NCC Officers' Training Academy
GWALIOR (Est 1965)
Paracetamol
What is paracetamol?
Paracetamol (Panadol, Calpol, Alvedon) is an analgesic and antipyretic drug that is used to temporarily relieve mild-to-moderate pain and fever. It is commonly included as an ingredient in cold and flu medications and is also used on its own.
Paracetamol is exactly the same drug as acetaminophen (Tylenol). Paracetamol is the drug’s name assigned using the International Nonproprietary Name (INN) generic name system. Paracetamol is the name used for the drug in places such as Europe, Australia, New Zealand and India. Acetaminophen is the generic name assigned using the United States Adopted Names (USAN) system. Acetaminophen is the name used in countries such as the US, Canada and Japan. Usually the INN and USAN generic names for a drug are the same and don’t differ between countries.
It is not clear exactly how paracetamol works. However, it is thought to work by blocking chemical messengers in the brain that let us know when we’re in pain and by affecting the chemical messengers that regulate our body temperature. The evidence suggests that paracetamol inhibits the production of prostaglandins, which are made by the body to deal with illness and injury. It’s also thought to act on the serotonergic, opioid, nitric oxide and cannabinoid pathways.
Paracetamol was first made in 1878, but only became more widely used in the 1950s. Today paracetamol is one of the most widely used painkillers in the world. Branded and generic versions of this drug are available.
What is paracetamol used for?
Paracetamol is available over-the-counter (OTC) and also as a prescription medication. It is used for the relief of:
- Headache
- Tension headache
- Migraine
- Backache
- Rheumatic and muscle pain
- Mild arthritis/osteoarthritis
- Toothache
- Period pain (dysmenorrhea)
- Colds and flu symptoms
- Sore throat
- Sinus pain
- Post-operative pain
- Fever (pyrexia)
What are the side effects of paracetamol?
Serious side effects of paracetamol include:
- Allergic reactions, which may be severe and include:
- Skin rashes, itching or hives
- Swelling of the throat, tongue or face
- Shortness of breath or wheezing
- Skin rash or peeling, or mouth ulcers
- Breathing problems. This is more likely if you have experienced them before when taking other painkillers such as ibuprofen and aspirin
- Unexplained bruising or bleeding or becoming unusually tired. Getting more infections than usual.
- Liver problems. Nausea, sudden weight loss, loss of appetite and yellowing of the eyes and skin can occur
If you get any of the rare side effects listed above, stop taking the medicine and contact your doctor immediately.
Common side effect of paracetamol suppositories include:
- Redness or soreness in or around the rectum
Everyday, long-term use (several months or more) of paracetamol can cause liver or kidney damage. People taking this medication in the usual way for shorter periods of time have not had these problems.
These are not all of the possible side effects of this medication.
Warnings
You should not take morphine if you have severe asthma or breathing problems, a blockage in your stomach or intestines, or a bowel obstruction called paralytic ileus.
Morphine can slow or stop your breathing and may be habit-forming. MISUSE OF OPIOID MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Keep the medication in a place where others cannot get to it.
Taking opioid medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.
Fatal side effects can occur if you use morphine with alcohol or with other drugs that cause drowsiness or slow your breathing.
What should I tell my doctor before taking paracetamol?
Before you take paracetamol, tell your healthcare provider about all of your medical conditions, including:
- if you suffer from mild arthritis and need to take pain relief every day
- have liver or kidney problems
- are underweight or malnourished
- regularly drink alcohol. You may be more open to the side effects of paracetamol if you drink large amounts of alcohol.
- have a severe infection as this may increase you risk of metabolic acidosis. Signs of metabolic acidosis include:
- deep, rapid, difficult breathing
- feeling sick (nausea)
- being sick (vomiting)
- loss of appetite
Contact your doctor immediately if you get a combination of these symptoms. You may need to avoid or limit paracetamol.
- have glucose-6-phosphatedehydrogenase deficiency (enzyme deficiency)
- suffer from asthma and are sensitive to aspirin
- have hemolytic anemia (abnormal breakdown of red blood cells)
How should I take paracetamol?
- Always use exactly as your doctor or pharmacist tells you to
- Always read the instructions on your medication before taking it
- Do not take more than the recommended dose. Check the instructions for the paracetamol product you have. The strength and recommended dose among for different paracetamol-containing products.
- Paracetamol may be taken every 4 to 6 hours. Leave at least 4 hours between doses.
- Do not take more than four doses in 24 hours.
- Do not take for more than 3 days, unless your doctor tells you to
- Contact your healthcare professional if your symptoms get worse or do not improve
Paracetamol 500mg tablets and capsules
- Swallow tablets or capsules whole with a glass of water
| Age | How much | How often (in 24 hrs) |
|---|---|---|
| 10 to 15 years | 1 Tablet | Up to 4 times |
| Adults and children 16 years and over | 1 to 2 Tablets | Up to 4 times |
Paracetamol 120 mg/5 ml, 250 mg/5 ml oral suspension
- Always use the oral syringe or measuring spoon that comes with your paracetamol suspension to make sure you are giving the correct dose. The recommended dose will depend on your child’s age and weight.
