Paracetamol is the most commonly prescribed medicine also most commonly sold over the counter medicine. It is also called as acetaminophen in some countries. It is available world wild in all the nations. It can be purchased as single drug or in combination commonly used as over-the-counter medicines.
It is the most common drug that causes poisoning in over dosages. Lat us see further details of paracetamol.
Name of drug
Paracetamol is also called acetaminophen in some countries. It is one of the most prescribed medicines in the world.
Is it OTC medicine
Yes, in many countries it is over the counter medicine. You can buy it without a doctor’s prescription.
Class of drug
It is an antipyretic and mild pain killer medicine.
It is used for
It is used to treat the following conditions:
- Being an antipyretic medicine that is used to treat fever.
- It is also a painkiller used to treat headache and body ache.
- It is commonly used as a combination to treat common cold and upper respiratory tract infection.
- It is commonly used drug to treat migraine as mild to moderate pain killer.
- Though not very effective paracetamol is also used in pain of osteoarthritis as alone or in combination with other drugs.
- It is used to treat pain of menstruation in combination with other drugs.
- Sometimes it is used to treat post surgical swelling in combination with other drugs.
Mechanism of action
Paracetamol acts by following mechanism:
- It is a central analgesic which inhibits serotonergic pathways.
- It inhibits synthesis of prostaglandins.
- It acts as a Cox 2 inhibitor.
- It has a mild anti-inflammatory action. It is not very strong in reducing the inflammation and swelling.
Paracetamol is available as following preparations:
- Oral drops for kids, streng 100 mg/ml and 150 mg/ml
- Syrups of strength 125 mg per 5 ml, 150 mg per 5 ml, 250 mg per 5ml
- It is available as injection 150 mg per ml and also 100ml injection for infusion containing 1 gram of paracetamol.
Paracetamol is administer by following routes:
- Oral form drops for children given orally.
- Oral form syrups for children given orally.
- Oral form tablets for adults.
- Injection is given either intramuscular or slow intravenous infusion.
Paracetamol is the medicine considered as safe in pregnancy, when given in appropriate dosages.
Paracetamol is the medicine considered as safe for use in lactating mothers, when given in appropriate dosages.
For elderly people also this is considered as safe medicine, when given in appropriate doses.
In liver failure
In case of liver failure the dose adjustment may be needed in some patients.
In kidney failure
In case of kidney failure it is considered as safe medicine, though some patients may need dose adjustment, depending on the condition of the patient.
Usually paracetamol does not have any significant side effects. If you are getting any unusual symptoms you should promptly revisit your doctor or pharmacist.
Very rarely some patients get allergic reactions in the form of skin rashes, spelling of lips and limbs, anaphylactic reactions.
Overdoses may cause damage to the liver presenting with loss of appetite, jaundice, altered consciousness, abdominal pain and other symptoms of toxicity.
Paracetamol is used as common combinations with following drugs:
- With Ibuprofen, paracetamol is used as an anti-inflammatory medication. The effect of combination is better than the single drug alone.
- With diclofenac, paracetamol is used as anti-inflammatory medication. The effect of combination is better than the single drug alone.
- With tramadol, paracetamol is used in combination as an effective pain killer. The effect of combination is better than the single drug alone.
- Over the counter remedies for common cold, it is used along with phenylephrine and antihistaminic medicines.
Common available brands
Following are the common available brands of the paracetamol across the world:
Signs of toxicity
On history patient may give intentional or accidental intake of toxic dose of paracetamol. The symptoms of paracetamol poisoning or toxicity are as follows:
- First 24 hours of intake there are non specific symptoms like tiredness, loss of appetite, abdominal pain and vomiting.
- As the time passes there is appearance of signs of liver failure inform of jaundice vomiting, abdominal pain, confusion, clotting defects, excessive bleeding, low blood sugar.
- Pancreatitis and kidney failure, lactic acidosis can occur as complications.
- It can cause death very rapidly if not treated early.
N-acetylcysteine is used as an antidote to treat the paracetamol toxicity.
Usual recommended drug dosages
For paracetamol usual recommended doses are as follows:
Infants and Children
Oral dose: 10 to 15 mg per kg per dose maximum 4 times a day. Do not exceed maximum dose of 60 mg per kg per day
Parenteral dose: 8 mg per kg per dose maximum 4 times a day. Give as IM injection or slow IV infusion over 15 to 30 minutes with proper dilution.
Oral dose: 500 mg – 1 gram dose maximum 4 times a day.
Injection: 500 mg – 1 gram dose maximum 3 times a day. Give as IM injection or slow IV infusion with proper dilution. Do not give as a bolus.