Revisit Acetaminophen Safety

Safe use of acetaminophen will be in the spotlight...as a new 80 mg gummy bite for kids (Dr. Kids Children’s Pain & Fever) hits shelves.

The idea is to reduce dosing issues with liquid forms.

But gummies look and taste like candy...raising concerns about an increased risk for accidental overdoses.

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Acetaminophen overdoses send about 50,000 people to the hospital each year...and are the leading cause of liver failure in the US.

And just four extra strength acetaminophen tabs can cause severe symptoms in kids.

Use this as an opportunity to revisit acetaminophen safety.

Always spell out “acetaminophen”...and avoid using the abbreviation “APAP” on med lists or Rxs. Others may not know what it stands for...and confusion could have serious consequences.

Stay alert for patients getting more than one source of acetaminophen, such as cough/cold meds, sleep aids, or pain meds.

Advise patients to look for products by ingredients...not by brand...to help prevent patients from taking too much acetaminophen.

For instance, patients may not realize the new Motrin Dual Action contains ibuprofen AND acetaminophen...and max doses can be reached quickly if they take other OTC or Rx meds with acetaminophen.

Caution patients about brand name extensions with Tylenol. For instance, people may think the new OTC topical Tylenol Precise contains acetaminophen...but it’s actually lidocaine and menthol.

Reinforce max doses. For instance, tell adults with chronic liver impairment to limit the dose to 2 to 3 g/day...and other adults to limit chronic acetaminophen use to 3 to 4 g/day.

Share tips to limit pediatric dosing errors. For example, counsel to use a recent patient weight to pick a dose...and measure the dose using an appropriate measuring device (oral syringe, etc).

Use Poison Prevention Week in March as an opportunity to encourage proper storage and disposal of acetaminophen products...and all meds...so they don’t accidentally wind up in the wrong hands.

For example, remind parents and caregivers to keep lids on tight and store meds “up, away, and out of sight”...ideally on a high shelf or locked cabinet.

Advise keeping Poison Control’s number (800-222-1222) handy.

See our resource, Analgesics for Acute Pain in Adults, for acetaminophen dosing recommendations and other med options.

Key References

  • Agrawal S, Khazaeni B. Acetaminophen Toxicity. StatPearls. June 9, 2023. https://www.ncbi.nlm.nih.gov/books/NBK441917/ (Accessed January 26, 2024).
  • National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Acetaminophen. January 28, 2016. https://www.ncbi.nlm.nih.gov/books/NBK548162/ (Accessed February 22, 2024).
  • Institute for Safe Medication Practices (ISMP) Canada, ISMP Canada Safety Bulletin. September 7, 2023. https://ismpcanada.ca/bulletin/acetaminophen-related-harm-a-call-for-improved-product-packaging/ (Accessed January 23, 2024).
Pharmacist's Letter. September 2024, No. 400302



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