Paracetamol

 

1. Generic Name & Brand Names

• Generic Name: Paracetamol (International) / Acetaminophen (USA, Canada, Japan, some others)

• Common Brand Names (Examples - Varies by Country):

  • Tylenol (USA, Canada, others)

  • Panadol (UK, Australia, many others)

  • Calpol (Pediatric, UK)

  • Ofirmev (IV formulation)

  • Numerous store/generic brands (e.g., Paracetamol-XXX, Aceta, APAP, etc.)

2. Dosage Forms

• Tablets (Immediate & Extended Release)

• Caplets

• Capsules

• Liquid Suspension/Solution (for adults and children)

• Effervescent Tablets/Sachets

• Suppositories (Rectal)

• Intravenous (IV) Solution (Hospital use)

• Orally Disintegrating Tablets

• Chewable Tablets

3. Drug Class

• Analgesic (Pain Reliever)

• Antipyretic (Fever Reducer)

• Not classified as an NSAID (Non-Steroidal Anti-Inflammatory Drug). Its exact mechanism is complex but involves central nervous system effects.

4. Uses

• Mild to Moderate Pain: Headaches, toothaches, backaches, muscle aches, menstrual cramps, arthritis pain, pain from cold/flu.

• Fever Reduction (Antipyresis).

5. Side Effects (Generally rare at recommended doses)

• Common (Usually Mild): Very few at normal doses.

• Serious (Require Immediate Medical Attention - Often linked to overdose):

  • Liver Damage/Failure: The MOST serious risk. Signs include nausea, vomiting, loss of appetite, sweating, extreme fatigue, unusual bleeding/bruising, pain in the upper right abdomen, yellowing of skin/eyes (jaundice), dark urine.

  • Severe Skin Reactions: Rare but potentially fatal - Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), Acute Generalized Exanthematous Pustulosis (AGEP). Signs: skin rash, blistering, peeling.

  • Allergic Reactions: Hives, itching, swelling (face/tongue/throat), difficulty breathing.

6. Warnings Before Taking

• Liver Disease/Impairment: Do not take or use only under strict doctor supervision and reduced dose. Paracetamol is metabolized by the liver.

• Alcohol Consumption: Avoid or strictly limit alcohol (3+ drinks/day significantly increases liver damage risk). Do not take if you have alcoholism or chronic heavy drinking.

• Allergy: Do not take if allergic to paracetamol/acetaminophen.

• Malnourishment/Low Body Weight: May increase risk of liver problems. Discuss dosing with a doctor.

• G6PD Deficiency: Use with caution (risk of hemolytic anemia).

• Kidney Disease: Use with caution; consult doctor for appropriate dosing.

• Other Medications: Inform your doctor/pharmacist about ALL medicines you take (prescription, OTC, vitamins, herbs). Crucially: Many cold/flu/allergy/pain medications contain paracetamol. Combining them can lead to accidental overdose.

• Pregnancy & Breastfeeding: Generally considered safe at recommended doses for short-term use, but always consult your doctor first.

7. How Should I Take It? (General Guidelines - ALWAYS follow label/dr instructions)

• Read the Label: Carefully check the strength and dosing instructions on the specific product.

• Oral Forms: Swallow tablets/capsules whole with water. Do not crush or chew extended-release tablets. Shake liquid suspensions well before measuring. Use the measuring device provided (spoon/cup/syringe), NOT a household spoon.

• Suppositories: Follow specific insertion instructions.

• With/Without Food: Can be taken with or without food. Taking with food might slightly reduce stomach upset (rare).

• Maximum Daily Dose: DO NOT EXCEED the maximum recommended daily dose. This is critical to prevent liver damage.

  • Standard Adult Max Dose: 4,000 milligrams (mg) per 24 hours. However, many experts and labels now recommend 3,000 mg per 24 hours as safer for most adults, especially those with risk factors. ALWAYS check your specific product label.

  • Standard Adult Dose: Usually 325mg to 1000mg per dose. Do not take more than 1000mg in a single dose.

  • Dosing Frequency: Typically every 4-6 hours as needed. Do not take more frequently than directed.

• Minimum Effective Dose: Use the lowest dose that works for the shortest time needed.

8. Uses in Adults

• As described in Section 4 (Pain, Fever), following the dosing guidelines in Section 7.

9. What Happens If I Miss a Dose?

• Not for Scheduled Use: Paracetamol is usually taken "as needed" for pain or fever, not on a strict schedule like antibiotics.

• If Needed: If you are in pain or have a fever and it's time for another dose according to the label (e.g., at least 4-6 hours since your last dose), take the recommended dose.

• Do NOT Double Dose: Never take two doses at once to make up for a missed dose.

10. What Happens in Overdose? (PARAMOUNT WARNING)

• Severe Liver Damage/Failure: This is the primary and potentially fatal consequence. Can occur with doses only slightly above the maximum daily limit, especially with risk factors (alcohol, liver disease).

• Symptoms (Often Delayed 24-72 hours): Nausea, vomiting, loss of appetite, sweating, extreme tiredness, unusual bleeding/bruising, pain in the upper right abdomen, yellowing of skin/eyes (jaundice), dark urine, confusion.

• Action is URGENT: Seek IMMEDIATE medical attention or call Poison Control (e.g., US: 1-800-222-1222) even if no symptoms are present. Early treatment (within ~8-10 hours) with the antidote N-acetylcysteine (NAC) is critical to prevent liver failure and death. Do not wait for symptoms.

11. Avoid While Taking (Contraindications / Precautions)

• Allergy: Do not take if allergic to paracetamol/acetaminophen.

• Severe Liver Impairment: Do not take.

• Other Paracetamol Products: Crucially avoid taking multiple medications containing paracetamol simultaneously (e.g., Tylenol + cold medicine + headache formula). Check ALL medication labels for "acetaminophen" or "APAP".

• Alcohol: Avoid excessive or chronic alcohol consumption (see Warnings).

• Warfarin: Use with caution and under doctor supervision (high doses/long-term use may slightly increase bleeding risk). Monitor INR.

• Certain Medications: Inform your doctor/pharmacist about all meds, especially isoniazid (TB treatment), phenytoin, carbamazepine, barbiturates, or long-term high-dose NSAIDs.

12. Storage

• Temperature: Store at room temperature (20°C to 25°C / 68°F to 77°F). Avoid excessive heat, moisture (e.g., bathroom), and freezing.

• Container: Keep in original container tightly closed.

• Location: Keep out of sight and reach of children and pets. Consider child-resistant packaging.

• Disposal: Safely dispose of unused or expired medication. Do not flush (unless specifically instructed). Use drug take-back programs or follow local disposal guidelines.

CRITICAL REMINDER: Paracetamol/Acetaminophen is very safe and effective when used correctly at recommended doses. The single greatest risk is accidental overdose leading to potentially fatal liver damage. Always check labels for hidden paracetamol in other medications, strictly adhere to dose and frequency limits, and never exceed the maximum daily dose. Consult a doctor or pharmacist with any questions.