How to Use Paracetamol Safely
When having pain or fever, one of the first medications that come to most people’s minds is paracetamol -- effective for mild and moderate pain reliefs, such as headaches or toothaches, and lowers the fever from common colds or influenza. It is safe to take without significant side effects. However, because of its ubiquitous uses, paracetamol is a leading cause of drug-induced liver injuries and the most common cause of acute liver failure in the U.S.
Paracetamol formulations
Paracetamol is available in many forms, such as:
- Oral tablets or capsules
- Syrup for young children
- Soluble tablets
- Suppositories
- Intravenous injection
Who can take paracetamol?
Paracetamol is generally safe. Pregnant or breastfeeding women and children over two months old can take it. However, if you have a preexisting condition, you should consult your doctor before use, particularly if you have the following health problems.
- You have liver or kidney issues.
- You have prolonged alcohol abuse.
- You are underweight.
- You are taking other medications.
If you have experienced an allergic reaction, do not take it. Ask your pharmacist or doctor for an alternative drug.
How should you take paracetamol?
Always follow the instructions provided on the label or leaflet or as directed by your doctor. Always use the smallest effective dose.
The appropriate dosage of paracetamol depends on factors such as age, weight, the specific formulation of paracetamol, and its strength. Here are some general guidelines:
- Adults could take one tablet (500mg) every 4-6 hours. However, the total daily intake should not exceed 4g (equivalent to 8 tablets of 500mg) within 24 hours.
- Children under 16 require a lower dose based on age and weight. Consult the drug insert, pharmacist, or doctor for appropriate advice. For young children, administer paracetamol syrup with a measuring spoon or an oral syringe.
Paracetamol usually starts to exert its effect within an hour and provides relief lasting several hours. If your symptoms persist, the use of paracetamol can continue but should not exceed the recommended dosage. Be cautious about using other medications that contain paracetamol as an ingredient (such as cold remedies).
Adults can take ibuprofen concurrently if necessary, but this is generally not recommended for children. If your symptoms worsen or persist for over three days, consult a doctor.
Is it safe to take paracetamol with other medications, food, and alcohol?
There is no credible evidence that taking paracetamol with foods and alcohol can cause any issues. However, alcohol consumption should be moderate. Carefully review the accompanying leaflet or consult a pharmacist or doctor before taking paracetamol with other medications. Taking paracetamol with certain drugs can lead to unpredictable drug interactions, potentially affecting their efficacy and increasing the risk of side effects.
The following drugs may not be safe to take with paracetamol:
- Warfarin -- a blood thinner.
- Carbamazepine -- an antiepileptic and analgesic drugs.
- Cholestyramine -- a bile salts sequestrant.
- Imatinib and Busulfan -- drugs for cancer treatment.
- Ketoconazole -- an antifungal medication.
- Lixisenatide -- Type 2 diabetes medication.
- Metoclopramide -- antiemetic drug.
- Phenobarbital, phenytoin, and primidone -- antiseizure medications.
What are the side effects of paracetamol?
In rare instances, paracetamol may cause the following side effects:
- Rash or swelling due to an allergic reaction
- Skin flushing or blushing, low blood pressure, and rapid heartbeat due to intravenous paracetamol.
- Blood disorders, such as depressed white blood cell and platelet counts
- Liver and kidney damage, which can be life-threatening.
What should you do if someone has a paracetamol overdose?
Paracetamol overdose can be life-threatening; you should promptly accompany the overdosed individual to the nearest hospital. If feasible, take the remaining medication and its original packaging or drug insert to the hospital. Some overdosed individuals may develop abdominal pain, vomiting, and malaise, but even for asymptomatic individuals, immediate medical attention at a hospital is crucial.
