Acetaminophen, a widely used over-the-counter medication, is a versatile and effective analgesic and antipyretic drug. It provides relief from pain and helps reduce fever, making it a household staple for many. Understanding the various dosage forms and strengths of acetaminophen is crucial for safe and effective use.
This medication is available in multiple forms, including infant drops, oral tablets, chewable tablets, intravenous injections, dissolved packets, oral suspensions, and rectal suppositories.
In this introduction, we will explore the different dosage options and strengths of acetaminophen, ensuring you have the knowledge needed for responsible and accurate dosing.
Acetaminophen Adult Tablet Dose for Pain and Fever
For adults and adolescents aged 12 years and older who weigh 96 pounds or more, it is advised to take 8 tablets of Acetaminophen Chewable Tablets (80 mg) or 4 tablets of Acetaminophen Chewable Tablets (160 mg) every 4-6 hours.
For those in the same age group, but with a lower body weight, taking 2 tablets of Acetaminophen Tablets (325 mg) or 2 tablets of Acetaminophen Tablets (500 mg) every 4-6 hours is recommended. Additionally, for those weighing 96 pounds or more, taking 2 tablets of Acetaminophen Tablets (650 mg) or 1 tablet of Acetaminophen Tablets (1000 mg) every 8 hours is the suggested dosing regimen.
The max daily dose is 4000 mg/day and the course duration is to be determined by a healthcare professional.
| Weight | Age | Acetaminophen Chewable tablets(80 mg) | Acetaminophen Chewable tablets(160 mg) | Acetaminophen tablets(325 mg) | Acetaminophen tablets(500 mg) | Acetaminophen tablets(650 mg) | Acetaminophen tablets(1000 mg) |
| 96 lbs or more | Adults(12 years and older) | 8 Tablets every 4-6 hours | 4 Tablets every 4-6 hours | 2 Tablets every 4-6 hours | 2 Tablet every 6 hours | 2 Tablets every 8 hours | 1 Tablets every 8 hours |
Acetaminophen Adult Oral Suspension for Pain and Fever
The dosing recommendations for this medication take into account both weight and age factors. For adults and individuals aged 12 years and older, with a weight of 96 pounds or more, the recommended dosage is 20 mL .
The dosing frequency is every 4 to 6 hours as needed, with a maximum of four doses within a 24-hour period, and the course duration is to be determined by a healthcare professional.
| Weight | Age | Dosage Strength (160 mg/5 mL) | Dosage Frequency | Max Daily Dose | Course Duration |
| 96 lbs or more | Adults(12 years and older) | 20 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
Acetaminophen Adult Suppository (Rectal Use Only) for Pain and Fever
For individuals weighing 96 pounds or more and aged 12 years and older, the typical dosage for this particular medication falls within the range of 325-650 mg. Maximum dose: 3900 mg per 24 hours. The maximum recommended daily dose of Acetaminophen for adults when administered as a suppository for pain and fever relief is 3900 mg over a 24-hour period.
| Weight | Age | Dosage Strength | Dosage Frequency | Max Daily Dose | Course Duration |
| 96 lbs or more | 12 years and Older | 325-650 mg | Every 4 to 6 hours as needed | 4 g/day | Determined by healthcare professional |
Acetaminophen Adult Intravenous (IV) Injection for Pain and Fever
For Individuals Weighing 50 kg or More: If the patient’s weight is 50 kg or greater, the recommended dosage for Acetaminophen when administered intravenously (IV) is 1000 mg every 6 hours. Alternatively, the patient can receive 650 mg IV every 4 hours. The maximum single dose should not exceed 1000 mg, and the minimum dosing interval should be no less than every 4 hours. The maximum allowable dose over a 24-hour period is 4000 mg.
For Individuals Weighing Less than 50 kg: For patients whose weight falls below 50 kg, the recommended IV dosage of Acetaminophen is based on weight. They should receive 15 mg per kilogram (kg) every 6 hours or 12.5 mg per kilogram every 4 hours. The maximum single dose should not exceed 15 mg per kilogram, and the minimum dosing interval should be every 4 hours. The total maximum dose allowed within a 24-hour period is 75 mg per kilogram.
