FDA label 67fa9f02-43dd-4d80-80b0-332bb5a83a24

openFDA label record#

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Verified complete openFDA source JSON (canonical bytes are SHA-256 checked before publication)

SPL set ID
046bfc2d-2eb7-4fd1-89b6-ea12db592458
SPL ID
67fa9f02-43dd-4d80-80b0-332bb5a83a24
Version
7
Effective date
2019-01-25
Source export date
2026-10-12
Source partition
6
Source file
https://download.open.fda.gov/drug/label/drug-label-0006-of-0014.json.zip
Source object key
raw/openfda/drug-label/2026-10-12/b25dad4aaef9c88f0e827394a34fbbd1ce7d71422fa46b5d1e123befad498c1d/drug-label-0006-of-0014.json.zip
Source manifest SHA-256
7e6b178df8f32cac9a78e0f5d09c588344509b04fe41effb1dde9102e2a45be6
Import run
20261013T011858Z
Imported at
2026-10-13 01:49:24

Boxed warning cross-check#

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boxed warning

WARNING: Risk of Medication Errors and Hepatotoxicity Take care when prescribing, preparing, and administering OFIRMEV Injection to avoid dosing errors which could result in accidental overdose and death. In particular, be careful to ensure that: • the dose in milligrams (mg) and milliliters (mL) is not confused; • the dosing is based on weight for patients under 50 kg; • infusion pumps are properly programmed; and • the total daily dose of acetaminophen from all sources does not exceed maximum daily limits. OFIRMEV contains acetaminophen. Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed the maximum daily limits, and often involve more than one acetaminophen-containing product [see Warnings and Precautions ( 5.1 )] . WARNING: RISK OF MEDICATION ERRORS AND HEPATOTOXICITY See full prescribing information for complete boxed warning Take care when prescribing, preparing, and administering OFIRMEV Injection to avoid dosing errors which could result in accidental overdose and death. OFIRMEV contains acetaminophen. Acetaminophen has been associated with cases of acute liver failure, at times resulting in liver transplant and death. Most of the cases of liver injury are associated with the use of acetaminophen at doses that exceed the recommended maximum daily limits, and often involve more than one acetaminophen-containing product ( 5.1 ).

Warnings cross-check#

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warnings and cautions

5 WARNINGS AND PRECAUTIONS • Administration of acetaminophen in doses higher than recommended (by all routes of administration and from all acetaminophen-containing products including combination products) may result in hepatic injury, including the risk of liver failure and death. ( 5.1 ) • Do not exceed the maximum recommended daily dose of acetaminophen (by all routes of administration and all acetaminophen-containing products including combination products). ( 5.1 ) • Take care when prescribing, preparing, and administering OFIRMEV injection to avoid dosing errors which could result in accidental overdose and death. ( 5.3 ) • Use caution when administering acetaminophen in patients with the following conditions: hepatic impairment or active hepatic disease, in cases of alcoholism, chronic malnutrition, severe hypovolemia, or severe renal impairment (creatinine clearance ≤ 30 mL/min). ( 5.1 ) • Discontinue OFIRMEV immediately at the first appearance of skin rash and if symptoms associated with allergy or hypersensitivity occur. Do not use in patients with acetaminophen allergy. ( 5.2 , 5.4 ) 5.1 Hepatic Injury Administration of acetaminophen in doses higher than recommended may result in hepatic injury, including the risk of liver failure and death [ see OVERDOSAGE ( 10 ) ]. Do not exceed the maximum recommended daily dose of acetaminophen [ see DOSAGE AND ADMINISTRATION ( 2 ) ]. The maximum recommended daily dose of acetaminophen includes all routes of acetaminophen administration and all acetaminophen-containing products administered, including combination products. Use caution when administering acetaminophen in patients with the following conditions: hepatic impairment or active hepatic disease, alcoholism, chronic malnutrition, severe hypovolemia (e.g., due to dehydration or blood loss), or severe renal impairment (creatinine clearance ≤ 30 mL/min) [ see USE IN SPECIFIC POPULATIONS ( 8.6 , 8.7 ) ]. 5.2 Serious Skin Reactions Rarely, acetaminophen may cause serious skin reactions such as acute generalized exanthematous pustulosis (AGEP), Stevens-Johnson Syndrome (SJS), and toxic epidermal necrolysis (TEN), which can be fatal. Patients should be informed about the signs of serious skin reactions, and use of the drug should be discontinued at the first appearance of skin rash or any other sign of hypersensitivity. 5.3 Risk of Medication Errors Take care when prescribing, preparing, and administering OFIRMEV (acetaminophen) Injection in order to avoid dosing errors which could result in accidental overdose and death. In particular, be careful to ensure that: • the dose in milligrams (mg) and milliliters (mL) is not confused; • the dosing is based on weight for patients under 50 kg; • infusion pumps are properly programmed; and • the total daily dose of acetaminophen from all sources does not exceed maximum daily limits [see DOSAGE AND ADMINISTRATION ( 2 )]. 5.4 Allergy and Hypersensitivity There have been post-marketing reports of hypersensitivity and anaphylaxis associated with the use of acetaminophen. Clinical signs included swelling of the face, mouth, and throat, respiratory distress, urticaria, rash, and pruritus. There were infrequent reports of life-threatening anaphylaxis requiring emergent medical attention. Discontinue OFIRMEV immediately if symptoms associated with allergy or hypersensitivity occur. Do not use OFIRMEV in patients with acetaminophen allergy.

