What is paracetamol? Effect and dosage

Paracetamol is a medicine used in the treatment of mild and moderate pain such as flu, headache, muscle ache . However, the use of drugs and what should be noted should not be known to everyone. .

Active ingredient: Paracetamol

Brands: Panadol®, Efferalgan Codein®, Efferalgan Paracetamol®, Efferalgan®, Efferalgan Vitamin C®, Tatanol®, Hapacol® and Paracetamol.

Effects of paracetamol

Paracetamol (acetaminophen) is an active ingredient that reduces pain and reduces fever.

Paracetamol is used to treat symptoms such as headache, muscle aches, arthralgia, back pain, toothache, fever, etc. The medicine works to relieve pain in people with mild arthritis, but does not work with more severe inflammation (inflammation of the joint joints). Commonly used content is paracetamol 500mg.

Paracetamol is used to treat symptoms such as headache, muscle pain, joint pain .

Warning information

Paracetamol should not be used in excess of the recommended dose. Overdose of paracetamol can cause serious danger. The maximum dose of paracetamol for adults is 4g (4000mg) daily. However, in case you are using alcoholic beverages every day, the recommended maximum dose is 2g / day and consult your doctor before taking the medicine.

Before taking paracetamol, tell your doctor if you have liver disease or a history of alcoholism.

Do not use any other over-the-counter medicine to treat coughs, colds, allergies or painkillers without consulting your doctor or pharmacist. The active ingredient paracetamol is available in many brand-name drugs that you do not know, so if you take some medications together, you may accidentally use paracetamol overdose. Therefore, you should read the label of any other medicine you are using to see if it contains paracetamol, Acetaminophen or APAP. You avoid drinking alcohol while taking this medicine. Alcohol may increase the risk of liver damage while taking paracetamol.

Caution / Note

Note before using paracetamol

Do not use paracetamol if you are allergic to acetaminophen or paracetamol.

Ask your doctor or pharmacist to see if paracetamol is safe if you are having the following problems:

1. Liver failure
2. History of alcoholism

Experts still do not know if paracetamol is harmful to an unborn baby. Before using paracetamol, tell your doctor if you are pregnant. This medicine can be passed into breastmilk and harms babies who are breast-feeding. Do not use paracetamol without a doctor's prescription if you breastfeed.

How should paracetamol be used?

You use paracetamol exactly as directed on the label or as directed by your doctor.

Do not use this medication more than recommended. Paracetamol overdose can cause serious danger. The maximum dose of paracetamol for adults is 4g (4000mg) daily. If you drink more than three alcoholic drinks a day, tell your doctor before taking paracetamol and never take more than 2g (2000mg) daily.

If you are treating your child, use paracetamol for children. Carefully follow the dosing instructions on the medicine label. Do not administer medicine to children under 2 years of age when not prescribed by a doctor.

You can measure the dose of liquid paracetamol with a spoon or a specialized dosimeter. If you do not have a dose meter, ask your pharmacist. You may have to shake the liquid before each use and follow the directions on the medicine label.

For chewable paravetamol tablets, you must chew the tablet thoroughly before swallowing.

Make sure your hands dry when holding the disintegrated paracetamol tablet. Put the tablet on the tongue and it will start to melt away. You should not swallow the whole tablet, let the medicine dissolve in your mouth without chewing.

To use foamy paracetamol, dissolve a pack of pills in at least 118ml of water. Stir this mixture and drink it immediately. To make sure you take the full dose, add some water to the cup you just took, gently stir and drink immediately.

Do not take paracetamol anal medicine. The drug is only for rectal use. You should wash your hands before and after placing the pill in the anus.

Try to empty your bladder and bladder immediately before using paracetamol anal suppository. Remove the outer cover of the medicine before placing it, avoid holding the tablet on your hand for too long if it does not dissolve in your hand.

For best results, lie down and insert the tip of the medicine into the anus. Keep the pill to sleep for a few minutes. The medicine will dissolve quickly after insertion into the anus and you will feel less or no discomfort when you hold it. You should avoid going to the bathroom or taking a shower after taking the medicine.

Stop taking paracetamol and see a doctor if:

1. You still have a fever after 3 days of use;
2. You still have pain after 7 days of use (or 5 days if your child is treated);
3. You have a rash, constant headache, redness or swelling;
4. Your symptoms get worse or / if you have any new symptoms.

A urine glucose test may give wrong results while taking paracetamol. Talk to your doctor if you have diabetes and notice a change in sugar levels during treatment.

How to preserve paracetamol?