It is essential to calculate and verify the dose both in milligrams (mg) and milliliters (mL) to ensure the accuracy of the administration. Additionally, it’s vital to confirm that infusion pumps are correctly programmed to maintain patient safety.
| Weight | Dosage | Minimum Dosing Interval | Maximum Single Dose | Maximum Dose per 24 Hours |
| 110 lbs or greater | 1000 mg IV every 6 hours OR 650 mg IV | Every 4 hours | 1000 mg | 4000 mg |
| Less than 110 lbs | 15 mg/kg IV every 6 hours OR 12.5 mg/kg IV | Every 4 hours | 15 mg/kg | 75 mg/kg |
Acetaminophen Pediatric Tablet Dose for Pain and Fever
The dosage recommendations for Acetaminophen, available in various forms such as Chewable Tablets and regular Tablets, are based on body weight and age.
For individuals weighing between 72-95 pounds and aged 11 years, it is suggested to take 6 Chewable Tablets of Acetaminophen (80 mg), or 3 Chewable Tablets of Acetaminophen (100 mg), or 3 Chewable Tablets of Acetaminophen (160 mg) every 4-6 hours. For the same weight range and age group, 1 1/2 Tablets of Acetaminophen (325 mg) or 1 Tablet of Acetaminophen (500 mg) every 4-6 hours is the recommended dosage.
If the weight falls between 60-71 pounds, and the individual is 9-10 years old, it is advisable to take 5 Chewable Tablets of Acetaminophen (80 mg), or 2 1/2 Chewable Tablets of Acetaminophen (100 mg), or 2 1/2 Chewable Tablets of Acetaminophen (160 mg) every 4-6 hours.
For a weight range of 48-95 pounds and an age of 6-8 years, the recommended dosage includes 4 Chewable Tablets of Acetaminophen (80 mg) every, 2 Chewable Tablets of Acetaminophen (100 mg), and 2 Chewable Tablets of Acetaminophen (160 mg) every 4-6 hours.
Children weighing 36-47 pounds and aged 4-5 years should take 3 Chewable Tablets of Acetaminophen (80 mg), 1 1/2 Chewable Tablets of Acetaminophen (100 mg) and 1 1/2 Chewable Tablets of Acetaminophen (160 mg) every 4-6 hours.
If the child’s weight ranges from 24-35 pounds and they are 2-3 years old, the recommended dosage is 2 Chewable Tablets of Acetaminophen (80 mg) , 1 Chewable Tablet of Acetaminophen (100 mg), and 1 Chewable Tablet of Acetaminophen (160 mg) every 4-6 hours.
For children weighing 18-23 pounds and aged 12-23 months, it is suggested to take 1 1/2 Chewable Tablets of Acetaminophen (80 mg) every 4-6 hours.
| Weight | Age | Acetaminophen Chewabletablets(80 mg) | Acetaminophen Chewabletablets(100 mg) | Acetaminophen Chewabletablets(160 mg) | Acetaminophen tablets(325 mg) | Acetaminophen tablets(500 mg) |
| 72-95 lbs | 11 years | 6 Tablets every 4-6 hours | 3 Tablets every 4-6 hours | 3 Tablets every 4-6 hours | 1 1/2 Tablets every 4-6 hours | 1 Tablet every 4-6 hours |
| 60-71lbs | 9-10 years | 5 Tablets every 4-6 hours | 2 1/2 Tablets every 4-6 hours | 2 1/2 Tablets every 4-6 hours | – | – |
| 48-95 lbs | 6-8 years | 4 Tablets every 4-6 hours | 2 Tablets every 4-6 hours | 2 Tablets every 4-6 hours | – | – |
| 36-47 lbs | 4-5 years | 3 Tablets every 4-6 hours | 1 1/2 Tablets every 4-6 hours | 1 1/2 Tablets every 4-6 hours | – | – |
| 24-35 lbs | 2-3 years | 2 Tablets every 4-6 hours | 1 Tablet every 4-6 hours | 1 Tablet every 4-6 hours | – | – |
| 18-23 lbs | 12-23 months | 1 1/2 Tablets every 4-6 hours | – | – | – | – |
Acetaminophen Pediatric Oral Suspension for Pain and Fever
Children aged 11 years, weighing between 72 and 95 pounds, are advised to take 15 mL of the medication. Similarly, for children aged 9-10 years and weighing 60-71 pounds, the recommended dosage is 12.5 mL.
