Paracetamol is a painkiller used for the relief of mild-moderate pain. It also helps to relieve a high temperature (fever)
It falls under the drug class non-opioid analgesics (analgesic is another name for painkiller)
Paracetamol tablets
10+ years
Calpol (paracetamol liquid for under 12s and those who are unable to swallow)
Other forms of paracetamol available OTC:
Paracetamol with caffeine
Paracetamol with codeine (co-codamol)
PANADOL – Paracetamol with dihydrocodeine (co-dydramol)
PARACETAMOL DRUG INFORMATION
ABOUT PARACETAMOL
Paracetamol is a painkiller used for the relief of mild-moderate pain. It also helps to relieve a high temperature (fever)
It falls under the drug class non-opioid analgesics (analgesic is another name for painkiller)
HOW DOES PARACETAMOL WORK?
The exact action mechanism of paracetamol is unknown. It is thought to inhibit enzymes that are part of a pathway of pain signals, and temperature regulation signals.
WHO CAN TAKE PARACETAMOL?
Paracetamol is a widely used and generally very well tolerated painkiller for people of all ages above 2 months old (3 months and above for application to the buttocks).
For young children, they should weigh at least 4kg and not be a premature birth (before 37 weeks). [2]
For infants under 2 months old, a doctor should be consulted (they can still give paracetamol under this age under special guidance from a paediatrician)
DO NOT TAKE PARACETAMOL IF:
- Under 2 months of age (unless under expert supervision)
- Have allergies to paracetamol or any of the other ingredients in the paracetamol-based product
PARACETAMOL WITH OTHER MEDICATIONS
Other medications may further increase the risk of liver damage that paracetamol already adds to.
Severe interactions – avoid taking together
- Flucloxacillin – an antibiotic mainly for skin related infections. Can cause high acidity in the body which could be dangerous
- A group of blood thinners known as heparins (eg: enoxaparin, tinzaparin)
- Phenindione – a blood thinner
- Anti-cancer drugs
Tell your doctor if you are also taking other medications including the following:
- Anti-epilepsy drugs (eg: Phenytoin, primidone)
- Other antibiotics
- Antifungal
- Antivirals
- Cholesterol medications (eg: Atorvastatin, Simvastatin)
- Heartbeat medications (eg: Amiodarone)
PARACETAMOL AND ALCOHOL
- Those who drink heavily should avoid paracetamol as it can cause severe liver damage.
- If you already have liver issues, it is best to avoid alcohol altogether to prevent further damage
USE PARACETAMOL WITHIN CAUTION IF:
- Before taking/giving, check when last dose of paracetamol was given (should be at least 4-6 hour spacing between doses) and check total amount of paracetamol dose over previous 24 hours (maximum 4000mg paracetamol per day)
- Body weight under 50kg – at higher risk for toxicity at the therapeutic dose
- Frequent alcohol consumers
- Chronic dehydration
- Chronic malnutrition
- Liver impairments – increased risk of toxicity, dose may need to be reduced
- Severe kidney impairment – dose adjustment may be needed
- Long term use – particularly in those who are malnourished
PREGNANCY AND BREASTFEEDING
- Safe in both
- Is present in breast milk but amount too small to cause any harm
- It is still best to use it at the lowest effective dose for the shortest possible time as there is a small chance of side-effects
SIDE EFFECTS OF PARACETAMOL INCLUDE
Common:
Rectal use – irritation of rectal area (redness and inflammation)
Unknown frequency (oral use) – speak to doctor if any signs of these occuring:
- Get infections, bruise easier than normal and possibly a sore throat. Sign of weakened immune system from lower white blood cell count or other blood disorders (agranulocytosis, neutropenia, thrombocytopenia)
- Excess acidity of blood (known as high anion-gap metabolic acidosis). A very serious and potentially life-threatening condition but thankfully rare. Those at risk are mainly people with severe illness or taking other medication, especially antibiotics such as Flucloxacillin.
- Bronchospasm – tightening of the airways leading to the lungs. May cause difficulty breathing or wheezing.
- Liver disorder or damage – look out for yellowing of skin + eye whites, tiredness, sickness and vomiting for more than 24 hours especially if with pain and tenderness around the lower right rib.
- Rash
- Skin reaction – can be severe
HOW TO TAKE PARACETAMOL – UNDER 16
For children under 16; the dose is highly dependent on age.
SYRUP
Calpol Infant – 2 months to 5 years old – Paracetamol 120mg/5mL
Give one dose at a time, maximum 4 times within 24 hours. Leave at least 4 hours between doses.
Appropriate dose for age:
3-5 months: 2.5mL (60mg)
6-23 months: 5mL (120mg)
2-3 years: 7.5mL (180mg)
4-5 years: 10mL (240mg)
Comes with spoon with 5mL and 2.5mL measurements.
Calpol Sixplus – 6+ years old – Paracetamol 250mg/5mL
Give one dose at a time, maximum 4 times within 24 hours. Leave at least 4 hours between doses.
Can also be used for older children/adults with swallowing difficulties.
Appropriate dose for age:
6-7 years: 5mL (250mg)
8-9 years: 7.5mL (375mg)
10-12 years: 10mL (500mg)
12-16 years: 10-15mL (500-750mg)
16+: 10-20mL (500-1000mg)
Comes with spoon with 5mL and 2.5mL measurements.
TABLETS
Calpol Fastmelts tablets – 6+ years old – Paracetamol 250mg melting tablets
Give one dose at a time, maximum 4 times within 24 hours. Leave at least 4 hours between doses.
Can also be used for adults with swallowing difficulties.
Appropriate dose for age:
6-9 years: 1 tablet (250mg)
10-12 years: 2 tablets (500mg)
12-16 years: 2-3 tablets (500-750mg)
16+: 2-4 tablets (500mg – 1000mg)
PARACETAMOL TABLETS 500mg – 10-15 years old (to swallow)
Take ONE tablet (500mg) up to FOUR times daily leaving at least a 4-6 hour gap in between doses. Do not take more than 4 tablets (2g) in 24 hours.
HOW TO TAKE PARACETAMOL – 16+:
Tablets (500mg)
Take 1-2 tablets up to 4 times a day, leaving at least a 4-6 hour gap in between doses. Do not take more than 8 tablets (4g) in 24 hours.
Do not take anything else containing paracetamol.
OVERDOSE
- Taking too much paracetamol (more than 2 tablets at once or more than 8 tablets a day) can causse significant liver injury and sometimes kidney damage.
- Severe overdoses can be fatal.
TAKING PARACETAMOL WITH IBUPROFEN
- Paracetamol can be taken together with ibuprofen
- It is better if can space them out by at least 1 hour apart as opposed to taking both at once (stagger the dose)
- Waiting at least an hour allows to see the need to take the other; if adequate relief is observed with just one it is best not to take the other due to higher risk of side-effects.
SOURCES:
https://bnf.nice.org.uk/drugs/paracetamol/
[2] https://www.calpol.co.uk/our-products/calpol-infant-suspension
[3] https://bnf.nice.org.uk/drugs/paracetamol/#pregnancy
[4] https://www.nhs.uk/medicines/paracetamol-for-adults/common-questions-about-paracetamol-for-adults/
[5] https://www.nhs.uk/medicines/paracetamol-for-children/how-and-when-to-give-paracetamol-for-children/
[6] https://www.calpol.co.uk/our-products/calpol-sixplus-oral-suspension-paracetamol
[7] https://www.calpol.co.uk/our-products/calpol-sixplus-fastmelts
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