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Home Health and Environment Awareness Patient Drug Information: Acetaminophen (Paracetamol)

Patient Drug Information: Acetaminophen (Paracetamol)

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Paracetamol (PCT), one of the very commonly prescribed, widely self-medicated over the counter drugs (OTC) in our part of world, deserves a well insight for its safe and effective use. We often consider PCT as a very safe drug for reducing fever (antipyretics), pain (analgesics) and other minor ailments etc. However, it's only an ever told myth! In fact not a single drug is safe for human beings unless it is used with basic precautions: after all we mustn't forget DRUGS ARE JUST THE CHEMICALS!

This article gives a brief overview about PCT and its important facts. It also provides PCT related drug information which may be useful for our day to day life.
PCT is an analgesic-antipyretic agent similar to those of aspirin; however its anti-inflammatory effects are much weaker. PCT is a suitable substitute for aspirin for analgesic or antipyretic uses; useful for patients in whom aspirin is contraindicated. The conventional oral dose of PCT is 325 to 1000mg (650 mg rectally); total daily doses should not exceed 4000 mg (2000 mg/day for chronic alcoholics). Single doses for children range from 40 mg to 480 mg, depending upon age and weight; no more than five doses should be administered in 24 hours. A dose of 10mg/kg also may be used.

Toxicity and common adverse drug reactions (ADRs): PCT is usually well tolerated at therapeutic doses. Sometimes patients may complain of rashes/ allergic reactions. There have been some reports about it causing neutropenia, thrombocytopenia and pancytopenia as well. There can be serious overdosage related ADRs of PCT like fatal hepatic necrosis, renal tubular necrosis and hypoglycemic coma. In adults, hepatotoxicity may occur after ingestion of a single dose of 10 to 15 g (150 to 250mg/kg) of PCT. Clinical indications of hepatic damage are manifest within 2 to 4 days of ingestion of toxic doses with right subcostal pain, tender hepatomegaly, jaundice, and coagulopathy. Liver enzyme abnormalities typically peak 72 to 96 hours after ingestion. Renal impairment or frank renal failure may occur. PCT overdose constitutes a medical emergency. N- Acetylcysteine (NAC) is indicated as an antidote treatment for those at risk of PCT induced hepatic injury.

1. PCT is available without a prescription, but your doctor may prescribe it to treat certain conditions. Follow the directions on the package or prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take PCT exactly as directed. Taking more than the recommended amount may cause damage to your liver.
2. If you are giving PCT to your child, read the package label carefully to make sure that it is the right product for the age of the child. Do not give children PCT products that are made for adults. Drops made for infants are more concentrated (much more medication in each drop) than liquids made for older children
3. PCT comes in combination with other medications to treat cough and cold symptoms. Ask your doctor or pharmacist for advice on which product is best for your symptoms. Check nonprescription cough and cold product labels carefully before using two or more products at the same time.
4. Stop taking PCT and call your doctor if your symptoms get worse, you develop new or unexpected symptoms, including redness or swelling, your pain lasts for more than 10 days, or your fever gets worse or lasts more than 3 days.
5. Do not give PCT to a child who has a sore throat that is severe or does not go away, or that occurs along with fever, headache, rash, nausea, or vomiting. Call the child's doctor right away, because these symptoms may be signs of a more serious condition.
6. Tell your doctor and pharmacist if you are allergic to PCT, any other medications, or any of the ingredients in the product. Ask your pharmacist or check the label on the package for a list of ingredients.
7. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking PCT, call your doctor.
8. If you drink three or more alcoholic beverages every day, ask your doctor if you should take PCT. Ask your doctor or pharmacist about the safe use of alcoholic beverages while taking PCT.
9. This medication is usually taken as needed. If your doctor has told you to take PCT regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
10. Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Durga Bista
Lecturer, Dept of Pharmacology, NMC.

1. Goodman and Gilman's: The Pharmacological basis of therapeutics. 11th edition
2. Medline Plus (www.medlineplus.gov)

Note: Please call us at 014911008 (ext 241) at Department of Clinical Pharmacology, Nepal Medical College, Jorpati Kathmandu Nepal for any drug related queries.
Last Updated ( Monday, 13 September 2010 18:51 )  

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