Children in the 6-8-year age group, weighing 48-95 pounds, are advised to take 10 mL.
For children aged 4-5 years, with a weight of 36-47 pounds, the recommended dosage is 7.5 mL. Lastly, for children aged 2-3 years and weighing 24-35 pounds, the advised dosage is 5 mL.
The dosing frequency is every 4 to 6 hours as needed, with a maximum of four doses within a 24-hour period, and the course duration is to be determined by a healthcare professional.
Always consult with a healthcare professional for precise dosing recommendations to ensure the safe and effective use of this medication across different age and weight categories.
| Weight | Age | Dosage Strength (160 mg/5 mL) | Dosage Frequency | Max Daily Dose | Course Duration |
| 72-95 lbs | 11 years | 15 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
| 60-71lbs | 9-10 years | 12.5 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
| 48-95 lbs | 6-8 years | 10 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
| 36-47 lbs | 4-5 years | 7.5 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
| 24-35 lbs | 2-3 years | 5 mL | Every 4 to 6 hours as needed | 4 Dose in 24 hours | Determined by healthcare professional |
Acetaminophen Pediatric Infant Drop for Pain and Fever
In the case of acetaminophen drops, the dosage is determined based on the patient’s weight, age, and the specific formulation. The dosing instructions are as follows:
For children weighing 36-47 pounds and aged 4-5 years, the dosage consists of 3 droppers. For those weighing 24-35 pounds and aged 2-3 years, the recommended dosage comprises 2 droppers (2.5 mL) or 2 droppers (80 mg/0.8 mL).
Children weighing 18-23 pounds, aged 12-23 months, should be given 1½ droppers (1.875 mL) of acetaminophen drops or 1½ droppers (80 mg/1.2 mL). For those weighing 12-17 pounds and aged 4-11 months, the recommended dosage is 1 dropper (1.25 mL) or 1 dropper (80 mg/0.8 mL).
In the case of infants weighing 9-11 pounds and aged 3-4 months, the dosage consists of 3/4 dropper (0.6 mL) of acetaminophen drops to be taken every 4 to 6 hours as needed.
For the youngest group, weighing 6-8 pounds and aged 0-3 months, the recommended dosage is 1/2 dropper (0.4 mL) of acetaminophen drops.
The Dose is administered every 4 to 6 hours as needed. As always, it is essential to consult with a healthcare professional for precise dosing recommendations and course duration to ensure the safe and effective use of acetaminophen drops for children of different age and weight categories.
| Weight | Age | Acetaminophen Drops (50 mg/1.25 mL) | Acetaminophen Drops (80 mg/0.8 mL) | Dosage Frequency | Course Duration |
| 36-47 lbs | 4-5 years | – | 3 droppers | Every 4 to 6 hours as needed | Determined by healthcare professional |
| 24-35 lbs | 2-3 years | (2.5 mL)2 droppers | 2 droppers | Every 4 to 6 hours as needed | Determined by healthcare professional |
| 18-23 lbs | 12-23 months | (1.875 mL) 1½ dropper | (1.2 mL) 1½ dropper | Every 4 to 6 hours as needed | Determined by healthcare professional |
| 12-17 lbs | 4-11 months | (1.25 mL) 1 dropper | (0.8 mL) 1 dropper | Every 4 to 6 hours as needed | Determined by healthcare professional |
| 9-11 lbs | 3-4 months | – | (0.6 mL) 3/4 dropper | Every 4 to 6 hours as needed | aDetermined by healthcare professional |
| 6-8 lbs | 0-3 months | – | (0.4 mL) ½ dropper | Every 4 to 6 hours as needed | Determined by healthcare professional |
Acetaminophen Pediatric Dissolvable Packets (160mg /Powder Pack) for Pain and Fever
For individuals weighing 72-95 pounds and aged 11 years, the recommended dosage consists of 160 mg per powder pack. This should be taken every 4 to 6 hours as needed, with a maximum daily allowance of 3 packets.
