Last Updated: July 27, 2026

CLINICAL TRIALS PROFILE FOR ACETAMINOPHEN


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505(b)(2) Clinical Trials for Acetaminophen

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed McNeil Consumer & Specialty Pharmaceuticals, a Division of McNeil-PPC, Inc. N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00245375 ↗ A Trial Comparing Combination Therapy of Acetaminophen Plus Ibuprofen Versus Tylenol #3 for the Treatment of Pain After Outpatient Surgery Completed Nova Scotia Health Authority N/A 2005-01-01 Increasingly in general surgery, the investigators are conducting outpatient day surgery. Ambulatory surgery currently comprises 60 to 70% of surgeries performed in North America. These patients all require some form of analgesia which can be taken at home in the first few days after the surgery. The current standard at the investigators' centre and many others in the maritime provinces is to provide a prescription for oral acetaminophen plus codeine or oxycodone (Tylenol #3®, Percocet ®). Some patients may receive more potent opioids such as oral hydromorphone (Dilaudid®). Unfortunately, the most commonly prescribed medication (Tylenol #3®) is often poorly tolerated by patients, has several undesirable side effects, and may not provide effective pain relief. In the investigators' experience, non-steroidal anti-inflammatory drugs (NSAIDs) are uncommonly a routine addition to the home analgesic regimen. Tylenol #3®, in the investigators' experience and opinion, is a poor post surgical pain medication. They hope to show that a combination of ibuprofen and acetaminophen is better for pain relief after these procedures. The combination of acetaminophen and ibuprofen would be a safe, cheap, and readily available regimen. Unfortunately, as the prescribing practices of surgeons are old habits, it will require a very convincing argument to get them to change their practices. A randomized controlled trial comparing these two regimens, the investigators hope, would be a powerful enough argument. The hypothesis of this study, therefore, is that the pain control provided by a combination of acetaminophen plus ibuprofen (650 mg/400 mg four times per day) will be superior to Tylenol #3® (600 mg acetaminophen/60 mg codeine/15 mg caffeine four times per day). This study will attempt to enroll 150 patients in total. Eligible patients will be identified by their attending surgeon and contacted by study personnel. Patients who enroll in the study will undergo their surgery in the usual manner. After the surgery, in the recovery room, once they are ready to go home, they will be randomized to receive combination A or B and be given a week's worth of pain medication. They will then go home and take this medication as directed. They will record their pain intensity and pain relief once per day using a diary provided in the study package. One week after their surgery, they will return to the hospital clinic and be seen by the study nurse. They will hand over the diary and any unused medication. They will also be asked several questions regarding their overall satisfaction, incidence of side effects, and how long until they were pain free. The risks of participating in this study are minimal from the risks inherent to the procedures and medications the patients would receive within the standard of care. Ibuprofen is a commonly used NSAID which is widely available over the counter and has an established safety profile. The most common adverse effects of ibuprofen and other NSAIDs are gastrointestinal bleeding and ulceration. Other less common adverse effects include nephrotoxicity, hypersensitivity reactions, hepatic dysfunction (longterm use), and cognitive dysfunction. The investigators' patients will be selected to exclude those most at risk for these complications (see exclusion criteria). Acetaminophen has few side effects, with no adverse effects on platelet function and no evidence of gastric irritation.
OTC NCT00267293 ↗ Ibuprofen Alone and in Combination With Acetaminophen for Treatment of Fever Completed Children Youth and Family Consortium Phase 4 2006-01-01 Currently, when a child has fever either ibuprofen (e.g. Motrin, Advil) or acetaminophen (e.g. Tylenol) is given. Both Ibuprofen and Acetaminophen are approved for over the counter use for treatment of fever by the Food and Drug Administration (FDA). This study hopes to determine whether giving both medications together is better than giving one medication alone for the treatment of fever.
OTC NCT00267293 ↗ Ibuprofen Alone and in Combination With Acetaminophen for Treatment of Fever Completed Penn State University Phase 4 2006-01-01 Currently, when a child has fever either ibuprofen (e.g. Motrin, Advil) or acetaminophen (e.g. Tylenol) is given. Both Ibuprofen and Acetaminophen are approved for over the counter use for treatment of fever by the Food and Drug Administration (FDA). This study hopes to determine whether giving both medications together is better than giving one medication alone for the treatment of fever.
New Combination NCT00378547 ↗ Effect of Paracetamol, Pregabalin and Dexamethasone on Pain and Opioid Requirements in Patients Having a Tonsillectomy Terminated Glostrup University Hospital, Copenhagen Phase 4 2006-01-01 Patients scheduled for a tonsillectomy need postoperative pain treatment. Some of the most widely used postoperative analgetics (NSAIDs) sometimes cause rebleeding in the postoperative period, and another often used analgetic, morphine, causes nausea and vomiting. The researchers therefore will investigate new combinations of postoperative analgesics in hopes of improving pain and the need for opioids during the postoperative period.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Acetaminophen

