Painkillers (Paracetamol)

Last updated: Tuesday, December 09, 2008 Print

How does it work?
It relieves musculoskeletal pain, when that is not associated with major inflammation. It relieves pain probably by inhibiting prostaglandin synthesis in the brain, but not in the peripheral areas. This explains the lack of anti-inflammatory action. Its antipyretic effect (reducing fever) is comparable to aspirin, and its analgesic properties are comparable to aspirin and other non-steroidal anti-inflammatory agents, e.g. Brufen, Voltaren.

Name a paracetamol painkiller
Panado, Dolorol, Tylenol
Paracetomol plus codeine: Panado-Co, Dolorol Forte, Suncodin

Who can benefit from paracetamol?
Painkillers like paracetamol has been shown to be an effective painkiller in a high percentage of rheumatological sufferers in need of pain relief.

Paracetomol is the first line of pain treatment for osteoarthritis, followed by paracetomol with codeine, followed by propoxyphene (Doxyphene) for severe night time pain or pain related to activity.

Many people with rheumatological disorders susch as osteoarthritis, rheumatoid arthritis, psoriatic arthritis, juvenile chronic arthritis and Reiter’s syndrome have symptoms such as pain and stiffness and need relief of these symptoms.

The benefits of painkillers such as paracetomol are: pain relief, and therefore more movement, which in turn will result in less pain.

It relieves pain probably by inhibiting prostaglandin synthesis in the brain, but not in the peripheral areas. This explains the lack of anti-inflammatory action.

What dose should I take?
The recommended adult dose is 500 – 1000 mg every 4 – 6 hours, with maximum 4000 mg in a 24 hour period.
For treatment of osteoarthritis 1000mg every 6 hours is recommended.
The dose for children: 10 mg for every kg weight of the child.
Children 3 – 12 months: 60 – 120 mg, 3 – 4 times in 24 hours;
Children 1 – 5 years: 120 – 250 mg, 3 – 4 times in 24 hours
Children 6 – 12 years: 250 – 500 mg, 3 – 4 times in 24 hours

What are the possible side-effects?
The possible adverse effects of longterm use of excessive doses or an overdose of these painkillers include liver and/or kidney damage.

In rare cases it can lead to blood disorders, and hypersensitivity skin reactions(skin rashes).

The use of more than eight 500-mg tablets per 24 hours for adults can cause liver damage. Do not exceed this dosage.

Can I take other medication at the same time?
Yes. Many people use paracetamol in combination with other medication such as non-steroidal anti-inflammatory drugs (NSAIDs) because the combination can enhance the effect of pain relief, e.g. Brufen, Voltaren, Nurofen.
No: Monitor very carefully when person is already taking any oral anti-coagulant medication to make the blood less likely to clot, e.g Warfarin, aspirin.

Who should not take paracetamol?
· People with impaired liver function
· People with kidney disease
· Alcoholics
· People with anaemia and other blood disorders
· Be careful when using aspirin, warfarin or any other medication with an anti-clotting effect.

It is considered safe for porphyria sufferers.

Can I take paracetamol during pregnancy and breastfeeding?
It is medication of choice for treatment of pain and fever in pregnant women. Long-term use of high dosages may have a toxic effect on the foetus, but therapeutic dosages are considered safe.

It is excreted in breast milk, and is regarded safe for use during breastfeeding.

Is it safe for children?
Yes, it is regarded safe for children, if the prescribed dose is not exceeded. High and prolonged use can, however, lead to kidney and liver damage, and blood disorders.