag

                eltrombopag increases levels of acetaminophen rectal by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.

              • finerenone

                acetaminophen rectal will increase the level or effect of finerenone by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Monitor serum potassium during initiation and dosage adjustment of either finererone or moderate CYP3A4 inhibitors. Adjust finererone dosage as needed.

              • flibanserin

                acetaminophen rectal will increase the level or effect of flibanserin by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased flibanserin adverse effects may occur if coadministered with multiple weak CYP3A4 inhibitors.

              • imatinib

                imatinib decreases levels of acetaminophen rectal by decreasing hepatic clearance. Modify Therapy/Monitor Closely. In vitro, imatinib was found to inhibit acetaminophen O-glucuronidation (Ki value of 58.5 micro-M) at therapeutic levels; avoid chronic acetaminophen therapy with imatinib; if occasional acetaminophen administered, do not exceed 1300 mg/day.

              • isavuconazonium sulfate

                acetaminophen rectal will increase the level or effect of isavuconazonium sulfate by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • isoniazid

                isoniazid will increase the level or effect of acetaminophen rectal by affecting hepatic enzyme CYP2E1 metabolism. Use Caution/Monitor.

              • ivacaftor

                acetaminophen rectal increases levels of ivacaftor by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Monitor when coadministered with weak CYP3A4 inhibitors .

              • lemborexant

                acetaminophen rectal will increase the level or effect of lemborexant by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Modify Therapy/Monitor Closely. Lower nightly dose of lemborexant recommended if coadministered with weak CYP3A4 inhibitors. See drug monograph for specific dosage modification.

              • levonorgestrel oral/ethinylestradiol/ferrous bisglycinate

                levonorgestrel oral/ethinylestradiol/ferrous bisglycinate will decrease the level or effect of acetaminophen rectal by unknown mechanism. Use Caution/Monitor.

              • lomitapide

                acetaminophen rectal increases levels of lomitapide by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Lomitapide dose should not exceed 30 mg/day.

              • midazolam intranasal

                acetaminophen rectal will increase the level or effect of midazolam intranasal by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Coadministration of mild CYP3A4 inhibitors with midazolam intranasal may cause higher midazolam systemic exposure, which may prolong sedation.

              • mipomersen

                mipomersen, acetaminophen rectal. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Both drugs have potential to increase hepatic enzymes; monitor LFTs.

              • tazemetostat

                acetaminophen rectal will increase the level or effect of tazemetostat by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • tetracaine

                tetracaine, acetaminophen rectal. Other (see comment). Use Caution/Monitor. Comment: Monitor for signs of methemoglobinemia when methemoglobin-inducing drugs are coadministered.

              • tinidazole

                acetaminophen rectal will increase the level or effect of tinidazole by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.

              • warfarin

                acetaminophen rectal increases effects of warfarin by anticoagulation. Use Caution/Monitor. Likely to occur at doses exceedin 1.3-2 g/day for multiple consecutive days.

              Minor (52)

              • acetazolamide

                acetazolamide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • antithrombin alfa

                acetaminophen rectal increases effects of antithrombin alfa by unknown mechanism. Minor/Significance Unknown.

              • antithrombin III

                acetaminophen rectal increases effects of antithrombin III by unknown mechanism. Minor/Significance Unknown.

              • argatroban

                acetaminophen rectal increases effects of argatroban by unknown mechanism. Minor/Significance Unknown.

              • bemiparin

                acetaminophen rectal increases effects of bemiparin by unknown mechanism. Minor/Significance Unknown.

              • bivalirudin

                acetaminophen rectal increases effects of bivalirudin by unknown mechanism. Minor/Significance Unknown.

              • busulfan

                acetaminophen rectal increases levels of busulfan by decreasing metabolism. Minor/Significance Unknown.

              • carbamazepine

                carbamazepine decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • cholestyramine

                cholestyramine decreases levels of acetaminophen rectal by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • clonazepam

                clonazepam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • colestipol

                colestipol decreases levels of acetaminophen rectal by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • dalteparin

                acetaminophen rectal increases effects of dalteparin by unknown mechanism. Minor/Significance Unknown.

