Literature DB >> 21134123

Safety of multiple-dose intravenous acetaminophen in adult inpatients.

Keith A Candiotti1, Sergio D Bergese, Eugene R Viscusi, Sonia K Singla, Mike A Royal, Neil Kumar Singla.   

Abstract

BACKGROUND: Intravenous (IV) acetaminophen provides rapid and effective analgesia in the postoperative and inpatient settings. The utility and efficacy of acetaminophen is well established; however, due to chronic excessive dosing of over-the-counter acetaminophen products and prescription opioid combination products resulting in the potential for hepatic toxicity, concerns remain about acetaminophen safety. In order to evaluate the safety of IV acetaminophen 1,000mg q6h or 650mg q4h with repeated dosing for 5 days, a randomized, open-label study assessed the safety and tolerability of repeated doses used to treat acute pain or fever in 213 adult inpatients was conducted.
METHODS: Subjects were randomized (3:3:1) to receive IV acetaminophen (1,000mg q6h or 650mg q4h) or standard-of-care treatment for pain or fever. Safety was assessed according to spontaneous reports of adverse events (AEs) and clinically meaningful changes from baseline laboratory parameters.
RESULTS: Overall, IV acetaminophen was shown to be safe and well tolerated in adult inpatients when given as repeated doses for up to 5 days. Owing to the comorbidities in the study population, the frequency of AEs reported was high. However, the majority of treatment-emergent adverse events (TEAEs) were unrelated to treatment, and only 8% of the study population withdrew because of TEAEs. No major hepatic issues associated with IV acetaminophen warranted concern, and most hepatic events were likely related to underlying medical conditions or recent trauma/surgery.
CONCLUSIONS: Consistent with the tolerability and safety results, both treatment groups (1,000mg q6h and 650mg q4h) demonstrated statistically significantly better ratings for the Subject Global Evaluations for the level of satisfaction with side effects related to study treatments as compared with the control group. The findings from this trial support the use of IV acetaminophen as a safe therapy in adult patients. Wiley Periodicals, Inc.

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Year:  2010        PMID: 21134123     DOI: 10.1111/j.1526-4637.2010.00991.x

Source DB:  PubMed          Journal:  Pain Med        ISSN: 1526-2375            Impact factor:   3.750


  9 in total

Review 1.  Intravenous versus Oral Acetaminophen for Pain: Systematic Review of Current Evidence to Support Clinical Decision-Making.

Authors:  Farah Jibril; Sherif Sharaby; Ahmed Mohamed; Kyle J Wilby
Journal:  Can J Hosp Pharm       Date:  2015 May-Jun

2.  Use of Intravenous Paracetamol Preoperatively Favors Lower Risk of Delirium and Functional Recovery in Elderly Patients with Hip Fracture: A Propensity Score-Matched Analysis.

Authors:  Junfei Guo; Tao Wang; Xuehong Zheng; Yubin Long; Xin Wang; Qi Zhang; Junchuan Liu; Guolei Zhang; Junpu Zha; Zhiyong Hou; Yingze Zhang
Journal:  Pain Res Manag       Date:  2022-04-13       Impact factor: 2.667

Review 3.  Intravenous non-opioid analgesia for peri- and postoperative pain management: a scientific review of intravenous acetaminophen and ibuprofen.

Authors:  Wonuk Koh; Kimngan Pham Nguyen; Jonathan S Jahr
Journal:  Korean J Anesthesiol       Date:  2015-01-28

Review 4.  The utility of intravenous acetaminophen in the perioperative period.

Authors:  Jason B O'Neal
Journal:  Front Public Health       Date:  2013-08-06

5.  The intraocular pressure-lowering properties of intravenous paracetamol.

Authors:  Henning van den Heever; David Meyer
Journal:  Clin Ophthalmol       Date:  2016-07-13

6.  Adverse effect profile comparison of pain regimens with and without intravenous acetaminophen in total hip and knee arthroplasty patients.

Authors:  Alyssa Gallipani; A Scott Mathis; Hoytin Lee Ghin; Germin Fahim
Journal:  SAGE Open Med       Date:  2017-03-17

Review 7.  Pain in Intensive Care: A Narrative Review.

Authors:  Vincenzo Pota; Francesco Coppolino; Alfonso Barbarisi; Maria Beatrice Passavanti; Caterina Aurilio; Pasquale Sansone; Maria Caterina Pace
Journal:  Pain Ther       Date:  2022-02-27

Review 8.  Predicting, preventing, and identifying delirium after cardiac surgery.

Authors:  Jason B O'Neal; Andrew D Shaw
Journal:  Perioper Med (Lond)       Date:  2016-04-26

Review 9.  Assessment and Early Management of Pain in Hip Fractures: The Impact of Paracetamol.

Authors:  Ján Dixon; Fiona Ashton; Paul Baker; Karl Charlton; Charlotte Bates; William Eardley
Journal:  Geriatr Orthop Surg Rehabil       Date:  2018-10-25
  9 in total

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