- Shake the bottle for 10 seconds then remove the cap
- Insert the syringe and draw up the recommended dose
- Place the syringe inside the child’s mouth against the inside of their cheek and press the plunger slowly to release the medicine
- Replace the cap on the paracetamol bottle and wash and dry the syringe
| Age | How much | How often (in 24 hours) |
|---|---|---|
| 2-3 months | 2.5ml* | Up to 2 doses |
| 3-6 months | 2.5 ml | Up to 4 times |
| 6-24 months | 5 ml | Up to 4 times |
| 2-4 years | 7.5 ml (5 ml + 2.5 ml) | Up to 4 times |
| 4-6 years | 10 ml (5 ml + 5 ml) | Up to 4 times |
* Only for use of relief of fever after the 2 month immunizations in children weighing more than 4 kg who were born after 37 weeks. If your child still has a fever after 2 doses consult your doctor.
| Age | How much | How often (in 24 hours) |
|---|---|---|
| 6 to 8 years | 5 ml | Up to 4 times |
| 8 to 10 years | 7.5 ml (5 ml + 2.5 ml) | Up to 4 times |
| 10 to 12 years | 10 ml (5 ml + 5 ml) | Up to 4 times |
| 12 to 16 years | 10 to 15 ml | Up to 4 times |
| Adults and children over 16 years | 10 to 20 ml | Up to 4 times |
Paracetamol 60 mg, 125 mg and 250 mg suppositories
- Your child’s bowels need to be empty when you give them this medication. If they need to go to the toilet, make sure they do this before you give then a suppository.
- Position your child lying on their front or side on a bed to administer the suppositories. Or select another position that is comfortable for your child.
- Wash your hands and unwrap the suppository, taking care not to break it
- Gently push the pointed end of the suppository into your child’s rectum (back passage), then wash your hands
- Try and keep your child still for 1 to 2 minutes. Add a second suppository if another one is required. Wash your hands.
- Try and keep your child still for another 1 to 2 minutes after the full dose is administered
| Age | How much# | How often (in 24 hours) |
|---|---|---|
| Infants under 3 months | 1 x 60 mg Suppository | Once* |
| 3 months to 1 year | 1 to 2 x 60 mg Suppositories | Up to 4 times |
| 1 to 5 years | 1 to 2 x 125 mg Suppositories | Up to 4 times |
| 6 to 12 years | 1 to 2 x 250 mg Suppositories | Up to 4 times |
#Check with your doctor or pharmacist about the correct dose for your child, which will be based on their age and weight. Do not guess the dose.
*One dose can be given to babies who develop a fever after their immunizations at 2 months of age. Otherwise do not use in babies less than 3 months old unless your doctor tells you to.
Paracetamol 650 mg oral powder
- Check the sachet is not broken before use
- Empty the content of 1 sachet into a glass. Fill with freshly boiled water and stir under dissolved
- Allow the solution to cool and then drink it
- Adults and children aged 12 years and over can take 1 sachet every 4 hours if required. Do not take more than 4 sachets in 24 hours.
- Do not give to children under 12 years of age.
Paracetamol 250 mg orally disintegrating tablets
- Remove the orally disintegrating tablet from the foil using your fingernail, pressing along the dotted line before pressing it out
- Tablets can be sucked gently on the tongue until they melt into a paste which is easily swallowed
- Tablets can also be dissolved in water or milk if preferred
| Age | How much | How often (in 24 hrs) |
|---|---|---|
| 6 to 9 years | 1 Tablet | Up to 4 times |
| 9 to 12 years | 2 Tablets | Up to 4 times |
| 12 to 16 years | 2 to 3 Tablets | Up to 4 times |
| Adults and children over 16 years | 2 to 4 Tablets | Up to 4 times |
Paracetamol 500 mg effervescents tablets
- Place the paracetamol effervescent tablet(s) in a full glass of water and allow to dissolve completed before swallowing
| Age | How much | How often (in 24 hrs) |
|---|---|---|
| 12* to 15 years (41 to 50 kg) | 1 Tablet | Up to 4 times |
| 16 to 18 years (50 kg+) | Same as adults | |
| Adults | 1 to 2 Tablets | Up to 4 times# |
* Do not give to children younger than 12 years old.
#Maximum 2 tablets per dose. Maximum 8 tablets in 24 hours.
Paracetamol 10 mg/ml solution for infusion
- This form of paracetamol comes in vials and is administered via intravenous (IV) infusion – an injection in your arm – over 15 minutes.
- The dose you need will depend on your age and weight and how well your kidneys work. Your healthcare provider will work out the dose you need.
Interaction
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