You can store paracetamol at room temperature, avoiding exposure to heat and moisture. The anal medicine may be stored at room temperature or in a refrigerator.

Do not use this medication more than recommended.

Dosage

Paracetamol has the following common forms and contents:

1. Tablets, oral forms: 325mg, 500mg.
2. Gel, oral form: 500mg.
3. Solution, oral form: 160 mg / 5 ml (120ml, 473ml); 500 mg / 5 ml (240ml).
4. Siro, oral form: Triaminic® brand name for children with antipyretic analgesic: 160 mg / 5ml (118ml).

Usual dosage of Paracetamol:

Antipyretic dose for adults:

1. General dose: 325-650mg every 4-6 hours or 1000mg every 6-8 hours orally or rectally.
2. Paracetamol Tablets 500mg: 2 500mg tablets taken every 4-6 hours.

Pain relief for adults:

1. General dose: 325-650mg every 4-6 hours or 500mg every 6-8 hours orally or anal anus.
2. Paracetamol Tablets 500mg: 1 tablet every 4-6 hours.

Antipyretic and analgesic dose for children:

Pain relief: Oral or anal anus:

1. <= 1 month: 10-15 mg / kg / dose every 4-6 hours if needed.
2. Over 1 month to 12 years: 10-15 mg / kg / dose every 4-6 hours as needed (maximum: 5 doses in 24 hours).

Fever:

1. 4 months to 9 years: Initial dose: 30 mg / kg (According to the study, this dose is more effective in reducing fever than maintenance dose of 15 mg / kg and there is no difference in tolerability. ready.)
2. > = 12 years: 325-650mg every 4-6 hours or 1000mg in 6-8 hours.

Time to work

The analgesic effect of paracetamol is effective for 30-60 minutes when the drug. The effect of the drug lasts for 3-4 hours.

Because paracetamol is usually used only when needed, you may not need a medication schedule. If you are taking medication regularly, use the missed dose as soon as you remember. If you are close to your next dose, skip the missed dose and use the next dose.

Call 911 immediately or go to the nearest local health station if you think you have taken an overdose.

The first signs of paracetamol overdose include loss of appetite, nausea, vomiting, stomach pain, sweating, confusion or weakness. The following symptoms may include epigastric pain, dark urine, jaundice or white eyes.

Things to avoid when using paracetamol

Do not use any over-the-counter medicine to treat coughs, colds, allergies or painkillers without consulting your doctor or pharmacist. Paracetamol is available in many medicines, so if you use certain products together, you may accidentally use too much paracetamol. So, you should read the label of any other medicine you are using to see if it contains paracetamol, acetaminophen (or APAP). You avoid drinking alcohol while taking this medicine. Alcohol may increase the risk of liver damage while taking paracetamol.

Side effects may be encountered when using paracetamol

Call an emergency immediately (phone number 115) or immediately go to the nearest clinic to check if you have any signs of an allergic reaction to paracetamol: a rash; shortness of breath; swelling of the face, lips, tongue, or throat. Stop using the medicine and see a doctor immediately if you have serious side effects such as:

1. Mild fever with nausea, stomach pain and loss of appetite;
2. The urine is dark, the stools are clay-colored;
3. Jaundice (including jaundice or yellowing of the white eyes).

This is not a complete list of side effects of paracetamol. Other side effects may occur. Please see your doctor for more details.

Drug interactions

Some medications may interact with paracetamol. Tell your doctor all prescription and over-the-counter medicines, vitamins, minerals, herbal products and drugs prescribed by other doctors. Do not start a new drug without consulting your doctor.

Some drugs interact when combined with paracetamol:

1. Acetaminophen
2. Amitriptyline
3. Amlodipine
4. Amoxicillin
5. Aspirin
6. Atorvastatin
7. Caffeine
8. Clopidogrel
9. Codeine
10. Diazepam
11. Diclofenac
12. Furosemide
13. Gabapentin
14. Ibuprofen
15. Lansoprazole
16. Levofloxacin
17. Levothyroxine
18. Metformin
19. Naproxen
20. Omeprazole
21. Pantoprazole
22. Prednisolone
23. Pregabalin
24. Ramipril
25. Ranitidine
26. Sertraline
27. Simvastatin
28. Tramadol
29. Tylenol (acetaminophen)

Paracetamol interacts with alcohol (Ethanol) / food

1. Alcohol (Ethanol): Serious interaction
   

   Ask your doctor before taking paracetamol (or medications containing acetaminophen) with alcohol (Ethanol). This can cause serious side effects affecting the liver. See your doctor right away if you have fever, chills, joint pain or swelling, fatigue or excessive weakness, bleeding or bruising, rash, itchy skin, loss of appetite, nausea, vomiting, yellow skin or white eyes. If your doctor prescribes these drugs together, you may need to be adjusted for medication or special tests to use both drugs safely. It is important that you tell your doctor about all other medicines you take, including vitamins and herbs. Do not stop using any medicine without a doctor's prescription.

