Paracetamol
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Paracetamol Uses, Side effects, Dosage, Interaction, Precautions

Get all information of Paracetamol includes uses, side effects, dosage, interaction, precautions, safety in pregnancy and breastfeeding with details

Paracetamol also known and called as ..

  • PCM  – Short name of Paracetamol
  • Acetaminophen – Synonym
  • N-acetyl-p-amino-phenol  – Mostly used by Pharmacy students

Description :

Paracetamol is a commonly used medicine that can help treat pain and reduce a high temperature which we called Fever.

It’s typically used to relieve mild or moderate pain, such as muscle ache, headache, toothache, arthritis and backache and reduce fevers caused by illnesses such as colds and flu and other occasional problems.

Paracetamol is often recommended as one of the first treatments for pain, as it’s safe for most people to take and side effects are rare.

Paracetamol commonly available as a Tablet as a Paracetamol 500 mg and Paracetamol 650 mg , while it also available as a Injection and as a syrup / Liquid for Children.


How it Works ?

Paracetamol / Acetaminophen is an analgesic (pain reliever) and anti-pyretic (fever reducer). It works by blocking the release of certain chemical messengers that cause pain and fever. Paracetamol increases the pain threshold and decreases swelling. It also brings down elevated body temperature by acting on heat regulatory centers in the brain.


Uses of Paracetamol

Why I have been prescribed Paracetamol?

  • Fever  : Provide temporary relief from fever without treating the underlying cause.
  • Headache : Relieve acute headaches including a migraine.
  • Muscle Pain : Used to relieve mild to moderate pain in the muscles.
  • Menstrual Cramps : Relieve pain and cramping associated with menstrual cycles in women.
  • Post Immunization Pyrexia : Used in the treatment of pain and fever that sets in after one has taken vaccinations.
  • Arthritis : Relieve joint pain including mild to moderate pain in arthritis.

Side effects  (Read in Depth)

What are the Major & minor side effects for Paracetamol?

  • Nausea or Vomiting
  • Allergic skin reaction
  • Gastric / Mouth Ulcer
  • Anemia
  • Fatigue
  • Stevens-Johnson Syndrome

When not to use?

what are the Contraindications of Paracetamol?

  • Allergy
  • Analgesic Nephropathy (Kidney Disease)
  • Severe liver impairment

Expert Advise for Paracetamol / Acetaminophen / PCM

  • Good for pain relief and fever but not effective in joint pain due to poor anti-inflammatory action.
  • Starts working within one hour. Wait for at least 4 hours before taking the next dose.
  • Present in many over-the-counter (OTC) and prescription medicines. Avoid taking more than one paracetamol product at a time to prevent overdose. Doses >4 g/day (2 g in alcoholics) may cause liver, kidney or heart problems.
  • Discontinue Paracetamol / Acetaminophen and inform your doctor immediately if rash occurs.
  • For children, measure the doses of liquid Paracetamol / Acetaminophen using the measuring cup instead of a teaspoon to avoid under or over-dosage.
  • Avoid excess alcohol intake (>3 glasses/day) when taking Paracetamol / Acetaminophen as it may cause liver damage.

Dosage of Paracetamol  (Read in Depth)

For Adult : the recommended paracetamol dosing for adults and children 12 years and over is 500 to 1000 mg every four to six hours as necessary, with a maximum of 4000 mg in any 24 hour period.

For Children : The optimal dosing for children (1 month to 12 years) is 15 mg per kg, which can be given every four to six hours as required, with no more than four doses in 24 hours.


Interactions 

Interaction with alcohol : MAJOR   (Read in Depth)

  • Drinking alcohol with this medicine can have a severe effect on the liver.
  • Consumption of alcohol is not recommended during treatment with this medicine due to the increased risk of serious side effects such as severe gastrointestinal bleeding, dizziness, fatigue, weakness, rashes, nausea, joint pain, fever, jaundice, etc.

Interaction with Medicine :

  • Carbamazepine : MODERATE
  • Phenytoin : MODERATE
  • Sodium Nitrite : SEVERE
  • Leflunomide : SEVERE
  • Prilocaine : SEVERE

Interaction With food :

  • Generally Safe

Disease interactions :

  • Alcoholism  SEVERE
  • Liver Disease  SEVERE

Lab Test Results interaction : 

  • 5-HIAA Urine Test MODERATE

Paracetamol In pregnancy? (Read in Depth)

Paracetamol has been used by pregnant women for many years without any obvious harmful effects on the developing baby. For this reason paracetamol is usually recommended as the first choice of painkiller for pregnant women though is not recommended for use in pregnant women unless necessary and the potential benefits outweigh the risks involved.

This medicine is not known to cause any harm to the fetus, but should only be used after consultation with your doctor. Oral administration of the medicine should be preferred over the intravenous route.

