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Updated 13 September 2013

Paracetamol

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever.

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Paracetamol (also known as Acetaminophen) is the active ingredient of Adco-Paracetamol, Antalgic, Calpol, Empaped, Fevamol, Go-Pain P, Micro Gesic, Napamol, Pacimol, Painamol, Panado, Paracetamol-Lennon, Perfalgan, Prolief, Pyradol, Tylenol Extended relief and Varipan.

Paracetamol is also one of multiple active ingredients found in a wide variety of combination-products ranging from cold and flu preparations to painkillers.

General information

Paracetamol is the analgesic of choice for mild to moderate pain and to reduce fever. Doctors and pharmacists commonly recommend it and a range of paracetamol preparations can be bought over the counter in tablet, capsule, powder sachet and liquid form. It is suited for both adults and children and, as it does not cause stomach irritation, it is safe to use by those who suffer from peptic ulcers and those who cannot take aspirin.

When taken by mouth it is rapidly absorbed into the body and will be effective within 30 minutes. Paracetamol is safe for occasional use by those being treated with anticoagulants. Unlike aspirin it does not reduce inflammation and is therefore not as effective in conditions such as rheumatoid arthritis and sports injuries.

In overdose, which is a medical emergency, it can cause fatal liver and kidney damage.

How does paracetamol work?

The mechanism by which paracetamol reduces fever and pain is still a source of debate, but it is widely accepted to interfere with the action of substances in the body called prostaglandins that are known to initiate inflammation and to sensitise nerves to pain impulses. Its antipyretic action - the ability of paracetamol to reduce fever - is thought to be a result of its effect on the heat-regulating centre of the brain.

Fast facts

Drug schedule: schedule 0

Available as: paracetamol is available as tablets, capsules, syrup, chewable tablets, effervescent tablets and as suppositories.

What does it do? Paracetamol reduces pain and fever.

Overdose risk: high

Dependence risk: low

Is paracetamol available as a generic? yes

Is paracetamol available on prescription only? no

User information

Onset of effect: 15 - 60 minutes

Duration of action: up to 6 hours

Dietary advice: alcohol in combination with paracetamol may substantially increase the risk of liver damage.

Stopping this medicine: paracetamol can be safely stopped when no longer needed. Limit use to 5 days for children under 12 years of age and 10 days for adults unless your prescriber has specifically told you to continue taking them for a longer period of time.

Prolonged use: evidence of harm from long-term use at therapeutic doses is indecisive. Periodic physical examinations are recommended if used for prolonged periods of time.

Special precautions

Consult your doctor before using this drug if you have known liver or kidney problems.

Pregnancy: safe for short-term use in therapeutic doses. It is recommended to consult your doctor before use.

Breastfeeding: this medication is safe use.

Porphyria: this medication is safe for use.

Infants and children: this medication is safe for use in children at the recommended dose.

The elderly: no special precautions need to be taken.

Driving and hazardous work: no special precautions need to be taken.

Alcohol: prolonged and/or excessive intake of alcohol in combination with paracetamol may substantially increase the risk of liver damage. If you consume 3 or more alcoholic drinks every day, ask your doctor whether you should take paracetamol.

Possible side effects

Side effects with paracetamol are rare when taken as recommended.

Side effect

Frequency

Consult your doctor

Common

Rare

Only if severe

In all cases

allergic reaction i.e. rash, hives, etc.

x

x

yellow-tinged skin and eyes

x

x

nausea

x

x

Interactions:

Drug interactions:

cholestyramine

« absorption of paracetamol; « effect

isoniazid

ª paracetamol toxicity; therapeutic doses may not be safe

metoclopramide, domperidone

ª absorption of paracetamol; ª effect

oral contraceptives

« paracetamol effect

anticoagulants

ª effect of anticoagulant with high/prolonged paracetamol use

Food interactions:

alcohol

severe and potential fatal liver damage

Disease interactions

Consult your doctor or pharmacist before using this drug if you have known liver or kidney problems, or if you have a history of alcohol abuse.

Overdose action

Paracetamol when taken in overdose is capable of causing serious damage to the liver and kidneys. Seek immediate medical advice in all cases to avoid potentially fatal liver damage.

Recommended dosage

Adults: 0.5 - 1.0g every 4 - 6 hours with a maximum dose of 4g over a 24-hour period.

Children 0 - 3 months: 5 - 10mg/kg 4 - 6 hours spaced apart with a maximum of 4 doses over a 24- hour period

Children 3 - 12 months: 50-120mg 4 - 6 hours spaced apart with a maximum of 4 doses over a 24- hour period

Children 1 - 5 years: 120-150mg 4 - 6 hours spaced apart with a maximum of 4 doses over a 24- hour period.

Children 6 - 12 years 250-500mg 4 - 6 hours spaced apart with a maximum of 4 doses over a 24- hour period.

Interesting fact

Paracetamol is extremely toxic to cats and should not be given to them under any circumstances as cats lack the necessary enzymes to safely metabolise paracetamol. Paracetamol is also lethal to snakes, and has been used in attempts to control the brown tree snake in Guam.

 
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