Paracetamol and the effect of health conditions

1. Alcoholism: Serious interaction: People with chronic alcoholism may be at high risk of liver toxicity when treated with acetaminophen (APAP). The risk of serious liver damage, including acute liver failure leading to liver transplantation and death, has been reported in patients taking acetaminophen. The use of acetaminophen should be carefully considered, especially in patients who drink alcohol three or more times a day.

1. Liver disease: Serious interaction: Acetaminophen is mainly metabolized in the liver into inactive forms. However, a small number of these forms are converted into smaller pathways into metabolites, which can cause liver toxicity or methemoglobinemia. Patients with liver failure may be at increased risk of toxicity due to increased activity of small metabolic pathways. Similarly, excessive or frequent use of acetaminophen may stagnate essential liver enzymes and lead to increased metabolism in small roads. Severe liver damage, including acute liver failure leading to liver transplantation and death, has been reported in patients taking acetaminophen. The use of paracetamol should be carefully considered, especially in patients with liver failure. Patients should be clinically monitored for liver function. You should also avoid drinking alcohol while taking medications that contain acetaminophen. The maximum dose of acetaminophen should not exceed the recommended daily dose (4g / day for adults and children 12 years and older). You should read all prescription and over-the-counter medications to make sure they do not contain acetaminophen, or consult a medical professional if you are unsure.

1. Phenylketonuria (PKU): Moderate interaction: Some oral acetaminophen products and combination acetaminophen, especially chewable tablets, contain artificial sweeteners - Aspartame (NutraSweet). Aspartame is converted to phenylalanine in the digestive tract after eating. Bubbling and chewing preparations of acetaminophen may also contain phenylalanine. You should consider the content of aspartame / phenylalanine if you are the subject of a need to limit the use of phenylalanine (phenylketonurics).

Tips for patients

1. The use of paracetamol may not be related to eating problems; Although food may reduce stomach pain, a common side effect when using common antipyretic analgesics.
2. Do not exceed the recommended dosage, as it may increase the risk of liver toxicity. Adults and teenagers who weigh at least 50kg should not take more than 1000mg of paracetamol in a dose or more than 4000mg in 24 hours. Children under 12 should only use the recommended dosage on the label (depending on the weight and age of the child).
3. Doctor's advice is required before taking paracetamol for children under 2 years of age. If you are taking paracetamol for children, always use a specialized dose meter. DO NOT use a teaspoon used for cooking.
4. Shake the solution containing paracetamol before use. Chewable tablets should be chewed properly before swallowing. Your hands must be dry before holding paracetamol disintegrated tablets, then place the tablet on the tongue and let the medicine dissolve completely before swallowing. Paracetamol disintegration drugs should be dissolved in at least 118ml of water; Stir and drink immediately.
5. Alcohol should not be taken while taking paracetamol.
6. Contact your doctor if your symptoms worsen, redness or swelling in the area of ​​pain, fever lasting more than 3 days (at any age), or persistent pain (excluding sore throat) longer 10 days in adults, 5 days in children and adolescents or 3 days for newborns.
7. Contact your doctor immediately if you or your child has severe sore throat, lasting more than 2 days or fever, rash, headache, nausea or vomiting.
8. Be careful not to use other products that contain paracetamol or acetaminophen at the same time. Paracetamol is often the ingredient in flu and cold combination drugs.
9. Check with your doctor right away if you have upper abdominal pain, dark urine, loss of appetite, jaundice or yellowing of the white eyes, clay-colored stools.
10. If you are pregnant, do not take paracetamol without your doctor's advice.

Interesting facts about paracetamol

1. Paracetamol is the name used in almost every country in the world, outside the United States and Canada (these two countries use the name acetaminophen).
2. Experts have not yet figured out exactly how paracetamol works, but there is a hypothesis: it is possible that the drug acts on the cyclo-oxygenase (COX) enzyme primarily in the brain.

