acetaminophen rectal (OTC)

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

            Acetaminophen is available in many dosage forms and products, check label carefully to avoid overdose

            Risk of hepatotoxicity is higher in alcoholics, chronic high dose, or use of more than one acetaminophen-containing product

            G6PD deficiency

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