- Body system
- Pain
- Brand names
- Tylenol, Ofirmev (IV)
- Antidote or reversal
- Acetylcysteine (Acetadote IV, or oral).
What is Acetaminophen used for?
- Mild to moderate pain
- Fever
- Adjunct to opioids for moderate to severe pain
Acetaminophen is not an NSAID: it relieves pain and fever but has little anti-inflammatory effect. It is grouped here with the other non-opioid analgesics.
How Acetaminophen works
Acts mainly in the central nervous system to reduce pain and fever; weak effect on peripheral inflammation and no effect on platelets.
Common side effects
- Usually well tolerated at recommended doses
- Liver injury with overdose or excess use
- Rare serious skin reactions
Report right away
- Nausea, vomiting, right upper abdominal pain, dark urine or yellow skin
- Rash or blistering
Nursing considerations for Acetaminophen
- Count acetaminophen from every source, including combination products such as hydrocodone-acetaminophen and cold medicines.
- Do not exceed the daily maximum on the order or label. A total of 4 g a day is the commonly cited adult maximum; lower limits apply in liver disease, regular alcohol use, malnutrition and low body weight.
- IV acetaminophen is infused over 15 minutes. It is safer than NSAIDs for the stomach and kidneys and preferred in many older adults.
Patient teaching
- Read labels: many products contain acetaminophen (sometimes written APAP).
- Limit alcohol.
- Overdose may cause no symptoms at first: seek emergency care right away after taking too much.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
NSAIDs and acetaminophen practice questions
NCLEX-style questions on the class Acetaminophen belongs to.
3 questions. Choose an answer to see the rationale.
-
Which finding in a patient taking ibuprofen daily should be reported?
Show answer
Answer D: Black, tarry stools Black, tarry stools suggest upper GI bleeding, a serious NSAID complication.
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What is the antidote for acetaminophen overdose?
Show answer
Answer A: Acetylcysteine Acetylcysteine replenishes glutathione and protects the liver after acetaminophen overdose.
-
What is the maximum total duration of ketorolac therapy?
Show answer
Answer A: 5 days Ketorolac (all routes combined) is limited to 5 days because of the risk of GI bleeding and kidney injury.
Frequently asked questions
What is Acetaminophen used for?
Mild to moderate pain; Fever; Adjunct to opioids for moderate to severe pain.
What drug class is Acetaminophen?
Acetaminophen belongs to the class NSAIDs and acetaminophen. Acts mainly in the central nervous system to reduce pain and fever; weak effect on peripheral inflammation and no effect on platelets.
What are the nursing considerations for Acetaminophen?
Count acetaminophen from every source, including combination products such as hydrocodone-acetaminophen and cold medicines. Do not exceed the daily maximum on the order or label. A total of 4 g a day is the commonly cited adult maximum; lower limits apply in liver disease, regular alcohol use, malnutrition and low body weight.
What should patients report while taking Acetaminophen?
nausea, vomiting, right upper abdominal pain, dark urine or yellow skin; rash or blistering.
What is the antidote for Acetaminophen?
Acetylcysteine (Acetadote IV, or oral).