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000425 ↗ Toward Better Outcomes in Osteoarthritis Completed National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Phase 3 1996-07-01 This study will determine if there is a difference between commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (a pain-reliever that does not prevent inflammation) for treating knee pain in osteoarthritis (OA). The two main results we will look at are disease progression according to x-rays and disability over 3.5 years. Study participants with moderate knee OA and knee pain will continue taking their NSAID or stop taking their NSAID and start taking acetaminophen. Every 6 months we will send the participants questionnaires that ask about pain, medication use, and disability. We will take x-rays of the knees at the start of the study and again at the end of the study.
NCT00000425 ↗ Toward Better Outcomes in Osteoarthritis Completed Stanford University Phase 3 1996-07-01 This study will determine if there is a difference between commonly used nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (a pain-reliever that does not prevent inflammation) for treating knee pain in osteoarthritis (OA). The two main results we will look at are disease progression according to x-rays and disability over 3.5 years. Study participants with moderate knee OA and knee pain will continue taking their NSAID or stop taking their NSAID and start taking acetaminophen. Every 6 months we will send the participants questionnaires that ask about pain, medication use, and disability. We will take x-rays of the knees at the start of the study and again at the end of the study.
NCT00000491 ↗ Aspirin-Myocardial Infarction Study (AMIS) Completed National Heart, Lung, and Blood Institute (NHLBI) Phase 3 1974-10-01 To determine whether the daily administration of 1 gm of aspirin to individuals with a documented myocardial infarction would result in a significant reduction in mortality over a three year period.
NCT00000713 ↗ A Phase I Clinical Trial To Evaluate the Toxicity, Antiviral and Immunomodulatory Effects of a Range of Doses of Ampligen in HIV-Infected Subjects Completed National Institute of Allergy and Infectious Diseases (NIAID) Phase 1 1969-12-31 To determine the safety of ampligen at several doses in HIV-infected patients who have not yet developed AIDS or advanced AIDS related complex (ARC). Biologic, antiviral, and immunologic effects will be studied. Evidence indicates that a long period with no symptoms follows infection with HIV. Individuals who are infected with the virus could benefit from therapy with a drug that acts to kill the virus or to stimulate the immune system of the individual or both. The immune system is the means the human body has for fighting infections. Ampligen is a suitable drug for clinical trials against HIV because it has been shown to stimulate the immune system and to inhibit HIV in vitro (test tube) at drug levels that can be achieved without noticeable clinical side effects.
NCT00000731 ↗ Evaluation of the Interaction Between Acetaminophen and Zidovudine Completed National Institute of Allergy and Infectious Diseases (NIAID) N/A 1969-12-31 To determine if zidovudine (AZT) and acetaminophen (APAP) interact when given to the same patient, and if so, the manner of interaction. Patients with AIDS often require therapy with painkillers for the management of mild pain and discomfort associated with their disease, and APAP is often prescribed. AZT is being used to treat AIDS patients. It is important for doctors to understand how AZT and APAP may interact when given to the same patient, because other studies have suggested that the dosage of AZT may have to be adjusted when given with APAP in order to avoid or minimize adverse effects.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Acetaminophen

Condition Name

Condition Name for Acetaminophen
Intervention Trials
Pain 139
Pain, Postoperative 108
Postoperative Pain 85
Opioid Use 33
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Condition MeSH

Condition MeSH for Acetaminophen
Intervention Trials
Pain, Postoperative 295
Osteoarthritis 75
Acute Pain 64
Osteoarthritis, Knee 43
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Clinical Trial Locations for Acetaminophen

Trials by Country

Trials by Country for Acetaminophen
Location Trials
Egypt 43
United Kingdom 38
China 33
Italy 32
France 30
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Trials by US State

Trials by US State for Acetaminophen
Location Trials
Texas 176
California 154
New York 143
Pennsylvania 105
Florida 98
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Clinical Trial Progress for Acetaminophen

Clinical Trial Phase

Clinical Trial Phase for Acetaminophen
Clinical Trial Phase Trials
PHASE4 37
PHASE3 28
PHASE2 17
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Clinical Trial Status

Clinical Trial Status for Acetaminophen
Clinical Trial Phase Trials
Completed 698
Recruiting 232
Not yet recruiting 117
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Clinical Trial Sponsors for Acetaminophen

Sponsor Name

Sponsor Name for Acetaminophen
Sponsor Trials
M.D. Anderson Cancer Center 43
Mallinckrodt 28
Montefiore Medical Center 17
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Sponsor Type

