Paracetamol: Uses,Dosage,Side Effects

Generic Name

Paracetamol
Therapeutic Class: Analgesic, Anti Inflammatory (Non opioid analgesics)

Indications:
All conditions requiring relief from pain and fever such as neuritis, neuralgia, headache, toothache, earache, body ache, myalgia, minor arthritis pain, pain due to rheumatic disorder, cold, influenza, dysmenorrhoea etc.

Presentation:
Paracetamolt Tablet: Each tablet contains Paracetamol BP 500 mg.
Paracetamol Syrup: Each 5 ml syrup contains Paracetamol BP 120 mg.
Paracetamol Paediatric Drops: Each ml paediatric drops contains Paracetamol BP 80 mg.

Description:
Paracetamol is a fast-acting and safe analgesic with the marked antipyretic property. It is especially suitable for patients who, for any reason, can not tolerate aspirin or other analgesics.

Dosage & Administration:
Tablet
Adult: 1 - 2 tablets every 4 to 6 hours up to a maximum of 4 g (8 tablets) daily
Children: (6 - 12 years): 1/2 to 1 tablet 3 to 4 times daily

Syrup/Suspension

• Children: 2 months: 60 mg (1/2 measuring spoonful) for post immunization pyrexia;
• Under 3 months (on doctor's advice only) : 10 mg/kg (5 mg/kg if jaundiced)
• 3 months - 1 year : 60 - 120 mg (1/2 - 1 measuring spoonful),
• 1 - 5 years : 1 - 2 measuring spoonful
• 6 - 12 years : 2 - 4 measuring spoonful
• Adults: 4-8 teaspoonful 3 to 4 times daily.

Suppository:

• Children 3-12 months: 60-120 mg,4 times daily.
• Children 1-5 years: 125-250 mg 4 times daily.
• Children 6-12 years: 250-500 mg 4 times daily.
• Adults & children over 12 years: 0.5-1 gm 4 times daily.

Paediatric Drops
2 months: 60 mg for post-immunization pyrexia; under 3 months (on doctors advice only), 10 mg/kg (5 mg/kg if jaundiced); 3 months- 1 year: 60-120 mg; 1 - 5 years: 120-250 mg.

Paediatric drops may be given to children and neonates according to the following guideline:
Age Dose of Paediatric Drops

• 0-3 months 0.5 ml (up to 4 times daily)
• 4-11 months 1 ml (up to 4 times daily)
• 12-23 months 1.5 ml (up to 4 times daily)
• 2-3 years 2 ml (up to 4 times daily)
• 4-5 months 3 ml (up to 4 times daily)

Side Effects:
Side effects of paracetamol are usually mild, though haematological reactions including thrombocytopenia, leukopenia, pancytopenia, neutropenia, and agranulocytosis have been reported. Pancreatitis, skin rashes, and other allergic reactions occur occasionally.

Pregnancy & Lactation:
Pregnancy category B according to USFDA. This drug should be used during pregnancy only if clearly needed

Precautions:
Paracetamol should be given with care to patients with impaired kidney or liver function. Paracetamol should be given with care to patients taking other drugs that affect the liver.

Interaction:

Patients who have taken barbiturates, tricyclic antidepressants and alcohol may show diminished ability to metabolise large doses of Paracetamol. Alcohol can increase the hepatotoxicity of Paracetamol overdosage. Chronic ingestion of anticonvulsants or oral steroid contraceptives induce liver enzymes and may prevent attainment of therapeutic Paracetamol levels by increasing first-pass metabolism or clearance.

Overdose:
Symptoms of paracetamol overdose in the first 24 hours are pallor, nausea, vomiting, anorexia and abdominal pain. Liver damage may become apparent 12 to 40 hours after ingestion. Abnormalities of glucose metabolism and metabolic acidosis may occur.

Storage:
Keep in a dry place away from light and heat. Keep out of the reach of children.