Paracetamol / Acetaminophen

Paracetamol: 

It is a very good and promptly acting antipyretic having negligible anti-inflammatory action.

Goodness:

• Does not stimulate respiration or affect acid-base balance; 
• Does not increase cellular metabolism. 
• Has no effect on CVS. 
• Gastric irritation is insignificant— mucosal erosion and bleeding occur rarely only in overdose. 
• Does not affect platelet function or clotting factors and is not uricosuric.

Adverse effects: 

• In isolated antipyretic doses paracetamol is safe and well tolerated. 
• Nausea and rashes occur occasionally, leukopenia is rare.

Uses:

 Paracetamol is one of the most commonly used ‘over-the-counter’ analgesics for 

• Headache, 
• Mild migraine, 
• Musculoskeletal pain, 
• Dysmenorrhea, etc. 
• Recommended as first choice analgesic for osteoarthritis by many professional bodies. 
• One of the best drugs to be used as antipyretic, especially in children (no risk of Reye’s syndrome). 
• Can be used in all age groups (infants to elderly), pregnant/lactating women, in presence of other disease states and in patients in whom aspirin is contraindicated. 
• Does not have significant drug interactions.

Acute paracetamol poisoning:

• Occurs especially in small children who have low hepatic glucuronide conjugating ability. 
• If a large dose (> 150 mg/kg or > 10 g in an adult) is taken, serious toxicity can occur. 
• Fatality is common with > 250 mg/kg

Dose: 

325–650 mg (children 10–15 mg/kg) 3–5 times a day. 

Examples:

• CROCIN 0.5, 1.0 g tabs; 
• METACIN, PARACIN 500 mg tab, 125 mg/5 ml syrup, 150 mg/ml paed. drops, 
• ULTRAGIN, PYRIGESIC, CALPOL 500 mg tab, 125 mg/5 ml syrup, 
• NEOMOL, FEVASTIN, FEBRINIL 300 mg/2 ml inj., 
• CROCIN PAIN RELIEF: 650 mg + Caffeine 50 mg tab. 
• JUNIMOL-RDS 80, 170, 250 mg suppository (for children), 
• PARACETAMOL RECTAL SUPPOSITORY 80, 170 mg

References:

1. Tripathi KD. Essentials of medical pharmacology. JP Medical Ltd; 2013 Sep 30.
2. https://www.typharm.com/products/paracetamol-suppositories/ photo credit
3. https://www.1mg.com/drugs/dolo-650-tablet-74467 photo credit
4. https://www.flipkart.com/crocin-650-advance-tablets/p/itm3ee60252e3497photo credit
5. https://www.calpol.co.uk/our-products/calpol-infant-suspension photo credit