Adverse reactions cross-check#

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adverse reactions

6 ADVERSE REACTIONS The following serious adverse reactions are discussed elsewhere in the labeling: • Hepatic Injury [ see WARNINGS AND PRECAUTIONS ( 5.1 ) ] • Serious Skin Reactions [ see WARNINGS AND PRECAUTIONS ( 5.2 ) ] • Allergy and Hypersensitivity [ see WARNINGS AND PRECAUTIONS ( 5.4 ) ] The most common adverse reactions in patients treated with OFIRMEV were nausea, vomiting, headache, and insomnia in adult patients and nausea, vomiting, constipation, pruritus, agitation, and atelectasis in pediatric patients. ( 6.1 ) To report SUSPECTED ADVERSE REACTIONS, contact Mallinckrodt Hospital Products Inc. at 1-800-778-7898 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. 6.1 Clinical Trial Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed cannot be directly compared to rates in other clinical trials and may not reflect the rates observed in practice. Adult Population A total of 1020 adult patients have received OFIRMEV in clinical trials, including 37.3% (n=380) who received 5 or more doses, and 17.0% (n=173) who received more than 10 doses. Most patients were treated with OFIRMEV 1000 mg every 6 hours. A total of 13.1% (n=134) received OFIRMEV 650 mg every 4 hours. All adverse reactions that occurred in adult patients treated with either OFIRMEV or placebo in repeated dose, placebo-controlled clinical trials at an incidence ≥ 3% and at a greater frequency than placebo are listed in Table 3. The most common adverse events in adult patients treated with OFIRMEV (incidence ≥ 5% and greater than placebo) were nausea, vomiting, headache, and insomnia. Table 3. Treatment-Emergent Adverse Reactions Occurring ≥ 3% of OFIRMEV-treated Patients and at a greater frequency than Placebo in Placebo-Controlled, Repeated Dose Studies System Organ Class – Preferred Term OFIRMEV (N=402) n (%) Placebo (N=379) n (%) Gastrointestinal Disorders Nausea Vomiting 138 (34) 62 (15) 119 (31) 42 (11) General Disorders and Administration Site Conditions Pyrexia* 22 (5) 52 (14) Nervous System Disorders Headache 39 (10) 33 (9) Psychiatric Disorders Insomnia 30 (7) 21 (5) Other Adverse Reactions Observed During Clinical Studies of OFIRMEV in Adults The following additional treatment-emergent adverse reactions were reported by adult subjects treated with OFIRMEV in all clinical trials (n=1020) that occurred with an incidence of at least 1% and at a frequency greater than placebo (n=525). Blood and lymphatic system disorders : anemia General disorders and administration site conditions : fatigue, infusion site pain, edema peripheral Investigations : aspartate aminotransferase increased, breath sounds abnormal Metabolism and nutrition disorders : hypokalemia Musculoskeletal and connective tissue disorders : muscle spasms, trismus Psychiatric disorders : anxiety Respiratory, thoracic and mediastinal disorders : dyspnea Vascular disorders : hypertension, hypotension Pediatric Population A total of 355 pediatric patients (47 neonates, 64 infants, 171 children, and 73 adolescents) have received OFIRMEV in active-controlled (n=250) and open-label clinical trials (n=225), including 59.7% (n=212) who received 5 or more doses and 43.1% (n=153) who received more than 10 doses. Pediatric patients received OFIRMEV doses up to 15 mg/kg on an every 4 hours, every 6 hours, or every 8 hours schedule. The maximum exposure was 7.7, 6.4, 6.8, and 7.1 days in neonates, infants, children, and adolescents, respectively. The most common adverse events (incidence ≥ 5%) in pediatric patients treated with OFIRMEV were nausea, vomiting, constipation, pruritus, agitation, and atelectasis. Other Adverse Reactions Observed During Clinical Studies of OFIRMEV in Pediatrics The following additional treatment-emergent adverse reactions were reported by pediatric subjects treated with OFIRMEV (n=355) that occurred with an incidence of at least 1%. Blood and lymphatic system disorders : anemia Cardiac disorders : tachycardia Gastrointestinal disorders : abdominal pain, diarrhea General disorders and administration site conditions : injection site pain, edema peripheral, pyrexia Investigations : hepatic enzyme increase Metabolism and nutrition disorders : hypoalbuminemia, hypokalemia, hypomagnesemia, hypophosphatemia, hypervolemia Musculoskeletal and connective tissue disorders : muscle spasm, pain in extremity Nervous system disorders : headache Psychiatric disorders : insomnia Renal and urinary disorders : oliguria Respiratory, thoracic and mediastinal disorders : pulmonary edema, hypoxia, pleural effusion, stridor, wheezing Skin and subcutaneous tissue disorders : periorbital edema, rash Vascular disorders : hypertension, hypotension

