Page 95 - 2026 SMOG

ACETAMINOPHEN (TYLENOL)
Class/Mechanism of Action
• Analgesic
Although not fully clear, the analgesic effects are believed to be due to activation of descending
serotonergic inhibitory pathways in the CNS. Interactions with other nociceptive systems may
be involved as well. Antipyresis is produced by inhibition of the hypothalamic heat-regulating
center.
˚ Onset of action—Oral: <1hr, IV: 5–10min; Duration: 4–6hr
Indications
• Labeled Indications
˚ Treatment of mild to moderate pain and fever
˚ Treatment of moderate to severe pain when provided via IV with opioid analgesia
Contraindications
• Hypersensitivity to acetaminophen or any component of the formulation
• Hepatic impairment or liver disease
Adverse Reactions/Precautions
• Use IV formulation cautiously in volume-depleted patients
• Avoid use in patients suffering from alcohol toxicity, known alcohol abuse, or renal impairment
• IV formulation can cause nausea, vomiting (especially in adults), and headaches
• Limit acetaminophen dose from all sources and all routes of administration to <4g/day (adults)
and <3.75g/day (infants and children <50kg)
• Pregnancy: Category C
• Lactation: Use caution
Dose/Administration
PEDIATRIC
ADULT
(Always reference Broselow Tape)
Pain or Fever Pain or Fever
(Limit total daily dose to <4g/day) • PO
• PO ˚ Infants and Children <12 years:
˚ 1g q6hr 10–15mg/kg/dose q4–6hr prn; do not
• IV exceed 5 doses (4g/day) in 24hr
˚ <50kg: 12.5mg/kg q4hr • IV Infants and Children <2 years:
OR
15mg/kg q6hr ˚ ˚ 15mg/kg q6hr (max DAILY dose:
˚ ≥50kg: 650mg q4hr 60mg/kg/day) MEDICATIONS
Children 2–12 years: 15mg/kg q6hr
OR
1g q6hr ˚ ■ Max SINGLE dose: 15mg/kg/dose
(≤750mg/dose)
■ Max DAILY dose: 75mg/kg/day
(≤3.75g daily)
NOTE: Children ≥12 years and Adolescents:
Refer to adult dosing

2026 Standard Medical Operating Guidelines (SMOG) • 87