Five-year trends in acetaminophen use exceeding the recommended daily maximum dose

Area of Science:

• Pharmacology
• Public Health
• Medication Safety

Background:

• Acetaminophen (APAP) is a widely used analgesic and antipyretic.
• Exceeding the recommended daily maximum dosage of 4 grams can increase the risk of liver toxicity.
• Understanding temporal trends in high-dose APAP use is crucial for public health initiatives.

Purpose of the Study:

• To evaluate temporal patterns of acetaminophen use exceeding the 4-gram daily maximum dosage over a 5-year period.
• To identify changes in the prevalence and frequency of exceeding labeled APAP dosage recommendations.

Main Methods:

• An online 1-week diary study involving 14,434 adult APAP users.
• Medication identification via list-based prompting, capturing daily APAP use details.
• Programmatic determination of total daily dosage and modeling of prevalence changes over time.

Main Results:

• The overall prevalence of exceeding 4g daily APAP use was 6.3% of users and 3.7% of usage days.
• No significant linear change in the prevalence of exceeding the maximum daily dose was observed over the 5-year study period.
• Odds ratios for exceeding the dose among persons (1.02) and days (0.98) indicated stability.

Conclusions:

• There was no evidence of change in the frequency of acetaminophen use exceeding the labeled maximum daily dose over the recent 5-year period.
• Deviations from label directions remained largely unchanged, with a slight increase in concomitant medication use.
• Findings suggest a persistent pattern of exceeding recommended acetaminophen dosages without significant temporal shifts.