Tylenol, Panadol, Crocin, Napa, Ace
Generic Name
paracetamol
Manufacturer
Various (e.g., Beximco Pharma, Square Pharma, Sanofi, GSK)
Country
Global
Loading images...
Description
Overview of the medicine
Paracetamol (also known as acetaminophen) is a widely used medication for the relief of pain and fever. It is one of the most common over-the-counter analgesics.
Uses & Indications
Dosage
Adults
500-1000 mg every 4-6 hours as needed, not exceeding 4000 mg in 24 hours. Extended-release: 1300 mg every 8 hours, not exceeding 3900 mg in 24 hours.
Elderly
Similar to adults, but caution is advised in patients with impaired renal or hepatic function. Consider reduced dose or extended dosing intervals.
Renal_impairment
Adjust dose based on creatinine clearance; e.g., CrCl < 10 ml/min: administer every 8 hours. Maximum daily dose should be reduced.
How to Take
Oral administration (with or without food), rectal administration (suppository), or intravenous infusion (hospital setting).
Mechanism of Action
Paracetamol's exact mechanism is not fully understood, but it is believed to inhibit prostaglandin synthesis primarily in the central nervous system, leading to analgesic and antipyretic effects. It may also act on the endocannabinoid system.
Pharmacokinetics
Onset
Pain relief starts within 30-60 minutes; fever reduction within 30 minutes.
Excretion
Excreted predominantly by the kidneys as glucuronide and sulfate conjugates.
Half life
Approximately 1.25 to 3 hours in adults.
Absorption
Rapidly and almost completely absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 30-60 minutes.
Metabolism
Primarily metabolized in the liver via glucuronidation and sulfation. A small portion is metabolized by cytochrome P450 enzymes to a toxic intermediate (N-acetyl-p-benzoquinone imine, NAPQI), which is normally detoxified by conjugation with glutathione.
Side Effects
Contraindications
- Hypersensitivity to paracetamol or any component of the formulation
- Severe hepatic impairment or active liver disease
Drug Interactions
Alcohol
Chronic heavy alcohol consumption increases the risk of hepatotoxicity with paracetamol, even at therapeutic doses.
Warfarin
May increase the anticoagulant effect of warfarin, leading to an increased risk of bleeding, especially with prolonged use of high doses of paracetamol. Monitor INR.
Other hepatotoxic drugs
Concurrent use may increase the risk of liver damage.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose can cause severe, potentially fatal liver damage (hepatotoxicity). Symptoms may include nausea, vomiting, abdominal pain, loss of appetite, and jaundice. Treatment involves gastric lavage, activated charcoal, and intravenous N-acetylcysteine (NAC) as an antidote.
Pregnancy & Lactation
Paracetamol is generally considered safe for use during pregnancy and lactation at recommended doses, making it a first-line analgesic. However, always consult a healthcare professional before use.
Side Effects
Contraindications
- Hypersensitivity to paracetamol or any component of the formulation
- Severe hepatic impairment or active liver disease
Drug Interactions
Alcohol
Chronic heavy alcohol consumption increases the risk of hepatotoxicity with paracetamol, even at therapeutic doses.
Warfarin
May increase the anticoagulant effect of warfarin, leading to an increased risk of bleeding, especially with prolonged use of high doses of paracetamol. Monitor INR.
Other hepatotoxic drugs
Concurrent use may increase the risk of liver damage.
Storage
Store below 30°C in a dry place, away from direct sunlight and moisture. Keep out of reach of children.
Overdose
Overdose can cause severe, potentially fatal liver damage (hepatotoxicity). Symptoms may include nausea, vomiting, abdominal pain, loss of appetite, and jaundice. Treatment involves gastric lavage, activated charcoal, and intravenous N-acetylcysteine (NAC) as an antidote.
Pregnancy & Lactation
Paracetamol is generally considered safe for use during pregnancy and lactation at recommended doses, making it a first-line analgesic. However, always consult a healthcare professional before use.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, depending on the formulation and packaging.
Availability
Pharmacies, supermarkets
Approval Status
Widely approved globally (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Paracetamol has undergone extensive clinical trials and research over decades, establishing its efficacy and safety profile for pain and fever management. Ongoing research may explore new formulations or specific patient populations.
Lab Monitoring
- Liver function tests (ALT, AST, bilirubin) in cases of suspected overdose or prolonged high-dose therapy.
- Serum paracetamol levels in overdose situations.
Doctor Notes
- Emphasize the critical importance of adhering to the maximum daily dose to prevent potentially fatal hepatotoxicity.
- Educate patients about the active ingredient acetaminophen being present in many combination products to avoid accidental overdose.
Patient Guidelines
- Do not exceed the recommended dose to avoid liver damage.
- Do not take with other paracetamol-containing products.
- Consult a doctor if pain or fever persists for more than a few days.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not take a double dose to make up for a missed one. Continue with your regular dosing schedule.
Driving Precautions
Paracetamol generally does not affect the ability to drive or operate machinery. However, if you experience dizziness or drowsiness (rare), avoid such activities.
Lifestyle Advice
- Avoid excessive alcohol consumption while taking paracetamol, especially with regular use.
- Ensure adequate hydration.
Alternative Medicines in Bangladesh
Similar medicines available in the market
Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.