Paracetamol

The exact mechanism of action of paracetamol is not fully understood. It is believed to work by inhibiting the production of prostaglandins in the brain, which are chemicals involved in pain perception and the regulation of body temperature. By reducing the levels of prostaglandins, paracetamol helps to alleviate pain and fever.

Uses and Indications:

Paracetamol is commonly used to relieve mild to moderate pain and reduce fever associated with various conditions, including:

• headaches
• toothaches
• muscle aches
• backaches
• menstrual cramps
• arthritis pain
• cold and flu symptoms
• post-surgical pain

Benefit of paracetamol

• paracetamol is available over-the-counter in most countries, making it easily accessible for self-management of pain and fever
• when used as directed, paracetamol is considered safe for most people, including children, pregnant women, and the elderly
• unlike nonsteroidal anti-inflammatory drugs (NSAIDs such as aspirin and ibuprofen, paracetamol has a lower risk of causing stomach irritation and gastrointestinal bleeding
• Paracetamol does not have significant blood-thinning effects, making it a safer option for individuals who are at risk of bleeding or taking anticoagulant medications.

What formulations can the medicine be delivered in?

Paracetamol is available in tablet, capsule, effervescent tablet (dissolve them in water before swallowing), orodispersible tablet (they melt in your mouth), oral liquid (sachets and bottles), suppository (tablet in the bum) and injection (prescription only) forms.

How much paracetamol can I take?

Paracetamol can be taken every 4 to 6 hours, no more than 4 times a day. The amount you can take depends on your age. This is listed below.

• Adults and anyone aged 16+ (500 mg - 1 g)
• Ages 12 - 15 (480 - 750 mg)
• Ages 10 - 11 (480 - 500 mg)
• Ages 8 - 9 (360 - 375 mg)
• Ages 6 - 7 (240 - 250 mg)
• Ages 4 - 5 (240 mg)
• Ages 2 - 3 (180 mg)
• Ages 6 months - 1 year (120 mg)
• Ages 3 - 5 months (60 mg)

Babies aged 2 months (that weigh more than 4kg and were born after 37 weeks) can be given 60 mg, which can be repeated just once after 4 - 6 hours if required.

Paracetamol is not suitable for everyone. You should not take paracetamol if you have previously had an allergic reaction to paracetamol or another ingredient listed in the medication. Paracetamol should not be given to babies under 2 months old.

You should speak to your local doctor before taking paracetamol if you have liver or kidney problems or drink more than 14 units of alcohol each week on a regular basis, as it may not be suitable for you.

Diabetics and people with phenylketonuria need to be careful when taking liquid, effervescent tablet and orodispersible tablet forms of paracetamol as they may contain sugar or aspartame, it may be best for them to avoid these formulations.

Paracetamol can interact with other medicines such as warfarin, lomitapide, colestyramine and lenalidomide. If you take any prescription, over-the-counter or herbal medicines we recommend you ask your doctor or pharmacist to check they are safe to take alongside paracetamol.

Considerations when taking paracetamol

Overdose

Paracetamol overdose is a serious medical emergency that can result in liver damage, organ failure, and even death if not treated promptly. Symptoms of paracetamol overdose may include nausea, vomiting, abdominal pain, confusion, and jaundice. If you suspect an overdose or have taken more than the recommended dose of paracetamol, seek immediate medical attention.

Considerations

Paracetamol is generally considered safe for use during pregnancy and breastfeeding when used as directed. However, it is essential to consult with a healthcare professional before taking any medication during pregnancy or while breastfeeding.

Paracetamol is commonly used to treat fever and pain in children and infants. However, it is crucial to use pediatric formulations and follow dosing instructions carefully to avoid overdose or adverse effects.

Older adults may be more susceptible to the side effects of paracetamol, especially liver toxicity. It is essential to use paracetamol cautiously in this population and consult with a healthcare professional if any concerns arise.

Side effects are generally uncommon for paracetamol.

As with all medications, there is the potential for serious side effects, such as an allergic reaction. You should stop taking paracetamol and seek urgent medical attention if you develop a skin rash, shortness of breath, wheezing, tightness in your chest or throat or swelling of your tongue, mouth, lips, face or throat.