              • diazepam

                diazepam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • disulfiram

                disulfiram will increase the level or effect of acetaminophen rectal by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              • enoxaparin

                acetaminophen rectal increases effects of enoxaparin by unknown mechanism. Minor/Significance Unknown.

              • ethanol

                ethanol will decrease the level or effect of acetaminophen rectal by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

                ethanol increases toxicity of acetaminophen rectal by decreasing metabolism. Minor/Significance Unknown.

              • ethosuximide

                ethosuximide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • exenatide injectable solution

                exenatide injectable solution decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • exenatide injectable suspension

                exenatide injectable suspension decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • felbamate

                felbamate decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • fondaparinux

                acetaminophen rectal increases effects of fondaparinux by unknown mechanism. Minor/Significance Unknown.

              • fosphenytoin

                fosphenytoin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • gabapentin

                gabapentin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • gabapentin enacarbil

                gabapentin enacarbil decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • green tea

                green tea increases effects of acetaminophen rectal by pharmacodynamic synergism. Minor/Significance Unknown. (Theoretical, due to caffeine content).

              • heparin

                acetaminophen rectal increases effects of heparin by unknown mechanism. Minor/Significance Unknown.

              • isoniazid

                isoniazid increases toxicity of acetaminophen rectal by unknown mechanism. Minor/Significance Unknown.

              • lacosamide

                lacosamide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • lamotrigine

                lamotrigine decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • levetiracetam

                levetiracetam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • lorazepam

                lorazepam decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • methsuximide

                methsuximide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • metoclopramide

                metoclopramide increases levels of acetaminophen rectal by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.

              • metronidazole

                metronidazole will increase the level or effect of acetaminophen rectal by affecting hepatic enzyme CYP2E1 metabolism. Minor/Significance Unknown.

              • oxcarbazepine

                oxcarbazepine decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • oxybutynin

                oxybutynin decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • oxybutynin topical

                oxybutynin topical decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • oxybutynin transdermal

                oxybutynin transdermal decreases levels of acetaminophen rectal by unspecified interaction mechanism. Minor/Significance Unknown.

              • phenindione

                acetaminophen rectal increases effects of phenindione by unknown mechanism. Minor/Significance Unknown.

              • phenobarbital

                phenobarbital decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • phenytoin

                phenytoin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • primidone

                primidone decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • protamine

                acetaminophen rectal increases effects of protamine by unknown mechanism. Minor/Significance Unknown.

              • rifabutin

                rifabutin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • rifampin

                rifampin decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • rufinamide

                rufinamide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • ruxolitinib

                acetaminophen rectal will increase the level or effect of ruxolitinib by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • ruxolitinib topical

                acetaminophen rectal will increase the level or effect of ruxolitinib topical by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Minor/Significance Unknown.

              • tiagabine

                tiagabine decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • topiramate

                topiramate decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • valproic acid

                valproic acid decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

              • zonisamide

                zonisamide decreases levels of acetaminophen rectal by increasing metabolism. Minor/Significance Unknown. Enhanced metabolism incr levels of hepatotoxic metabolites.

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              Adverse Effects

              Frequency Not Defined

              Pruritic maculopapular rash

              Urticaria

              Rectal discomfort

              Angioedema

              Increase in bilirubin, alkaline phosphatase

              Nephrotoxicity (chronic overdose)

              Analgesic nephropathy

              Decrease in chloride, glucose, uric acid

              Laryngeal edema

              Agranulocytosis

              Decrease in bicarbonate, sodium, calcium

              Leukopenia

              Neutropenia

              Pancytopenia

              Thrombocytopenia

              Thrombocytopenic purpura

              Anaphylactoid reaction

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              Warnings

              Contraindications

              Hypersensitivity

              Cautions

              For rectal use only

              Avoid overdose by checking product labels carefully; acetaminophen is found in many dosage forms and many combination products

              If not sure whether a drug contains acetaminophen, ask a physician or a pharmacist

              If experiencing liver disease, ask a physician or a pharmacist before using

              Ask a physician or pharmacist if taking warfarin or blood-thinning products

              Discontinue use and ask a physician if fever lasts >3 days (72 h) or recurs, pain lasts >5 days continuously or recurs

              Use caution in patients with known G6PD deficiency

              Risk of hepatotoxicity is higher in alcoholics, chronic high dose

              Risk for rare, but serious skin reactions that can be fatal; these reactions include Stevens-Johnson Syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP); symptoms may include skin redness, blisters and rash

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              Pregnancy & Lactation

              Pregnancy category: B; Crosses placenta, safe to use in all stages of pregnancy short term

              Lactation: Excreted in breast milk; compatible w/ breastfeeding

              Pregnant or breastfeeding patients should seek advice of health professional before using OTC drugs

              Pregnancy Categories

              A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

              B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

              C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

              D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

              X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

              NA: Information not available.