For children falling within the 60-71 pound weight range, aged 9-10 years, the advised dosage is 160 mg per powder pack. The dosing frequency remains the same, every 4 to 6 hours as needed, with a maximum daily dose of 2 packets.
Similarly, for those weighing 48-59 pounds and aged 6-8 years, the recommended dosage comprises 160 mg per powder pack. This should also be taken every 4 to 6 hours as needed, with a maximum daily allowance of 2 packets.
As always, the exact course duration should be determined by a healthcare professional, ensuring that the medication is administered safely and effectively.
| Weight | Age | Dosage Strength | Dosage Frequency | Max Daily Dose | Course Duration |
| 72-95 lbs | 11 years | 160 mg/ powder pack | Every 4 to 6 hours as needed | 3 packets | Determined by healthcare professional |
| 60-71 lbs | 9-10 years | 160 mg/ powder pack | Every 4 to 6 hours as needed | 2 packets | Determined by healthcare professional |
| 48-59 lbs | 6-8 years | 160 mg/ powder pack | Every 4 to 6 hours as needed | 2 packets | Determined by healthcare professional |
Acetaminophen Pediatric Suppository (Rectal Use Only) for Pain and Fever
For children aged 6 to 11 months, the recommended rectal dosage of Acetaminophen is 80 mg every 6 hours, with a maximum limit of 4 doses within a 24-hour period.
Children between 12 to 36 months of age can receive 80 mg rectally every 4 to 6 hours, and it is safe to administer up to a maximum of 5 doses in 24 hours.
In the age group of 3 to 6 years, the recommended dosage is 120 mg rectally every 4 to 6 hours, with a maximum allowance of 5 doses in a 24-hour period. For children aged 6 to 12 years, the appropriate dosage is 325 mg rectally every 4 to 6 hours, and it’s safe to have up to 5 doses in a 24-hour window.
Children aged 12 years or older can be administered 650 mg rectally every 4 to 6 hours, with a maximum limit of 6 doses in a 24-hour period.
It’s important to follow these recommended dosages carefully to ensure the safe and effective use of the medication, and as always, consult a healthcare professional for personalized guidance.
| Weight | Age | Dosage | Frequency | Maximum Doses in 24 Hours |
| 12-17 lbs | 6-11 months | 80 mg | Every 6 hours | 4 doses |
| 18-23 lbs | 12-36 months | 80 mg | Every 4 to 6 hours | 5 doses |
| 36-47 lbs | 3- 6 years | 120 mg | Every 4 to 6 hours | 5 doses |
| 48-95 lbs | 6- 12 years | 325 mg | Every 4 to 6 hours | 5 doses |
| 96 lbs or more | 12 years or older | 650 mg | Every 4 to 6 hours | 6 doses |
Acetaminophen Pediatric Intravenous (IV) Injection for Pain
For patients aged 2 to 12 years, the recommended dosage of acetaminophen is weight-based, with options for either 12.5 mg/kg intravenously (IV) every 4 hours or 15 mg/kg IV every 6 hours. The maximum single dose should not exceed 15 mg/kg or 750 mg, with a minimum dosing interval of every 4 hours. The total maximum daily dose is 75 mg/kg within a 24-hour period, not to exceed 3750 mg.