adverse reactions table

<table ID="_RefID0EUHAE" width="100%"> <caption>Table 3. Treatment-Emergent Adverse Reactions Occurring &#x2265; 3% of OFIRMEV-treated Patients and at a greater frequency than Placebo in Placebo-Controlled, Repeated Dose Studies</caption> <col width="57%"/> <col width="24%"/> <col width="19%"/> <tbody> <tr> <td styleCode="Rrule Botrule Lrule Toprule " valign="top"> <paragraph> <content styleCode="bold">System Organ Class &#x2013; Preferred Term</content> </paragraph> </td> <td align="center" styleCode="Rrule Botrule Toprule " valign="top"> <paragraph> <content styleCode="bold">OFIRMEV</content> <content styleCode="bold">(N=402)</content> <content styleCode="bold">n (%)</content> </paragraph> </td> <td align="center" styleCode="Rrule Botrule Toprule " valign="top"> <paragraph> <content styleCode="bold">Placebo</content> <content styleCode="bold">(N=379)</content> <content styleCode="bold">n (%)</content> </paragraph> </td> </tr> <tr> <td styleCode="Rrule Lrule Botrule " valign="bottom"> <paragraph> <content styleCode="bold">Gastrointestinal Disorders</content> Nausea Vomiting</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 138 (34) 62 (15)</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 119 (31) 42 (11)</paragraph> </td> </tr> <tr> <td styleCode="Rrule Lrule Botrule " valign="bottom"> <paragraph> <content styleCode="bold">General Disorders and Administration Site Conditions</content> Pyrexia*</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 22 (5)</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 52 (14)</paragraph> </td> </tr> <tr> <td styleCode="Rrule Lrule Botrule " valign="bottom"> <paragraph> <content styleCode="bold">Nervous System Disorders</content> Headache</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 39 (10)</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 33 (9)</paragraph> </td> </tr> <tr> <td styleCode="Rrule Botrule Lrule " valign="bottom"> <paragraph> <content styleCode="bold">Psychiatric Disorders</content> Insomnia</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 30 (7)</paragraph> </td> <td align="center" styleCode="Rrule Botrule " valign="bottom"> <paragraph> 21 (5)</paragraph> </td> </tr> </tbody> </table>

Reported adverse events (FAERS/openFDA)#

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