Acetaminophen, IV

Provider Level

AEMT/RN/Paramedic

Class

Analgesic, Antipyretic

Mechanism of Action

The precise mechanism is not fully established but is thought to primarily involve central actions resulting in analgesic and antipyretic effects.

Indications

• Mild to moderate acute pain • Adjunct for severe pain in a multimodal approach • Symptomatic pyrexia/fever

Contraindications

• Known hypersensitivity to acetaminophen or any excipients • Severe hepatic impairment or severe active liver disease

Routes

Intravenous (IV) infusion

Onset / Duration

Onset: 10 to 15 minutes. Duration: 4 to 6 hours.

Adverse Effects

• Hepatic injury (dose-related) • Nausea and vomiting • Headache • Insomnia

Precautions & Interactions

• Calculate total daily acetaminophen from all sources (PO, PR, IV) to avoid toxicity. • Use caution and consider reduced total daily dose (e.g., 2000 mg max) in patients with mild/moderate hepatic impairment, severe renal impairment, chronic alcoholism, or malnutrition.

Special Considerations

• Infuse undiluted over 15 minutes. • Do not add other medications to the acetaminophen bag. • For doses less than 1000 mg, withdraw the appropriate weight-based volume and transfer to a separate empty sterile container to prevent inadvertent overdose.