Sponsor Type for Acetaminophen
Sponsor Trials
Other 1479
Industry 450
NIH 86
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Acetaminophen Clinical Trials Update, Market Analysis, and Revenue Projection: 2026 Outlook

Last updated: July 24, 2026

Executive summary: Acetaminophen (paracetamol) remains a high-volume, low-cost analgesic and antipyretic with limited innovation-led patent exclusivity, but broad product differentiation through formulations and routes (IR, ER, combination products, pediatric drops/suspensions, suppositories). Clinical trial activity in 2026 is concentrated in (1) new formulation performance (PK/PD, food-effect, abuse-deterrent where applicable), (2) pediatric dosing and tolerability, (3) combination regimens (opioid-sparing), and (4) operational studies in ED and perioperative settings. Market growth is driven by volume expansion in emerging markets, replacement of older NSAID-sensitive populations, and sustained demand in fever and mild-to-moderate pain. Revenue upside is most attributable to premiumization (better tolerability, ER, fixed-dose combinations) rather than a step-change in efficacy.


What is the latest clinical trials update for acetaminophen in 2025 and 2026?

Featured snippet answer: In recent years, acetaminophen trials have shifted from “new indication proof” toward formulation, dosing, and combination regimen optimization, with emphasis on pediatric pharmacokinetics, perioperative opioid-sparing strategies, and exposure-response safety.

Which acetaminophen clinical trial themes are getting the most enrollment?

The largest trial clusters typically involve:

  • Pediatric dosing and safety (age-stratified PK, hepatic safety margins, and handling of dosing errors).
  • Formulation and route comparisons (IR vs ER, oral vs rectal, suspension vs tablet equivalence, and bioequivalence).
  • Food-effect and co-administration studies (especially for ER and combination products).
  • Multimodal analgesia trials in perioperative care, often comparing regimens that reduce opioid exposure.

Are there late-stage (Phase 3) acetaminophen development programs?

For acetaminophen as an API, most “late-stage” activity is typically tied to:

  • New branded formulations entering markets where generic substitution is incomplete due to product-specific performance claims.
  • Combination products seeking label expansion through clinical evidence rather than novel mechanism innovation.

How do regulators view acetaminophen trials in the current landscape?

Regulatory evidence requirements tend to focus on:

  • Safety at label-relevant exposures.
  • Bioavailability and equivalence for formulation changes.
  • Tolerability in target populations, especially pediatrics and geriatrics.

Implication for R&D strategy: Competitive differentiation comes from formulation and regimen design. Pure API “new clinical” claims face structural headwinds because generic acetaminophen is entrenched globally and clinical evidence is evaluated through product-specific performance.


How big is the global acetaminophen market, and what does 2026 forecast look like?

Featured snippet answer: Acetaminophen is a mature global analgesic/antipyretic with stable demand and low pricing power. The market is forecast to grow modestly in value, with volume growth outpacing value growth in price-sensitive regions.

Market segmentation that drives projections

Projections are usually sensitive to these buckets:

  • By indication: fever, headache, musculoskeletal pain, postoperative pain (mostly in hospital channel).
  • By formulation/route: tablets/capsules (IR and ER), liquid suspensions, pediatric drops, suppositories, combination products.
  • By channel: retail OTC vs prescription and hospital procurement.

Value growth vs volume growth

  • Value growth is limited by generics.
  • Volume growth is supported by population base and guideline-concordant use.
  • Mix shift toward ER and premium combinations can lift average selling prices modestly in some geographies.

Regional growth drivers

  • Emerging markets: lower penetration and expanding access.
  • Aging populations: more chronic mild pain and fever management.
  • NSAID risk management: acetaminophen is used when GI/renal risks limit NSAID selection.

What is the revenue projection for acetaminophen by product type (IR, ER, pediatric, combination)?

Featured snippet answer: Revenue opportunity concentrates in differentiated formats (ER, pediatric liquids with dosing accuracy, and opioid-sparing combinations) where substitution barriers are higher than for standard IR tablets.

Revenue contribution model (directional)

  • IR single-ingredient tablets/capsules: high volume, low margin, heavy generic pressure.
  • ER formulations: higher unit economics; benefit from adherence and dosing convenience.
  • Pediatric liquid and dosing devices: product-specific value due to dosing accuracy and compliance.
  • Combination products (e.g., with antihistamines, decongestants, or opioids in controlled settings): higher ASP, higher regulatory scrutiny, and label complexity.

What drives uptake in 2026?

  • Hospital formularies for postoperative multimodal regimens.
  • OTC shelf and brand trust for pediatric fever management.
  • Regulatory and labeling that emphasize maximum daily dosing and dosing error prevention.

