Paracetamol is a medicine used to treat mild to moderate pain and fever (high temperature) in adults. It can be bought over the counter in pharmacies, supermarkets, and other shops . Paracetamol is commonly used to relieve pain caused by conditions such as headache, backache, toothache, muscle strains, period pain, and aches and pains due to colds and flu . It is important to note that paracetamol does not treat the cause of the pain, but rather eases the feeling of pain 

Usage

Paracetamol is commonly used to relieve pain caused by conditions such as:

• Headache

• Toothache

• Muscle strains

• Period pain (dysmenorrhea)

• Colds and flu symptoms

• Sore throat

• Sinus pain

• Post-operative pain

• Fever (pyrexia) 2

It is important to note that paracetamol is not a treatment for the underlying cause of pain but rather provides temporary relief from pain symptoms.

Dosage

The usage of paracetamol depends on various factors such as age, weight, the type of paracetamol being taken, and its strength. Here are some general guidelines:

• Adults: Adults can usually take 1 or 2 tablets (500mg) of paracetamol every 4-6 hours, but should not take more than 4g (8 x 500mg tablets) within a 24-hour period 1.

• Children: The dosage for children varies based on their age and weight. It is important to follow the instructions provided by a healthcare professional or the packaging of the specific paracetamol product.

 

Side Effects

It is generally considered safe when taken as directed. However, like any medication, it can have side effects. Here are some common side effects associated with paracetamol:

• Drowsiness and fatigue: Paracetamol may cause drowsiness or tiredness in some individuals.

• Rashes and itching: Skin rashes and itching are rare side effects of paracetamol.

• Allergic reactions: Although rare, some individuals may experience allergic reactions to paracetamol, which can include skin rashes, itching, swelling of the throat, tongue, or face, shortness of breath, or wheezing.

• Liver problems: Taking excessive amounts of paracetamol or using it for a prolonged period can potentially cause liver damage. Symptoms of liver problems may include nausea, sudden weight loss, loss of appetite, and yellowing of the eyes and skin.

Precaution

When taking paracetamol, it is important to consider the following precautions:

1. Allergies: Do not take paracetamol if you are allergic to it or any of the other ingredients in the product you are taking 1.

2. Other medications: Paracetamol is found in many over-the-counter cold and flu medications. It is important to check the ingredients of other medications to avoid exceeding the recommended dose of paracetamol 1.

3. Medical conditions: Before taking paracetamol, inform your healthcare provider about any medical conditions you have, including liver or kidney problems, mild arthritis, being underweight or malnourished, or regularly consuming alcohol. Certain medical conditions may require special consideration or dosage adjustments when taking paracetamol 1.

4. Dosage: It is important to follow the recommended dosage instructions provided by healthcare professionals or the packaging of the specific paracetamol product you are using. Taking excessive amounts of paracetamol or using it for a prolonged period can potentially cause liver damage 2.

5. Overdose: Taking too much paracetamol can be dangerous and may lead to liver damage. If you suspect an overdose, seek immediate medical attention or call emergency services.

Overdose

Paracetamol overdose can occur after excessive ingestion of paracetamol or paracetamol-containing medication as an acute or staggered overdose, or therapeutic excess. Initial symptoms may be mild gastrointestinal symptoms or no symptoms at all. However, if left untreated, paracetamol poisoning can lead to liver failure 1.

When paracetamol is taken in overdose, a toxic compound called N-acetyl-p-benzoquinone imine (NAPQI) can build up in the liver. Normally, this compound is quickly detoxified by a substance called glutathione. However, in cases of overdose, the stores of glutathione can be depleted, leading to an accumulation of NAPQI and potential liver damage 2.

Prompt treatment is crucial in cases of paracetamol overdose. The main treatment for paracetamol overdose is acetylcysteine, which is believed to reduce liver damage and mortality. Acetylcysteine works by replenishing the depleted glutathione stores and helping to detoxify the NAPQI compound 3.

Interaction

Paracetamol can interact with certain medications and medical conditions. Here are some important points to consider:

1. Medication Interactions: Paracetamol can interact with other medications, including prescription drugs, over-the-counter medications, and herbal supplements. It is important to inform your healthcare provider about all the medications you are taking to avoid potential interactions. Some medications that may interact with paracetamol include certain antibiotics, anticoagulants (blood thinners), and medications that affect liver function.

2. Alcohol: Drinking alcohol while taking paracetamol can increase the risk of liver damage. It is generally recommended to avoid alcohol when using paracetamol.

3. Medical Conditions: Certain medical conditions may require caution when taking paracetamol. For example, individuals with liver or kidney disease should consult their healthcare provider before using paracetamol. Additionally, individuals with a history of alcohol abuse or malnutrition may be at a higher risk of liver damage from paracetamol and should use it with caution.

4. Warfarin: There is some controversy regarding the potential interaction between paracetamol and warfarin, a blood-thinning medication. Some studies suggest that paracetamol may increase the anticoagulant effects of warfarin, while others show no significant interaction. It is important to consult with a healthcare provider if you are taking warfarin and considering using paracetamol 1.

5. Gastric Emptying: The absorption of paracetamol can be affected by drugs that alter gastric emptying. However, this is unlikely to cause serious adverse effects 2.

Mechanism

The exact mechanism of action of paracetamol (also known as acetaminophen) is not fully understood, despite being used for over 100 years. However, there are several proposed mechanisms:

1. Prostaglandin Inhibition: Paracetamol is believed to inhibit the production of prostaglandins, which are substances involved in pain and inflammation. Unlike non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol does not significantly reduce tissue inflammation 1.

2. COX Enzyme Inhibition: Paracetamol has been shown to inhibit cyclooxygenase (COX) enzymes, particularly COX-2. COX enzymes are involved in the production of prostaglandins. However, the inhibition of COX by paracetamol is considered weak compared to NSAIDs 2.

3. Actions of Metabolite AM404: Paracetamol is metabolized in the body to produce a metabolite called N-arachidonoylphenolamine (AM404). This metabolite is believed to have additional analgesic effects by acting on cannabinoid receptors and inhibiting the reuptake of certain neurotransmitters like serotonin 2.

4. Other Pathways: Paracetamol may also have effects on serotonergic, opioid, and nitric oxide pathways, although the extent and significance of these effects are still being studied 1.

Disclaimer

It is important to talk to a healthcare provider or pharmacist about all medications and supplements being taken, to determine whether any interactions may occur. They can advise on the appropriate use and dosage of aspirin to avoid any potential drug interactions.