Family doctor

Brands:

• Pamol
• Panadol
• Tylenol (US)
• Disprol
• Calpol (UK)

Use: for fever and pain relief

Paracetamol is a medicine that is used for mild to moderate pain and fever in adults and children. Paracetamol is often used in people who cannot take anti-inflammatories (e.g. due to stomach ulcer), as it is gentle on the stomach.

Paracetamol is less likely than anti-inflammatories (NSAIDs) to cause worsening of asthma or an asthma attack.

For children, paracetamol is the most commonly prescribed medicine to reduce a high temperature or for pain relief.

It works by blocking the making of prostaglandins (pros-ta-glan-dins) which can cause pain (including headaches), fever (high temperature), and inflammation (swelling and redness). Paracetamol is not very good at reducing inflammation, but is very effective at reducing pain and fever. It is used both for acute pain (e.g. headache, accident) and for chronic pain (e.g. osteo-arthritis). It is sometimes used for cancer pain.

Paracetamol is available in tablets, capsules, soluble tablets, children's mixtures and suppositories.

Paracetamol is an ingredient in:

• Many cold and flu tablets
• Cold and flu drinks e.g. Lemsip
• Some cough mixtures
• Combination pain relievers, e.g. Digesic, Panadeine, Codcomol, Pirophen
• Some migraine tablets e.g. Paramax

Paracetamol is also known as acetaminophen.

Usual dose:

• Adults: 500mg - 1000mg every four hours - but no more than 4000mg (eight 500mg tablets) per day.
• Children 1-5 years old: 120mg-250mg every four hours - but no more than 4 doses per day (24 hours).
• Children 6-12 years old: 250-500mg every four hours - but no more than 4 doses per day (24 hours).
• Children under 1 year: check with your doctor or pharmacist.

The mixtures for children usually come in 120mg/5ml or 250mg/5ml. Take care that you use the correct amount according to the strength of the mixture.

It is very important not to take more than the recommended dose - too much will not give you any better pain relief, but is very dangerous. If you still have pain or fever after using the correct dose of paracetamol, check with your doctor. Paracetamol should take about 20 minutes to start to work.

Cautions:

• Liver damage (alcoholics, hepatitis, AIDS, malnutrition)
• Kidney problems

Side effects

Side effects are rare and include skin rashes, other allergy symptoms and blood disorders. It is thought that chronic abuse of paracetamol may cause kidney problems.

Overdose: liver damage - seek emergency medical treatment immediately, even if there are no symptoms. It is very important to keep paracetamol tablets or mixtures well out of the reach of children to prevent overdose, as you should with all medicines.

Interactions:

It is wise to avoid excessive alcohol while using paracetamol.

Take care with Warfarin (may cause increased INR).

Patient information:

• Follow the instructions on the label of the medicine or as directed by your doctor
• Paracetamol for children comes in different strengths. Take care you are giving your child the correct dose
• Do not exceed the maximum dose recommended (four doses in 24 hours)
• Food: can be taken on an empty stomach
• Alcohol: do not drink excessive quantities of alcohol while taking paracetamol
• Keep all paracetamol well out of reach of children
• Contact your doctor or seek urgent help if overdose occurs
• Paracetamol is an ingredient in a number of medicines for pain, or colds and flu. If taking paracetamol in one medicine, make sure you don't take other medicines also containing paracetamol.