For individuals aged 13 years or older, weighing less than 50 kg, the suggested IV dosage is also weight-based, with choices of 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours. The maximum single dose remains at 15 mg/kg or 750 mg, and the minimum dosing interval is every 4 hours. The maximum daily dose is the same as for the previous group, at 75 mg/kg within 24 hours, not exceeding 3750 mg.
For those aged 13 years or older and weighing 50 kg or more, the recommended IV dosage is fixed at 650 mg every 4 hours or 1000 mg every 6 hours, with a maximum single dose of 1000 mg and a minimum dosing interval of every 4 hours. The maximum daily dose is 4000 mg within a 24-hour period. These dosage guidelines are crucial to ensure the safe and effective use of acetaminophen. Always consult with a healthcare professional for personalized recommendations.
| Weight | Age | Dosage | Maximum Single Dose | Minimum Dosing Interval | Maximum Daily Dose (24 hours) |
| 36-96 lbs | 2 -12 years | 12.5 mg/kg IV or 15 mg/kg IV | 15 mg/kg; not to exceed 750 mg | Every 4 hours | 75 mg/kg in 24 hours; not to exceed 3750 mg |
| Less than 110 lbs | 13 years or more | 12.5 mg/kg IV or 15 mg/kg IV | 15 mg/kg; not to exceed 750 mg | Every 4 hours | 75 mg/kg in 24 hours; not to exceed 3750 mg |
| More than 110 lbs | 13 years or more | 650 mg IV or 1000 mg IV | 1000 mg | Every 4 hours | 4000 mg in 24 hours |
Acetaminophen Pediatric Intravenous (IV) Injection for Fever
For neonates, including premature neonates born at 32 weeks gestational age or later, up to 28 days chronological age, the recommended intravenous (IV) dosage is 12.5 mg/kg every 6 hours, with a minimum dosing interval of 6 hours and a maximum daily dose not exceeding 50 mg/kg per day.
For infants aged 29 days to 2 years, the suggested IV dosage is 15 mg/kg every 6 hours, with the same minimum dosing interval of 6 hours, and the maximum daily dose is limited to 60 mg/kg per day.
Children aged 2 to 12 years can receive either 12.5 mg/kg IV every 4 hours or 15 mg/kg IV every 6 hours, with a maximum single dose of 15 mg/kg, not to exceed 750 mg. The minimum dosing interval is every 4 hours, and the maximum daily dose should not exceed 75 mg/kg within a 24-hour period, not exceeding 3750 mg in total.
For individuals aged 13 years or older weighing less than 50 kg, the recommended IV dosage is 12.5 mg/kg every 4 hours or 15 mg/kg every 6 hours, with a maximum single dose of 15 mg/kg, not to exceed 750 mg. The minimum dosing interval remains every 4 hours, and the maximum daily dose is set at 75 mg/kg within a 24-hour period, not exceeding 3750 mg in total.
For individuals aged 13 years or older weighing 50 kg or more, the recommended IV dosage is 650 mg every 4 hours or 1000 mg every 6 hours, with a maximum single dose of 1000 mg. The minimum dosing interval is every 4 hours, and the maximum daily dose is 4000 mg within a 24-hour period. It’s essential to adhere to these recommended dosages to ensure safe and effective use, and consulting a healthcare professional for personalized guidance is advisable.
| Weight | Age | Dosage | Minimum Dosing Interval | Maximum Single Dose | Maximum Daily Dose (24 hours) |
| Upto 2 lbs | Neonates (up to 28 days chronological age) | 12.5 mg/kg IV | Every 6 hours | – | 50 mg/kg/day |
| 6 lbs -23 lbs | 1 Month- 2 years | 15 mg/kg | Every 6 hours | – | 60 mg/kg/day |
| 36- 95 lbs | Age: 2 to 12 years | 12.5 mg/kg IV every 4 hours OR 15 mg/kg IV | Every 4 hours | 15 mg/kg; not to exceed 750 mg | 75 mg/kg in 24 hours; not to exceed 3750 mg |
| Less than 110 lbs | 13 years or more | 12.5 mg/kg IV every 4 hours OR 15 mg/kg IV | Every 4 hours | 15 mg/kg; not to exceed 750 mg | 75 mg/kg in 24 hours; not to exceed 3750 mg |
| More than 110 lbs | 13 years or more | 650 mg IV every 4 hours OR 1000 mg IV | Every 4 hours | 1000 mg | 4000 mg in 24 hours |
Renal Dose Adjustments
In cases of severe renal impairment where the creatinine clearance (CrCl) is less than 30 mL/min, caution should be exercised. It may be necessary to extend the dosing intervals and reduce the total daily dose accordingly.