This is not a complete list of side effects; you can find a complete list in the patient information leaflet provided with paracetamol. If you are concerned about any side effects, you should speak to your doctor or pharmacist.

Can I take paracetamol with other medications?

Paracetamol can interact with certain medications and supplements, potentially increasing the risk of side effects or reducing the effectiveness of other drugs. It is essential to consult with your pharmacist before taking paracetamol if you are taking other medications, especially blood-thinning medications, drugs that affect liver function, or herbal supplements.

Can I take paracetamol if I am pregnant or breastfeeding?

Paracetamol is generally considered safe for use during pregnancy and breastfeeding when used as directed. However, it is essential to consult with your doctor before taking any medication during pregnancy or while breastfeeding to ensure the safety of both the mother and the baby.

What should I do if I overdose on paracetamol?

Paracetamol overdose is a serious medical emergency that requires immediate medical attention. If you suspect an overdose or have taken more than the recommended dose of paracetamol, seek immediate medical attention or contact your emergency department. Prompt treatment is essential to prevent liver damage or other complications.

Can I give paracetamol to my child?

Paracetamol is commonly used to treat fever and pain in children and infants. However, it is crucial to use paediatric formulations and follow dosing instructions carefully to avoid overdose or adverse effects. It is also essential to consult with a healthcare professional before giving paracetamol to a child, especially if they have any underlying health conditions or are taking other medications.

Is paracetamol addictive?

Paracetamol is not considered addictive, as it does not have the same potential for dependence or abuse as some other pain medications. However, it is essential to use paracetamol responsibly and according to the recommended dosage instructions to avoid potential risks or adverse effects. If you have concerns about addiction or dependence on pain medication, it is essential to discuss them with a healthcare professional.

Are there any long-term effects of regular paracetamol use?

Long-term use of paracetamol at recommended doses is generally considered safe for most people. However, some studies have suggested a potential link between long-term paracetamol use and an increased risk of certain health conditions, such as liver damage or kidney problems. It is essential to use paracetamol responsibly and according to the recommended dosage instructions to minimise the risk of adverse effects.

Can paracetamol be used to prevent hangovers?

While paracetamol may help alleviate headaches and other symptoms associated with hangovers, it does not prevent or cure hangovers. Drinking alcohol excessively can have numerous adverse effects on health, and relying on paracetamol to manage hangover symptoms is not a recommended or effective long-term solution. It is essential to drink alcohol responsibly and in moderation to avoid hangover symptoms and minimise the risk of harm to health.

Does paracetamol interact with herbal supplements or alternative remedies?

Paracetamol can interact with certain herbal supplements or alternative remedies, potentially increasing the risk of side effects or reducing the effectiveness of other drugs. It is essential to consult with your doctor before taking paracetamol with herbal supplements or alternative remedies to ensure safety and efficacy.

Can paracetamol be used in combination with other pain medications?

Paracetamol is often used in combination with other pain medications, such as opioids or nonsteroidal anti-inflammatory drugs (NSAIDs), to enhance pain relief. However, it is essential to use combination medications containing paracetamol responsibly and according to the recommended dosage instructions to avoid potential overdose or adverse effects. It is also crucial to consult with a healthcare professional before combining paracetamol with other pain medications to ensure safety and efficacy.

Is there a difference between paracetamol and acetaminophen?

Paracetamol and acetaminophen are two names for the same medication. In most countries outside the United States, the medication is known as paracetamol, while in the United States and some other countries, it is known as acetaminophen. Both names refer to the same drug, which is commonly used to relieve pain and reduce fever.

Can paracetamol be used in veterinary medicine?

Paracetamol is not commonly used in veterinary medicine due to its potential toxicity in animals, especially cats. Even small doses of paracetamol can be fatal to cats and can cause liver damage in dogs and other animals. It is essential to avoid giving paracetamol to pets or other animals without the guidance of a veterinarian. If you suspect that your pet has ingested paracetamol, seek immediate veterinary care.