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              Pharmacology

              Mechanism of Action

              Inhibits prostaglandin synthesis in the CNS and works peripherally to block pain impulse generation; acts on hypothalamus to produce antipyresis

              Pharmacokinetics

              Onset: 1 hr

              Duration: 4-6 hr (analgesia)

              Half-life: 2.4 hr (adolescents); 2-3 hr (adults); 2-5 hr (children); 4-10 hr (neonates)

              Plasma Time: 107-288 min

              Peak Plasma Concentration: dose-dependent; (10 mg/kg) 5.5 mcg/mL, (20 mg/kg) 8.8 mcg/mL, (30 mg/kg) 14.2 mcg/mL

              Protein Bound: 10-25% (therapeutic concentrations); 43% (toxic concentrations)

              Distribution: 1 L/kg

              Metabolism: Liver (microsomal enzyme systems); conjugation (glucuronic/sulfuric acid)

              Metabolites: N-acetyl-p-benzoquinoneimine, N-acetylimidoquinone, NAPQI; further metabolized via conjugation with glutathione

              Excretion: <5% is excreted in the urine as unconjugated (free) acetaminophen and 60-80% as glucuronide metabolites

              Hemodialysis: Yes

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              Images

              BRAND FORM. UNIT PRICE PILL IMAGE
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              160 mg/5 mL liquid
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              160 mg/5 mL (5 mL) solution
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              325 mg tablet
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              325 mg tablet
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              500 mg tablet
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              500 mg tablet
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              500 mg tablet
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              500 mg tablet
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              325 mg tablet
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              325 mg tablet
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              325 mg tablet
              M-PAP oral
              -
              160 mg/5 mL liquid
              M-PAP oral
              -
              160 mg/5 mL liquid
              Mapap (acetaminophen) oral
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              325 mg tablet
              Mapap (acetaminophen) oral
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              500 mg capsule
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              160 mg/5 mL suspension
              Children's Pain and Fever Relief oral
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              160 mg/5 mL suspension
              Children's Pain and Fever Relief oral
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              160 mg/5 mL suspension
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              Children's Pain and Fever Relief oral
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              Children's Pain and Fever Relief oral
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              Children's Pain and Fever Relief oral
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              Children's Pain and Fever Relief oral
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              Children's Pain and Fever Relief oral
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              160 mg/5 mL suspension
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              Children's Pain and Fever Relief oral
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              Children's Pain and Fever Relief oral
              -
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              -
              160 mg/5 mL suspension
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              -
              32 mg/mL solution
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              -
              160 mg/5 mL suspension
              Children's Acetaminophen oral
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              160 mg/5 mL suspension
              Children's Acetaminophen oral
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              160 mg/5 mL suspension
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              -
              160 mg chewable tablet
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              -
              1,000 mg/100 mL (10 mg/mL) vial
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              160 mg/5 mL liquid
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              500 mg tablet
              acetaminophen intravenous
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              1,000 mg/100 mL (10 mg/mL) vial
              acetaminophen intravenous
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              1,000 mg/100 mL (10 mg/mL) vial
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              650 mg suppos
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              500 mg tablet
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              -
              160 mg/5 mL suspension
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              -
              650 mg tablet
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              -
              650 mg tablet
              Arthritis Pain Relief (acetaminophen) oral
              -
              650 mg tablet
              Arthritis Pain Relief (acetaminophen) oral
              -
              650 mg tablet
              Pharbetol oral
              -
              500 mg tablet
              Pharbetol oral
              -
              325 mg tablet

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              Patient Education
              acetaminophen oral

              ACETAMINOPHEN - ORAL

              (a-SEET-a-MIN-oh-fen)