Liver Dose Adjustments
Parenteral
Severe hepatic impairment and severe active hepatic disease: Usage is not recommended.
Mild to moderate hepatic impairment and mild to moderate active hepatic disease: Exercise caution; a lower total daily dose may be necessary.
For over-the-counter products, the label must include the following warning:
- An adult exceeds the maximum daily dose within a 24-hour period.
- A child consumes more than 5 doses within 24 hours.
- More than 3 alcoholic drinks are ingested per day while using this product.
Dialysis
| Children | Adults | |
| Intermittent hemodialysis or peritoneal dialysis | Administer every 8 hours | No adjustment necessary |
| CRRT | No adjustments necessary | Administer every 8 hours |
Administration Advice
When calculating daily acetaminophen doses, ensure you account for all acetaminophen-containing products and all routes of administration, and do not exceed maximum doses.
For Chewable Tablets
- Chew tablets before swallowing
For Extended-release
- Swallow whole; do not crush, chew, split, or dissolve
For Oral Disintegrating Tablets
- Allow to dissolve in the mouth or chew before swallowing
For Oral Suspension
- Shake well before using.
- Use the enclosed measuring device to accurately measure the dose
For Parenteral (Intravenous)
- Infuse intravenously over 15 minutes.
- Ensure that infusion pumps are properly programmed.
- Monitor the end of the infusion to prevent the possibility of an air embolism, particularly when it is the primary infusion.
For Suppositories
- For rectal use only.
- Remove the wrapper.
- Carefully insert the suppository well up into the rectum.
Precautions
Acetaminophen, a widely used medication, comes with essential precautions and warnings to ensure safe and responsible usage:
US Boxed Warning – Risk of Medication Errors
When prescribing, preparing, or administering IV acetaminophen injection, it is crucial to take precautions to avoid dosing errors that could lead to accidental overdose and severe consequences, including death. Particular care should be taken to:
- Prevent confusion between the dose in milligrams (mg) and milliliters (mL).
- Ensure dosing based on weight for patients under 50 kg.
- Properly program infusion pumps.
- Ensure that the total daily dose of acetaminophen from all sources does not exceed the maximum daily limits.
US Boxed Warning – Hepatotoxicity
Acetaminophen has been associated with cases of acute liver failure, which, in some instances, have resulted in the need for liver transplants and, tragically, death. Most of these cases of liver injury are linked to the use of acetaminophen at doses exceeding the maximum daily limits. Often, they involve the use of more than one acetaminophen-containing product.
US Over the Counter Labeling – Adults Only
For products containing acetaminophen available over the counter, it’s important to note that they are intended for adults only. A severe risk of liver damage is present if any of the following occur:
- Consumption of more than the maximum daily dose within 24 hours.
- Use of the product in combination with other drugs containing acetaminophen.
- Consumption of three or more alcoholic drinks per day while using this product.
US Over the Counter Labeling – Adults and Children Under 12 Years of Age
Similar to the previous point, products containing acetaminophen that are available over the counter are suitable for both adults and children under 12 years of age. However, severe liver damage may occur if:
- An adult takes more than the maximum daily dose within 24 hours.
- A child takes more than five doses within 24 hours.
- The product is used with other drugs containing acetaminophen.
- Individuals consume three or more alcoholic drinks per day while using this product.
