Acetaminophen IV

Acetaminophen IV is a prescription medication used to treat pain and fever.

• Acetaminophen IV is available under the following different brand names: Ofirmev.

Adult and pediatric dosage

Injectable, ready-to-use IV solution

• 500mg/50mL
• 1000mg/100mL

Pain and Fever

Adult dosage

• Weighing less than 50 kg: 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours; not to exceed 750 mg/dose or 3.75 g/day
• Weighing over 50 kg: 650 mg IV every 4 hours or 1,000 mg IV every 6 hours; not to exceed 4 g/day
• Infuse IV over at least 15 minutes.

Pain

Pediatric Dosage

• Children younger than 2 years of age: Safety and efficacy not established
• Children 2-12 years of age: 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours; not to exceed 75 mg/kg/day. 
• Children 13 years or older: 
  • Weighing less than 50 kg: 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours; not to exceed 750 mg/dose or 3.75 g/day
  • Weighing over 50 kg: 650 mg IV every 4 hours or 1,000 mg IV every 6 hours; not to exceed 4 g/day

Fever

Pediatric Dosage

Neonates

• Neonates, including premature neonates born at 32 weeks or older of gestational age, up to 28 days chronological age
• 12.5 mg/kg IV every 6 hours
• The maximum daily dose is 50 mg/kg/day, with a minimum dosing interval of 6 hours

Infants

• Infants 29 days to Children 2 years: 15 mg/kg IV every 6 hours
• The maximum daily dose is 60 mg/kg/day, with a minimum dosing interval of 6 hours

Children aged 2-12 years

• 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours; not to exceed 75 mg/kg/day 
• Maximum single dose: 750 mg
• Children 13 years of age or older: 
  • Weighing less than 50 kg: 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours; not to exceed 750 mg/dose or 3.75 g/day; maximum single dose is 750 mg
  • Weighing over 50 kg: 650 mg IV every 4 hours or 1,000 mg IV every 6 hours; not to exceed 4 g/day

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”.

Common side effects of Acetaminophen IV include:

• breathing problems, 
• nausea, 
• vomiting, 
• constipation, 
• agitation, 
• itching, 
• headache, and 
• sleep problems (insomnia)

Serious side effects of Acetaminophen IV include:

• hives, 
• difficulty breathing, 
• swelling in the face, lips, tongue, or throat, 
• skin redness, 
• rash that spreads and causes blistering and peeling, 
• chest pain, 
• trouble breathing, 
• nausea, 
• upper stomach pain, 
• itching, 
• loss of appetite, 
• dark urine, 
• clay-colored stools, and
• yellowing of the skin or eyes (jaundice)

Rare side effects of Acetaminophen IV include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them.  Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first

• Acetaminophen IV has severe interactions with no other drugs.
• Acetaminophen IV has serious interactions with the following drug:
  • lonafarnib
• Acetaminophen IV has moderate interactions with at least 21 other drugs.
• Acetaminophen IV has minor interactions with at least 51 other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity 
• Severe hepatic impairment or severe active liver disease

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Acetaminophen IV?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Acetaminophen IV?”

Cautions

• Doses higher than recommended may result in hepatic injury, including the risk of severe hepatotoxicity and death
• Do not exceed the maximum recommended daily dose
• Caution with the following conditions: hepatic impairment or active hepatic disease, in cases of alcoholism, chronic malnutrition, severe hypovolemia, G6PD deficiency, hypovolemia, or severe renal impairment (CrCl less than 30 mL/min)
• Discontinue immediately if symptoms associated with allergy or hypersensitivity occur
• Rare serious skin reactions were reported including acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal; discontinued at the first appearance of skin rash or any other sign of hypersensitivity
• Based on animal data use of acetaminophen may cause reduced fertility in males and females of reproductive potential; it is not known whether effects on fertility are reversible

Pregnancy and Lactation

• Prolonged experience with acetaminophen in pregnant women over several decades, based on published observational epidemiological studies and case reports, did not identify a drug-associated risk of major birth defects, miscarriage, or adverse maternal or fetal outcomes
• There is no information regarding the presence of acetaminophen in human milk, effects on the breastfed infant, or milk production; however, limited published studies report that acetaminophen passes rapidly into human milk with similar levels in milk and plasma
• Average and maximum neonatal doses of 1% and 2%, respectively, of weight-adjusted maternal dose, are reported after single oral administration of 1-gram APAP
• There is one well-documented report of a rash in a breastfed infant that resolved when the mother stopped acetaminophen use and recurred when she resumed acetaminophen use
• Developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for acetaminophen injection and any potential adverse effects on the breastfed infant from acetaminophen injection or underlying maternal condition