Other painkillers, including those sold over the counter without a prescription have not been shown to be any safer than paracetamol; some are not suitable for use during certain stages of pregnancy. Although it is not possible to say that any medicine is absolutely safe to use in pregnancy, there is currently no good evidence that paracetamol will harm your baby. It is however generally recommended that women who are pregnant use the lowest dose of paracetamol that works, only for as long as needed.


Usage while breast-feeding?

This medicine is safe to use during breastfeeding. It is advised to consult your doctor before taking this medicine. Monitor the infant for any undesired side effects and report any incidence of rashes on skin or diarrhea in the infant to the doctor immediately.


Warnings

Overdose – This medicine is available in the market in various dosage forms. Read the label carefully before consuming this medicine to avoid overdosage. Overdose may result in liver damage. Seek emergency medical attention if an overdose of this medicine is suspected.

Liver Disease – This medicine should be used with extreme caution in patients suffering from liver function impairment or active liver diseases due to the increased risk of severe adverse effects. Close monitoring of liver function is necessary while receiving this medicine. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.

Chronic Malnutrition – This medicine should be used with extreme caution in patients suffering from malnourishment due to the increased risk of severe adverse effects. Appropriate dose adjustments or replacement with a suitable alternative may be required in some cases based on the clinical condition.


Other Details 

Onset of action : The effect of this medicine can be observed within 1 hour of oral administration. When given in the form of an intravenous injection, the pain-relieving action starts in 5-10 minutes. For fever reduction, the time taken is about 30 minutes.

Duration of effect : The effect of this medicine lasts for an average duration of 4-6 hours.

Must know

  • Can be taken with or without food, as advised by your doctor
  • To be taken as instructed by doctor
  • Does not cause sleepiness

Legal Status :  Approved


Commonly Asked Questions / FAQs 

Can I take Paracetamol / Acetaminophen with vitamin B complex?

Yes, Paracetamol / Acetaminophen can be taken with vitamin B-complex preparations. They have been used together in the treatment of acute and painful diseases affecting nerves like trigeminal neuralgias, post-operative pain, etc. Paracetamol / Acetaminophen helps to relieve pain and vitamin B-complex corrects the deficiency that might be causing your symptoms.

Is Paracetamol / Acetaminophen use associated with Helicobacter pylori infection?

No, Paracetamol / Acetaminophen use is not associated with Helicobacter pylori infection. Painkiller drugs can increase the acid secretion in the stomach, aggravate the symptoms of this infection and the risk of stomach and the intestine ulcer. However, this risk is minimum with Paracetamol / Acetaminophen as compared to other pain killers.

Can I take Paracetamol / Acetaminophen with fexofenadine?

Yes, Paracetamol / Acetaminophen can be taken safely with fexofenadine. No drug-drug interactions or any harmful effects have been reported. These are used together to treat the symptoms of cold, cough, flu or a sore-throat and other allergic or viral diseases. Fexofenadine helps to relieve sneezing, runny nose, itchy throat, or eyes and Paracetamol / Acetaminophen helps to relieve pain or fever.

Can I take Paracetamol / Acetaminophen with warfarin?

Paracetamol / Acetaminophen is safe to use occasionally with warfarin as other painkillers like ibuprofen and aspirin can increase the risk of bleeding. However, on a long-term use, Paracetamol / Acetaminophen can also increase the risk of bleeding. Talk to your doctor before taking them together as you may need to be monitored regularly.

Can I take Paracetamol / Acetaminophen with tamsulosin?

Paracetamol / Acetaminophen can be taken with Tamsulosin. No harmful side effects or other interactions have been seen when they are taken together. Tamsulosin is an alpha adrenergic receptor blocker used to treat symptoms of benign prostatic hyperplasia.

Can I take Paracetamol / Acetaminophen with cetirizine?

Yes, Paracetamol / Acetaminophen can be taken safely with cetirizine. No drug-drug interactions or any harmful effects have been reported. These are used together to treat the symptoms of cold, cough, flu or a sore throat and other allergic or viral diseases. Cetirizine helps to relieve sneezing, runny nose, itchy throat, or eyes and Paracetamol / Acetaminophen helps to relieve pain or fever.

Can I take Paracetamol / Acetaminophen with ibuprofen?

Yes, Paracetamol / Acetaminophen can be taken with ibuprofen. Both help to relieve pain and fever and ibuprofen also decreases inflammation and swelling. However, both increase the acid secretion in the stomach and can cause acid reflux, heartburn, stomach, and intestinal ulcers and gut bleeding on long-term use.

Does Paracetamol / Acetaminophen cause weight loss?

Paracetamol / Acetaminophen is not known to cause weight loss. It is a very safe medicine for short term use and can cause minor and rare side effects like low blood pressure, and allergic reactions.

