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1. Indications for injectable Acetaminophen
Acetaminophen injection containing the active ingredient Acetaminophen is indicated in the following cases:Control of mild to moderate pain in adult and pediatric patients 2 years of age and older. Management of moderate to severe pain in combination with opioid analgesics in adult and pediatric patients 2 years of age and older. Reducing fever in adults and children.
2. Dosage and how to use Acetaminophen injection form
2.1. Dosage
Acetaminophen injection may be given as a single or repeated dose to treat acute pain or fever. No dose adjustment is required when using oral to injectable drugs in adults and adolescents weighing 50 kg or more. The calculated maximum dose of Acetaminophen Injection is based on the route of administration (oral, intravenous, rectal).The recommended dose in adults and adolescents weighing 50 kg or more is 1000 mg every 6 hours or 650 mg every 4 hours, up to a maximum dose of 4000 mg per day.
The recommended dose in adults and adolescents weighing less than 50 kg is 15 mg/kg every 6 hours or 12.5 mg/kg every 4 hours. The maximum dose of Acetaminophen for a single injection is 15mg/kg, the minimum dosing interval is 4 hours and the maximum dose is 75mg/kg/day.
The recommended dose is summarized in the following table:
| Độ tuổi | Liều thuốc cách mỗi 4 giờ | Liều thuốc cách mỗi 6 giờ | Liều duy nhất tối đa | Tổng liều dùng tối đa trong ngày |
| Người lớn và thanh thiếu niên (13 tuổi trở lên) cân nặng từ 50kg trở lên | 650mg | 1000mg | 1000mg | 4000mg trong vòng 24 giờ |
| Người lớn và thanh thiếu niên (13 tuổi trở lên) cân nặng nhỏ hơn 50kg | 12.5mg/ kg | 15mg/ kg | 15mg/ kg | 75mg/ kg trong vòng 24 giờ |
The recommended dose of Acetaminophen for injection for the treatment of fever in premature infants (≥ 32 weeks of age) and infants under 28 days of age is 12.5 mg/kg every 6 hours, maximum daily dose not to exceed 50 mg / kg with a minimum interval of 6 hours.
The recommended dose of injectable Acetaminophen for the treatment of fever in infants from 29 days of age to 2 years is 15mg/kg every 6 hours, the maximum daily dose should not exceed 60mg/kg/day with the maximum interval. 6 hours minimum.
2.2. Overdose
Overdose of injectable acetaminophen can lead to liver necrosis, dose-dependent death being the most serious side effect. Hypoglycemic coma, tubular necrosis, and thrombocytopenia may also occur. Initial symptoms after drug overdose include vomiting, nausea, electrophoresis and general malaise,...In case of suspected drug overdose, the patient should be taken to a medical facility. as soon as possible. Test serum Acetaminophen as soon as possible, test liver function and repeat every 24 hours. Take acetylcysteine (NAC) as directed by your doctor
3. Side effects of Acetaminophen injection
Acetaminophen injection can cause some of the following side effects:Common effects: Shortness of breath, cough, constipation, agitation, itching and rash. Gastrointestinal disorders: Nausea, vomiting. Nervous disorders: Headache, insomnia. Discontinue use and inform your doctor in case of side effects including cough, fever, shortness of breath, chest pain, liver problems (upper abdominal pain, loss of appetite, dark urine, colored stools) clay, yellow skin, yellow eyes).
4. Use caution
4.1. Contraindications
Acetaminophen injection is contraindicated in patients with hypersensitivity to acetaminophen or to any of its excipients, patients with liver failure, cirrhosis or severe liver disease.4.2. Careful
Using injectable acetaminophen at doses higher than recommended can lead to liver damage, including liver failure and death. Therefore, patients should be careful not to exceed the maximum recommended dose.Caution when using the drug in patients with liver failure, people with active liver diseases, alcoholics, chronic malnutrition, severe hypovolemia (blood loss, dehydration) or kidney failure severe (creatinine clearance ≤ 30 ml/min).
Be careful when prescribing injectable Acetaminophen in particular and injectable painkillers in general to avoid dosing errors that can lead to accidental overdose and death. Some notes are as follows:
Avoid confusing drug doses in milligrams (mg) and milliliters (mL). Dosage is based on weight in patients less than 50 kg. The total daily dose from all routes of administration should not exceed the recommended dose. There have been reports of hypersensitivity and anaphylaxis reactions associated with the use of Acetaminophen. Clinical symptoms include swelling of the face, mouth and throat, respiratory distress, rash and pruritus, and urticaria. Stop injecting Acetaminophen immediately if symptoms related to allergy or hypersensitivity appear.
Pregnant women, lactating women: Only use Acetaminophen on these subjects when absolutely necessary.
Effects on fertility: Several recent studies have demonstrated that acetaminophen use can reduce fertility in both men and women. Animal studies have shown that treatment with acetaminophen in male animals at doses 1.2 times the normal dose resulted in decreased testicular weight, decreased spermatogenesis, and decreased fertility. Similar effects occurred when administered in female animals. Published animal studies have also shown that use of acetaminophen during pregnancy has an adverse effect on intercourse and pregnancy.
5. Drug interactions
Inducers of the cytochrome CYP2E1 enzyme may alter the metabolism of acetaminophen and increase its potential for hepatotoxicity.Alcohol inhibits the metabolism of the drug Acetaminophen.
Simultaneous use of Acetaminophen with anticoagulants (warfarin, Coumadin, ...) may lead to increased plasma concentrations of anticoagulants, increasing the likelihood of side effects.
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