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.