              COMMON BRAND NAME(S): Panadol, Tylenol

              WARNING: Taking too much acetaminophen may cause serious (possibly fatal) liver disease. Adults should not take more than 4000 milligrams (4 grams) of acetaminophen a day. People with liver problems and children should take less acetaminophen. Ask your doctor or pharmacist how much acetaminophen is safe to take.Do not use with any other drug containing acetaminophen without asking your doctor or pharmacist first. Acetaminophen is in many nonprescription and prescription medications (such as pain/fever drugs or cough-and-cold products). Check the labels on all your medicines to see if they contain acetaminophen, and ask your pharmacist if you are unsure.Get medical help right away if you take too much acetaminophen (overdose), even if you feel well. Overdose symptoms may include nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, and dark urine.Daily alcohol use, especially when combined with acetaminophen, may damage your liver. Avoid alcohol.

              USES: This drug is used to treat mild to moderate pain (from headaches, menstrual periods, toothaches, backaches, osteoarthritis, or cold/flu aches and pains) and to reduce fever.

              HOW TO USE: Take this product by mouth as directed. Follow all directions on the product package. If you have any questions, ask your doctor or pharmacist.There are many brands and forms of acetaminophen available. Read the dosing instructions carefully for each product because the amount of acetaminophen may be different between products. Do not take more acetaminophen than recommended. (See also Warning section.)If you are giving acetaminophen to a child, be sure you use a product that is meant for children. Use your child's weight to find the right dose on the product package. If you don't know your child's weight, you can use their age.For suspensions, shake the medication well before each dose. Some liquids do not need to be shaken before use. Follow all directions on the product package. Measure the liquid medication with the provided dose-measuring spoon/dropper/syringe to make sure you have the correct dose. Do not use a household spoon.For rapidly-dissolving tablets, chew or allow to dissolve on the tongue, then swallow with or without water. For chewable tablets, chew thoroughly before swallowing.Do not crush or chew extended-release tablets. Doing so can release all of the drug at once, increasing the risk of side effects. Swallow the tablets whole.For effervescent tablets, dissolve the dose in the recommended amount of water, then drink.Pain medications work best if they are used as the first signs of pain occur. If you wait until the symptoms have worsened, the medication may not work as well.Do not take this medication for fever for more than 3 days unless directed by your doctor. For adults, do not take this product for pain for more than 10 days (5 days in children) unless directed by your doctor. If the child has a sore throat (especially with high fever, headache, or nausea/vomiting), consult the doctor promptly.Tell your doctor if your condition lasts or gets worse or if you develop new symptoms. If you think you may have a serious medical problem, get medical help right away.

              SIDE EFFECTS: See also Warning section.This drug usually has no side effects. If you have any unusual effects, contact your doctor or pharmacist promptly.If your doctor has directed you to use this medication, remember that your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

              PRECAUTIONS: See also Warning section.Before taking acetaminophen, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this product, tell your doctor or pharmacist your medical history, especially of: liver disease, regular use/abuse of alcohol.Liquid products, chewable tablets, or dissolving/effervescent tablets and powders may contain sugar or aspartame. Caution is advised if you have diabetes, phenylketonuria (PKU), or any other condition that requires you to limit/avoid these substances in your diet. If you have any of these conditions, ask your doctor or pharmacist about using these products safely.Tell your doctor if you are pregnant before using this medication.Acetaminophen passes into breast milk. Consult your doctor before breast-feeding.

              DRUG INTERACTIONS: See also Warning section.Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: ketoconazole, levoketoconazole.This medication may interfere with certain lab tests, possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

              OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: nausea, vomiting, loss of appetite, sweating, stomach/abdominal pain, extreme tiredness, yellowing eyes/skin, dark urine.

              NOTES: Acetaminophen does not cause the stomach and intestinal ulcers that NSAIDs such as aspirin, ibuprofen, and naproxen may cause. However, acetaminophen does not reduce swelling (inflammation) like the NSAIDs do. Consult your doctor for more details and to see which medication might be right for you.

              MISSED DOSE: If you are taking this medication on a regular schedule and miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

              STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

              Information last revised May 2023. Copyright(c) 2023 First Databank, Inc.

              IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.