Advantages of paracetamol

1. Effective to temporarily relieve mild aches and pains, traumatic pain and headaches. The drug can be used in the treatment of many diseases such as arthritis, back pain, colds, menstrual pain and toothache.
2. Not only that, the drug has antipyretic effects, but does not control inflammation.
3. The first option to treat mild to moderate pain (due to its effectiveness, low toxicity and low cost)
4. At low doses, the drug does not cause gastrointestinal side effects such as NSAID anti-inflammatory analgesics (no ulcer, bleeding or perforation inside the gastrointestinal tract).
5. Can be combined with strong opioids (such as Morphine, Oxycodone, Fentanyl) to treat severe pain.
6. There are several other common types of drugs including liquid, oral tablets, gradual disintegrating pills in the mouth, chewable tablets, slowly released form, dispersible tablets, injections and anus.
7. Paracetamol active ingredients are always sold outside the pharmacy in the form of generic drugs.

Limitations of paracetamol

If you are between the ages of 18 and 60 and do not take any other medicines or have other health conditions, you may experience some unwanted effects such as:

1. Rare side effects: itching, constipation, nausea, vomiting, headache, insomnia and agitation. May cause gastrointestinal side effects with high doses.
2. Likely to cause liver damage, even at recommended doses. The risk increases when you take higher doses, shorter intervals, especially for patients who drink alcohol three or more times a day or when taken with other drugs containing paracetamol or acetaminophen as well as those patients with pre-existing liver disease.
3. Considered to be less effective in reducing pain than nonsteroidal anti-inflammatory drugs NSAIDs but the risk of side effects is less.
4. May interact with some other medications including Warfarin.

Note: In general, the elderly or children, who have certain medical conditions (such as liver, kidney, heart disease, diabetes, epilepsy problems) or those taking other drugs There is a risk of more side effects.

Paracetamol dosage for children

The usual dose of fever relief for children

Preterm infants 28-32 weeks:

1. The next injection of 20 mg / kg dose is 10 mg / kg / dose every 12 hours.
2. Oral: 10-12 mg / kg / dose every 6-8 hours. The maximum daily oral dose: 40 mg / kg / day.
3. Rectal: 20 mg / kg / dose every 12 hours. The maximum daily dose: 40 mg / kg / day.

Preterm infants 32-37 weeks and infants less than 10 days:

1. The next intravenous dose of 20 mg / kg is 10 mg / kg / dose every 6 hours.
2. Oral: 10-15 mg / kg / dose every 6 hours. Maximum daily dose: 60 mg / kg / day.
3. Rectal: 30 mg / kg; then 15 mg / kg / dose every 8 hours. Maximum daily dose: 60 mg / kg / day.

Infants are round or older than 10 days:

1. The next intravenous dose of 20 mg / kg is 10 mg / kg / dose every 6 hours.
2. Oral: 10-15 mg / kg / dose every 4-6 hours. Maximum daily dose: 90 mg / kg / day.
3. Rectal: 30 mg / kg; then 20 mg / kg / dose every 6-8 hours. The maximum daily dose: 90 mg / kg / day.

Infants and children:

Less than 2 years old:

1. Intravenous injection: 7.5 to 15 mg / kg / dose every 6 hours.
2. Maximum daily dose: 60 mg / kg / day.

From 2 to 12 years old:

1. Intravenous injection: 15 mg / kg every 6 hours or 12.5 mg / kg every 4 hours.
2. The maximum dose is 15 mg / kg.
3. The maximum daily dose: 75 mg / kg / day should not exceed 3750 mg / day.
4. Oral: 10-15 mg / kg / dose every 4-6 hours as needed; Do not exceed 5 doses in 24 hours.

In addition, manufacturers list the following recommended doses:

1. 2.7-5.3 kg: 0-3 months: 40 mg.
2. 5.4-8.1 kg: 4-11 months: 80 mg.
3. 8.2-10.8 kg: 1-2 years: 120 mg.
4. 10,9-16,3 kg: 2-3 years: 160 mg.
5. 16.4-21.7 kg: 4-5 years: 240 mg.
6. 21.8-27.2 kg: 6-8 years: 320 mg.
7. 27.3-32.6 kg: 9-10 years: 400 mg.
8. 32.7-43.2 kg: 11 years old: 480 mg.

Manufacturers recommend that relying on weight to choose a dose is an appropriate method. If your baby's weight is not known, it may be based on age.

Rectal: 10-20 mg / kg / dose every 4-6 hours as needed (although the use of high doses of paracetamol in the rectum (for example, 25-45 mg / kg / dose) has been studied, the Its use is still controversial, the optimal dose and frequency of medication to ensure efficacy and safety have not been studied, need to learn more.