Can anyone be allergic to Paracetamol / Acetaminophen?

Yes, there have been reports of hypersensitivity and allergic reaction with the use of Paracetamol / Acetaminophen. Symptoms of an allergy include swelling of the face, mouth, and throat, shortness of breath, urticaria, red rash, and severe itching. Stop taking Paracetamol / Acetaminophen if you have such symptoms and immediately consult your doctor.

How beneficial is to use Paracetamol / Acetaminophen with diclofenac?

Paracetamol / Acetaminophen and Diclofenac might be given together in case of fever and pain. Paracetamol / Acetaminophen has an early onset of action and it helps in relieving the symptoms till diclofenac starts working. However, both are pain killers and can affect stomach lining on long-term use leading to acid reflux, heartburn, and stomach ulcers and bleeding.

Can I take Paracetamol / Acetaminophen for stomach pain?

No, Paracetamol / Acetaminophen should not be taken for stomach pain. You must consult your physician for this. The stomach pain could be due to some underlying condition, which needs attention.

Can I take Paracetamol / Acetaminophen with aceclofenac?

Yes, Paracetamol / Acetaminophen can be given with aceclofenac for fever and pain. Paracetamol / Acetaminophen has an early onset of action and it helps in relieving the symptoms till Aceclofenac starts working. However, both are pain killers and can affect stomach lining on long-term use leading to acid reflux, heartburn, and stomach ulcers and bleeding.

Does Paracetamol / Acetaminophen treat sore-throat, flu or cold?

Paracetamol / Acetaminophen does not treat sore-throat, flu or cold but it can help in relieving fever and body aches associated with these conditions.

Can I take Paracetamol / Acetaminophen with codeine?

Paracetamol / Acetaminophen and codeine can be taken together. No drug-drug interactions or any harmful effects have been reported when they are used together. They are commonly given together for the relief of mild to moderate pain due to different reasons.

Does Paracetamol / Acetaminophen help a cough?

No, Paracetamol / Acetaminophen does not help in the relief of cough but it can help in relieving associated fever and body aches.

Does Paracetamol / Acetaminophen contain alcohol?

No, Paracetamol / Acetaminophen does not contain any alcohol.

Can I take Paracetamol / Acetaminophen with amoxicillin?

Paracetamol / Acetaminophen and amoxicillin can be taken together. Amoxicillin is an antibiotic and is used to treat bacterial infections. Paracetamol / Acetaminophen is given along, for the relief of any associated pain and fever. No drug-drug interactions or any harmful effects have been reported when they are used together.

Does Paracetamol / Acetaminophen have side effects?

Paracetamol / Acetaminophen is quite safe for short term use. It has side effects if taken in more than the dose advised and for a long-term. Immediately consult a doctor if there is nausea, stomach pain, loss of appetite, dark colored urine, clay colored stools or jaundice as it could be due to an overdose of Paracetamol / Acetaminophen.

Is Paracetamol / Acetaminophen safe to use?

Paracetamol / Acetaminophen is safe to use in the dose as advised by the doctor. Use in more than recommended doses can do serious harm.

Is it safe to take Paracetamol / Acetaminophen with erythromycin?

Paracetamol / Acetaminophen and Erythromycin can be taken together. Erythromycin is an antibiotic and is used to treat bacterial infections. Paracetamol / Acetaminophen is given along, for the relief of associated fever. No drug-drug interactions or any harmful effects have been reported when they are used together.

Is Paracetamol / Acetaminophen an antibiotic?

Paracetamol / Acetaminophen is not an antibiotic. It’s an analgesic (pain-killer) and antipyretic (for the relief of fever), whereas an antibiotic is useful for the treatment of infections.

Can I take Paracetamol / Acetaminophen with metronidazole?

Paracetamol / Acetaminophen and Metronidazole can be taken together. No drug-drug interactions or any harmful effects have been reported when used together.

Can I take Paracetamol / Acetaminophen with homeopathic medicine?

Ask your doctor before taking Paracetamol / Acetaminophen with homeopathic medicine as there is no information available on this.

Is it safe to take Paracetamol / Acetaminophen with Tramadol?

Yes, Paracetamol / Acetaminophen can be taken with Tramadol. They are used together for moderate to severe pain in various diseases and their use is associated with common side effects like nausea, dizziness, and sleepiness.No drug-drug interactions have been reported when they are used together.

Can I take Paracetamol / Acetaminophen with Azithromycin?

Paracetamol / Acetaminophen and Azithromycin can be taken together. Azithromycin is an antibiotic and is used to treat bacterial infections. Paracetamol / Acetaminophen is given along, for the relief of any associated pain and fever. No drug-drug interactions or any harmful effects have been reported when they are used together.

