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Acetaminophen
Easier Dosing
Rose Ann Gould
Soloway
The Bottom Line
Acetaminophen is a
very safe medicine when used in recommended doses to treat pain and fever.
But too much
acetaminophen can cause liver damage and even death.
This has happened
when parents didn't understand the concentration or measurements.
New formulations of
acetaminophen for children make it easier to give the correct dose.
The Full Story
Beginning in the
fall of 2011, acetaminophen products (such as Tylenol®) for infants
and children contained exactly the same concentration, instead of two different
concentrations.
Products labeled
for infants include a dosing syringe; products for children contain a measuring
cup.
Markings on the
syringes and cups match up to the doses recommended on the label.
These changes were
made for several reasons.
Without meaning to,
many parents gave their children the wrong dose because they confused infants'
acetaminophen and children's acetaminophen.
Both liquids
contained the same ingredient, but in different concentrations; the infant
product was more concentrated.
Also, measuring
devices didn't always contain the same markings recommended on the product
label.
For example,
"one teaspoon" is the same as "5 ml [milliliters]", but
most people don't know that.
If the markings
didn't match, parents would often use household spoons to measure the medicine
– but household spoons are NOT the same as measuring spoons for medicines.
This confusion can
be dangerous for children.
Acetaminophen is a
very safe medicine when used in recommended doses to treat pain and fever. But
too much acetaminophen can cause liver damage and even death.
This has happened
when parents didn't understand the concentration or measurements. It was
especially dangerous when children were treated with too much acetaminophen
over a period of days.
It's important to
read the label carefully when giving medicine, including liquid acetaminophen.
NEVER measure a
dose without checking the label first. Use the right dose for your child's age
and weight.
If you already have
a bottle of infants' or children's acetaminophen, continue to use it according
to label instructions, unless it is past its expiration date.
As the new packages
become available, older ones will be removed from drugstore shelves.
This Really
Happened
A mother gave her 2-year-old daughter
her regular dose of acetaminophen, 1 teaspoon (5mL), but didn't realize that
she was using a more concentrated version.
The more concentrated version
contained 500 mg instead of 160 mg in each teaspoon. The child received more
than three times her usual dose.
The poison specialist calculated the
amount of acetaminophen given compared to the child's body weight.
Fortunately, this overdose was not
dangerous. The poison specialist recommended waiting for 8 hours before giving
the next dose, instead of 4-6 hours.
That would give the excess
acetaminophen time to be metabolized.
If you have a question about the
right drug or right dose for your child, ask your health care provider. If you
think you've given (or taken) too much acetaminophen, use the webPOISONCONTROL® online
tool for guidance or call Poison Control right away at 1-800-222-1222. webPOISONCONTROL and
the poison specialists are available 24 hours a day to tell you exactly what
you should do.
Rose Ann Gould Soloway, RN, BSN, MSEd,
DABAT emerita
Clinical Toxicologist
Clinical Toxicologist
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