Children older than or equal to 12 years:

Less than 50kg:

1. Intravenous injection: 15 mg / kg every 6 hours or 12.5 mg / kg every 4 hours.
2. The maximum single dose: 750 mg / dose.
3. Total daily maximum dose: 75 mg / kg / day (less than or equal to 3750 mg / day).

Above or equal to 50kg:

1. Intravenous injection: 650 mg every 4 hours or 1000 mg every 6 hours.
2. The maximum single dose: 1000 mg / dose.
3. Total maximum daily dose: 4000 mg / day.
4. Oral or rectal: 325-650 mg every 4-6 hours or 1,000 mg 3-4 times a day.
5. The maximum daily dose: 4000 mg / day.

The usual dose of pain relief for children:

Preterm infants 28-32 weeks:

1. The next intravenous dose of 20 mg / kg is 10 mg / kg / dose every 12 hours
2. Mouth: 10-12 mg / kg / dose every 6-8 hours. The maximum daily oral dose: 40 mg / kg / day.
3. Rectal: 20 mg / kg / dose every 12 hours. The maximum daily rectal dose: 40 mg / kg / day.

Preterm infants 32-37 weeks and infants less than 10 days:

1. The next 20 mg / kg intravenous injection is 10 mg / kg / dose every 6 hours.
2. Oral: 10-15 mg / kg / dose every 6 hours. Maximum daily dose: 60 mg / kg / day.
3. Rectal: dose: 30 mg / kg; then 15 mg / kg / dose every 8 hours. Maximum daily dose: 60 mg / kg / day.

Infants with 10 days or more than 10 days of age:

1. The next intravenous dose of 20 mg / kg is 10 mg / kg / dose every 6 hours.
2. Oral: 10-15 mg / kg / dose every 4-6 hours. The maximum daily dose: 90 mg / kg / day. Rectal: 30 mg / kg; then 20 mg / kg / dose every 6-8 hours. The maximum daily dose: 90 mg / kg / day.

Infants and children:

Less than 2 years old:

1. Intravenous injection: 7.5 to 15 mg / kg / dose every 6 hours.
2. Maximum daily dose: 60 mg / kg / day.

From 2 to 12 years old:

1. Intravenous injection: 15 mg / kg every 6 hours or 12.5 mg / kg every 4 hours.
2. The maximum dose is 15 mg / kg.
3. The maximum daily dose: 75 mg / kg / day should not exceed 3750 mg / day.
4. Oral: 10-15 mg / kg / dose every 4-6 hours as needed; Do not exceed 5 doses in 24 hours.

In addition, manufacturers list the following recommended doses:

1. 2.7-5.3 kg: 0-3 months: 40 mg.
2. 5.4-8.1 kg: 4-11 months: 80 mg.
3. 8.2-10.8 kg: 1-2 years: 120 mg.
4. 10,9-16,3 kg: 2-3 years: 160 mg.
5. 16.4-21.7 kg: 4-5 years: 240 mg.
6. 21.8-27.2 kg: 6-8 years: 320 mg.
7. 27.3-32.6 kg: 9-10 years: 400 mg.
8. 32.7-43.2 kg: 11 years old: 480 mg.

Manufacturers recommend that relying on weight to choose a dose is an appropriate method. If you don't know your baby's exact weight, it can be based on age.

Rectal: 10-20 mg / kg / dose every 4-6 hours as needed (Although the use of high doses of paracetamol surgery cycle of the rectum (for example, 25-45 mg / kg / dose) has been studied. Research, its use is still controversial, the optimal dose and frequency of medication to ensure efficacy and safety have not been studied, need to learn more.

Children older than or equal to 12 years:

Less than 50kg:

1. Intravenous injection: 15 mg / kg every 6 hours or 12.5 mg / kg every 4 hours.
2. The maximum single dose: 750 mg / dose.
3. Total daily maximum dose: 75 mg / kg / day (less than or equal to 3750 mg / day).

Above or equal to 50 kg:

1. Intravenous injection: 650 mg every 4 hours or 1000 mg every 6 hours.
2. The maximum single dose: 1000 mg / dose.
3. Total maximum daily dose: 4000 mg / day.
4. Oral or rectal: 325-650 mg every 4-6 hours or 1,000 mg 3-4 times a day. The maximum daily dose: 4000 mg / day.

Conclude

Paracetamol is a mild analgesic that is effective with low risk of side effects.

Note: Information on drugs and brand names posted in the Family Medicine Cabinet section on Website Khoahoc.tv is for reference only. Consult your doctor before deciding to treat any medicine to bring about good and safe effects for your health.

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