Introduction

Paracetamol or sometimes recognized by various brands available in the market such as Panadol™, Uphamol™ and many others has come long since it become the most widely used antifever and pain medication in Malaysia. Most Malaysians are well informed on the proper way to take paracetamol which. can be found easily in grocery shops, hypermarkets and pharmacies.

Paracetamol is safe and effective in lowering body temperature due to fever if taken in the amount recommended by the package label. However, paracetamol can be dangerous if taken more than the indicated amount.

Paracetamol is also effective in management of mild to moderate pain such as pain caused by osteoarthritis, migraine headache and tension headache. However, patients should always get medical advice from doctor if paracetamol is to be taken for a long period of time. Paracetamol can also be found in combination with other therapeutic agents such as antihistamine to provide relief in condition that accompanies fever such as running nose.

What paracetamol is used for

Paracetamol is used to relieve pain (and discomfort) associated with : several types of headache, toothache, backache, arthritic pain, muscular aches, osteoarthritis, menstrual/ period pain, fever and/or discomfort with fever.

Dosage and administration

Paracetamol is often taken orally in various types of preparation such as suspensions, tablets or effervescent tablet. It also comes in different strength. For patient who may not tolerate orally, paracetamol can be given through rectal route by using suppository.

For self medication, the use of paracetamol is not advisable for a period of more than 10 days in adults and 5 days in children unless directed by doctors. Paracetamol should not be used in a period  of more than 3 days in high fever condition unless under proper medical  advice.

The usual dosage for adult is 500mg every 4-6 hours or 1g every 4-6 hours when needed, the total dosage taken per day should never exceeds 4g.

Before you take Paracetamol

Paracetamol is generally safe if taken within the recommended dose. Always make sure that not more than one preparation containing paracetamol is taken together at one time. Check the medication labels to avoid taking more than the recommended dose. Medication labels usually provide the ingredients of the medication.

Take necessary caution when administering paracetamol to children. You need to know that paracetamol preparation for children contains different strength of paracetamol from the adult preparation. Paracetamol preparation for children usually is in the form of liquid, syrup or suppository and different strength. Make sure that you have read the labels before administering the medication to your children. Label on the bottles usually indicates the suitable dose for certain groups of age. Ensure that your children received the dose suitable to their age group. Never assume the dose to be given to your children.

Side Effects/Adverse Drug Reaction

Most people taking paracetamol do not experience any serious side effects. However, immediately inform your doctor if you experience any serious side effects such as increased bleeding tendency, bruising and signs of infection such as fever and sore throat.

Continuous consumption of paracetamol or taking paracetamol more than the recommended dose may results in liver disease. Immediately seek medical help if you picked up any of these following liver damage symptoms: persistent nausea and vomiting, yellowing eyes/skin, dark urine, stomach/abdominal pain, extreme tiredness.

Allergic reaction is also rare in taking paracetamol, however if occur, watch out for allergic reaction symptoms such as itching, rash, swelling (face/tongue/throat), severe dizziness and breathing difficulties.
In case of paracetamol overdose or poisoning, seek medical attention immediately even if there is no signs of poisoning. Delayed effects are often observed in paracetamol poisoning. The patient may not experience the symptoms of poisoning at first but the symptoms may appear days later. Early treatment may prevent permanent damage to the liver.

Drug Interaction

Always ensure that your doctor or pharmacist knows the list of medication you are taking to avoid possible interaction with other medicine.

Missed dose

If you missed a dose, take as soon as you remember however if it is already near the next dose skip the dose and take the medication on the next scheduled time. Never double your dose.

Storage

Keep all your medicines away from lights and moisture and do not store in bathroom. Medicine should also be kept away from children.

References

Acetaminophen: Patient Handout, www.medscape.com