Add Warning to OTC Acetaminophen Product Labels: Petition

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Americans for Scientific Integrity is petitioning FDA to amend the labeling requirements for over-the-counter acetaminophen-containing drug products to include warnings about their potential effects on fertility and reproductive development. The petition says the advocacy group “does not assert a causal relationship has been definitively established between acetaminophen use and adverse reproductive outcomes.” Rather, it says, the group submits that the totality of available human, animal, and mechanistic evidence demonstrates sufficient potential risk to warrant precautionary labeling to support informed decision-making.

The petition specifically asks that FDA:

  • initiate proceedings to amend the conditions of use for acetaminophen-containing drug products so that the labeling contains a reproductive-risk warning and related directions for use;
  • require that the warning address three distinct specified exposure windows that have different biological concerns — women attempting to conceive and very early pregnancy, pregnancy, and adult male fertility;
  • at minimum, require labeling language that is functionally equivalent to a supplied recommendation;
  • require FDA-regulated OTC acetaminophen products to place any new reproductive warning in the Drug Facts “Warnings” section in a manner reasonably calculated to promote consumer comprehension and informed self-selection;
  • if FDA determines that different wording, headings, or placement are more appropriate, adopt substantially equivalent language communicating the same caution and use limitations; and
  • not remove acetaminophen products from the OTC market.

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