Is it safe to take Paracetamol / Acetaminophen with Naproxen?

Yes, Paracetamol / Acetaminophen can be taken with Naproxen. Both are painkillers and belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs) and are used to relieve pain and fever. However, long-term use affects the stomach lining and increase acid secretion which can lead to side effects like acid reflux, heartburn, stomach, and intestinal ulcers and bleeding.

Can a patient with high blood pressure take Paracetamol / Acetaminophen?

Occasional use of Paracetamol / Acetaminophen is safe in patients with high blood pressure. However, if it is to be taken for a long time, you must talk to your doctor. Paracetamol / Acetaminophen belongs to the group of painkillers called analgesics and antipyretics and these drugs can decrease the action of medicines taken by the patient for control of high blood pressure.

Does Paracetamol / Acetaminophen interact with vitamin C?

Vitamin C can be taken with Paracetamol / Acetaminophen. However, vitamin C increases the blood levels of other drugs similar to Paracetamol / Acetaminophen, so it is advised to talk to your doctor if you have to take both these medicines for a long-term.

What happens if you take an overdose of Paracetamol / Acetaminophen?

Overdose of Paracetamol / Acetaminophen can cause potentially life-threatening liver damage, which is the most serious side effect. Early symptoms may include nausea, vomiting, profuse sweating, and general tiredness. Kidney damage, decreased platelet count and coma may also occur. Immediately consult a doctor or consult an emergency in the case of suspected overdosage.

Can I take Paracetamol / Acetaminophen with hyoscine?

Yes, Paracetamol / Acetaminophen and hyoscine can be taken together. Hyoscine is used to relieve pain and cramps of the stomach, gut, urinary bladder and urinary tract while Paracetamol / Acetaminophen is used to relieve mild to moderate pain of a headache, toothache, muscle pain, joint pain, and fever. Together they can be advised by a doctor for painful conditions of the gut and urinary tract.

Can I take Paracetamol / Acetaminophen with Betahistine?

Paracetamol / Acetaminophen can be taken with Betahistine. There are no reported drug-drug interactions or harmful effects when they are used together.

Can I take Paracetamol / Acetaminophen with rabeprazole?

Paracetamol / Acetaminophen and Rabeprazole can be taken together. Rabeprazole is used to prevent Paracetamol / Acetaminophen (painkillers) induced gastritis and stomach ulcers by decreasing the production of acid in the stomach. There are no clinically significant drug-drug interactions or harmful effects seen when they are used together.

How beneficial is to take urofollitropin alpha with Paracetamol / Acetaminophen?

Urofollitropin alpha is given as a subcutaneous injection with the human chorionic gonadotropin (hCG) hormone to assist in ovulation and fertility. Urofollitropin alpha can cause abdominal or pelvic pain or pain and swelling at the injection site in some patients which can be relieved by taking Paracetamol / Acetaminophen.

Can vitamin D be taken safely with Paracetamol / Acetaminophen?

Yes, vitamin D can be taken with Paracetamol / Acetaminophen. Patients with osteoarthritis who are on vitamin D and calcium may need to take Paracetamol / Acetaminophen for the relief of any associated pain. No drug-drug interactions or any harmful effects have been reported.

Can I take clindamycin with Paracetamol / Acetaminophen?

Paracetamol / Acetaminophen and Clindamycin can be taken together. Clindamycin is an antibiotic and is used to treat bacterial infections. Paracetamol / Acetaminophen may be given along, for the relief of associated fever. No drug-drug interactions have been reported clinically. However, both are known to cause liver damage. Talk to your doctor if you need them for a long time.

Does Paracetamol / Acetaminophen affect the liver?

Use of Paracetamol / Acetaminophen for a long time and above recommended doses can cause liver damage ranging from abnormal liver tests to liver failure. If you are taking Paracetamol / Acetaminophen from a long time and have nausea, stomach pain, loss of appetite, dark colored urine, clay colored stools or jaundice, inform your doctor as these could be signs of an underlying liver damage.

Can I take Paracetamol / Acetaminophen if I have hepatitis?

Paracetamol / Acetaminophen is considered the safest painkiller to take for people with hepatitis for mild to moderate pain and fever. However, Paracetamol / Acetaminophen is metabolized in the liver, so, consult your doctor before taking Paracetamol / Acetaminophen if you have hepatitis as it can cause liver damage if taken in higher doses or for a very long time.

What are the serious side effects of taking excess Paracetamol / Acetaminophen?

Potentially severe life-threatening liver injury is a serious side effect seen with an overdose of Paracetamol / Acetaminophen. Overdose can also cause kidney injury, coma, and decreased platelet count. Early symptoms of an overdose include nausea, vomiting, and general tiredness. Immediately consult a doctor or reach an emergency in case of suspected overdose.

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