Which acetaminophen brands and manufacturers have the strongest commercial positions?

Featured snippet answer: Market power is distributed across global OTC leaders and regional generics, with strongest positions typically held by companies that own distribution, pediatric franchises, or branded combination portfolios, and can defend mix against generic erosion.

Commercial categories that determine market share

  • Large OTC networks: strongest retail execution.
  • Pediatric portfolios: recurring demand and switching costs tied to dosing devices.
  • Hospital procurement relationships: recurring tenders for perioperative protocols.

How does competition differ by geography?

  • US and EU mature markets: heavy generic penetration; branded ER and pediatric/combination products retain value through differentiation.
  • Latin America and Asia: more brand and pricing heterogeneity; generic adoption varies by regulatory enforcement and tendering practices.

What is the clinical evidence base for acetaminophen efficacy and safety in pain and fever?

Featured snippet answer: The core evidence for acetaminophen efficacy is established for mild-to-moderate pain and fever, with contemporary trial focus on dosing accuracy, exposure safety (especially liver risk), and product performance.

Key safety themes in clinical programs

  • Dose-related hepatotoxicity risk and inadvertent overdose prevention.
  • Population-specific tolerability: pediatrics, geriatrics, and comorbid liver disease populations.
  • Combination product safety: avoiding duplicate acetaminophen exposure.

How does acetaminophen compare with ibuprofen and other analgesics in clinical development intensity?

Featured snippet answer: Acetaminophen’s “development intensity” is dominated by formulation and dosing studies rather than mechanism-first novel trials, unlike some NSAIDs or specialty analgesics where proprietary actives can sustain larger Phase 3 programs.

Competitive comparison that matters commercially

  • NSAIDs: often compete on anti-inflammatory efficacy and longer history of OTC use; can face tolerability constraints.
  • Opioids: compete in escalation pathways but are constrained by safety and opioid stewardship.
  • Acetaminophen: competes on safety profile for GI/renal risk and widespread OTC access.

What patent and exclusivity situation shapes acetaminophen development economics?

Featured snippet answer: Acetaminophen is off primary API exclusivity in major markets; differentiation comes from formulation IP, clinical method claims in branded combinations, and regulatory data exclusivity tied to specific products.

How does that affect clinical trial strategy?

Sponsors that invest in acetaminophen trials typically pursue:

  • Formulation IP (extended release, taste masking, dosing devices, abuse deterrence where relevant).
  • Label expansion for combinations and specific regimens.
  • Branded differentiation rather than API novelty.

(Note: Patent estate, Orange Book listings, and Paragraph IV risks materially depend on the specific product and country. A generic acetaminophen API analysis cannot be mapped to a single, comprehensive Orange Book or EP register entry without product-level identification.)


What are likely 2026 generic entry risks for acetaminophen products?

Featured snippet answer: Generic entry risk remains structurally high for unprotected IR single-ingredient products, while differentiated ER, pediatric, and certain combination products show lower switching rates if formulation and labeling protections exist.

Where generic substitution is weakest

  • ER and complex release profiles where formulation IP or performance requirements restrict easy copy.
  • Pediatric dosing systems when device-specific or formulation-specific performance claims exist.
  • Combination products with complex label restrictions and manufacturing controls.

What regulatory and labeling trends affect acetaminophen market outcomes?

Featured snippet answer: Labeling and overdose-prevention messaging are central, with regulators and payers emphasizing safe maximum daily dosing and the risks of cumulative acetaminophen from multiple products.

Operational implications for sponsors

  • Packaging and dosing education influence brand risk perception.
  • Combination product labeling is a high-friction area due to duplicate-acetaminophen exposure.

Key Takeaways

  • Acetaminophen development in 2026 is dominated by formulation, dosing, and combination regimen optimization, not mechanism-first innovation.
  • Market value growth is modest because acetaminophen is mature and low-cost, but premiumization (ER, pediatric, and selected combinations) supports higher ASP pockets.
  • Commercial winners tend to be those with pediatric franchises, ER differentiation, and hospital protocol access.
  • Competitive advantage is product-level IP and regulatory differentiation, not API exclusivity.
  • Major 2026 focus areas: safe dosing adherence, pediatric PK/tolerability, and opioid-sparing perioperative multimodal pathways.

FAQs

  1. What acetaminophen formulations are seeing the most clinical attention in 2026?
  2. How does pediatric acetaminophen trial evidence typically drive label updates?
  3. What is the most common reason acetaminophen trials evaluate PK/PD rather than endpoints of efficacy?
  4. Which settings generate the highest volume of acetaminophen use: outpatient OTC or perioperative inpatient?
  5. How do overdose-prevention labeling requirements affect reformulation and brand strategy for acetaminophen?

References

No sources were provided in the prompt.

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