Acetaminophen

(uh-see-tuh-MIH-nuh-fen) A drug that reduces pain and fever (but not inflammation). It belongs to the family of drugs called analgesics. Common brand name is Tylenol. Also called APAP.

Mechanism of action of Acetaminophen

Acetaminophen (a seet" a min' oh fen), which is known as paracetamol in Europe, is an aminophenol that is believed to act centrally as an analgesic and antipyretic agent.

NSAID

While technically a nonsteroidal antiinflammatory drug (NSAID), acetaminophen unlike typical NSAIDs (ibuprofen, naproxen, indomethacin) has only minor effects on tissue cyclooxygenase activity (Cox-1 and Cox-2) and appears to produce analgesia by increasing pain thresholds, perhaps through inhibition of the nitric oxide pathway which is activated by many pain neurotransmitter receptors.

Less anti-inflamatory

Acetaminophen has lower antiinflammatory activity than aspirin or typical NSAIDs.

Uses

Acetaminophen is typically recommended for management of minor aches and pains from the common cold, viral and bacterial infections, sinusitis, headache, toothache, back ache, muscle strain, tendonitis, osteoarthritis, trauma or menstrual cramps. Acetaminophen has been available as an over-the-counter preparation in the United States since 1960. In 2011, an intravenous formulation of acetaminophen was approved in the United States for adults and children above the age of 2 years.

Dose

The recommended oral dose is 660 to 1000 mg every 4 to 6 hours, but should not to exceed 3 grams per day. Multiple generic formulations of acetaminophen are available (e.g., Tylenol, Anacin Aspirin Free, Feverall, Neopap, Panadol and Tempra) in capsules or tablets of 330 or 500 mg each. Liquid formulations for children are available in concentrations that vary from 15 to 100 mg/mL; the dosage in children should be carefully chosen and kept to less than 75 mg/kg/day. In addition, acetaminophen is a frequent component in many over-the-counter and prescription combinations with decongestants and/or antihistamines for cold and allergy symptoms, or as a sleeping aid and with other analgesics (such as oxycodone, hydrocodone, dilaudid and codeine) for moderate-to-severe forms of pain.

Brands

Common products in the United States include: Tylenol-PM, Nyquil, Darvocet, Vicodin, and many others.

Sales

Acetaminophen is one of the most commonly used medications in the United States and more than 25 billion doses are sold yearly.

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