Paracetamol
Published by Bupa's health information team, March 2007.
This factsheet is for people who would like information about paracetamol and how to use it safely.
Paracetamol (known as acetaminophen in the USA) is a painkiller that lowers a high temperature. Provided that you take the correct dose at the right intervals, paracetamol is relatively safe. An overdose is dangerous.
- Why would I take it?
- How does paracetamol work?
- How to take paracetamol
- Avoiding accidental overdose
- Children and paracetamol
- Special care
- Side-effects
- Interactions with other medicines
- Paracetamol products
- Further information
- Questions and answers
- Sources
Why would I take it?
Paracetamol can be taken to relieve a variety of common aches and pains including headache, muscle and joint pain, backache and period pains.
Paracetamol brings down a high temperature caused by a cold or flu. It can be given to children after they have had vaccinations to prevent a high temperature after immunisation. It's often included in cough, cold and flu remedies, which you can buy in pharmacies and shops (see Paracetamol products).
How does paracetamol work?
No one is sure how paracetamol works. It probably acts by blocking the way in which pain signals are processed in the brain. It doesn't have the anti-inflammatory action of NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin. You can't get addicted to paracetamol.
How to take paracetamol
The recommended dose for adults is 500mg to 1000mg - that's usually one or two tablets (depending on tablet size) - every four to six hours with a maximum of 4000mg (usually eight tablets, but make sure you check the size of your tablets) in 24 hours.
However, just twice this dose can be dangerous and you should never exceed the recommended dose. Keep all medicines out of the reach of children.
Paracetamol comes as:
- tablets, caplets (torpedo-shaped tablets that may be easier to swallow) or capsules for swallowing
- a powder or tablet to dissolve in water, or a liquid/syrup form
- a suppository, for inserting into the rectum (back passage)
You can buy paracetamol from pharmacies in packs of 32 tablets. You don't need a prescription.
For safety reasons, you can't buy more than 100 tablets at any one time from a pharmacy. In other shops, such as supermarkets or convenience stores, the packs contain a maximum of 16 tablets. It's crucial that you don't take more paracetamol than the dose recommended on the packet.
Over-the-counter painkillers - ones you buy without a prescription - are only meant to be taken occasionally. If you have to take painkillers for more than three days you should ask your GP or pharmacist about what to take and what else might help. Taking painkillers too often or for too long may make headaches worse.
It's always best to get advice from your GP if you need daily pain relief. Many GPs advise using paracetamol for problems such as painful joints.
Always read the patient information leaflet that comes with your medicine.
Avoiding accidental overdose
Paracetamol comes as tablets, but it is also contained in several other over-the-counter cold and flu remedies, such as powders that you make up into flavoured hot drinks (eg Lemsip). Make sure you count the paracetamol in all the medicines you have taken.
Children and paracetamol
The dose for a child depends on their age and weight and is clearly given on the medicine's container. On a doctor or nurse's advice, you can give paracetamol to young babies after they have had vaccinations, but otherwise it's not recommended for babies under three months old. Syrups containing paracetamol (eg Calpol) can be easier for younger children to take. The children's version of paracetamol syrup contains 120mg of paracetamol per 5ml (teaspoon). Sugar-free versions are available.
Special care
Check with your doctor or pharmacist before taking paracetamol if:
- you know that your kidneys or liver are not working properly
- you are a very heavy drinker (both paracetamol and alcohol can harm the liver)
- you are malnourished
If you're pregnant
As with any drug, it's always wise to discuss your situation with your pharmacist or doctor. However, in general, paracetamol is not known to be harmful in pregnancy.
If you're breastfeeding
Very little paracetamol gets into breast milk so experts say that it's usually safe for nursing mothers to take it.
Side-effects
When taken at the recommended dose, side-effects of paracetamol are rare. Skin rashes, blood disorders and a swollen pancreas have occasionally happened in people taking the drug on a regular basis for a long time.
One advantage of paracetamol over aspirin and similar drugs (eg ibuprofen and diclofenac) is that it won't upset your stomach or cause it to bleed.
A paracetamol overdose is particularly dangerous because the liver damage may not be obvious for four to six days after the drug has been taken. Even if someone who has taken a paracetamol overdose seems fine and doesn't have any symptoms, it's essential that they are taken to hospital urgently. An overdose of paracetamol can be fatal.
Interactions with other medicines
Check with your doctor or pharmacist before you take any other medicines or herbal remedies at the same time as paracetamol.
You may need to adjust your usual dose of anticoagulants (eg warfarin) if you take paracetamol regularly. Check with your anticoagulation clinic. Otherwise there are no serious interactions between paracetamol and other drugs.
Paracetamol products
Paracetamol is often contained in branded pain-relieving products (see examples of paracetamol brand names) and cough and cold remedies. These often contain a combination of paracetamol with other painkillers such as codeine and other ingredients such as caffeine or a decongestant. These extra ingredients can have their own side-effects.
Your doctor can also prescribe paracetamol for you, either on its own or in a combination medicine containing another painkiller such as dihydrocodeine or codeine.
Some common medicines containing paracetamol are shown in the table.
| Brand names of paracetamol alone |
|---|
Calpol, Medinol (liquid form for children) |
Disprol (soluble) |
Panadol |
| Brand names of paracetamol in combination with other ingredients |
|---|
Anadin/Anadin Extra |
Beechams products (including powder and capsules) |
Benylin Day and Night |
Boots Cold & Flu Relief Tablets |
Day Nurse |
Feminax |
Hedex |
Lemsip |
Migraleve |
Night Nurse |
Paracodol |
Paramol |
Propain |
Resolve |
Sinutab |
Solpadeine |
Veganin |
Vicks Medinite |
Further information
- electronic Medicines Compendium
www.emc.medicines.org.uk
Sources
- Rang HP, Dale MM, Ritter JM, Moore PK. Pharmacology. 5th ed. Edinburgh, London, New York, Oxford, Philadelphia, St Louis, Sydney, Toronto: Churchill Livingstone, 2003: 251-252
- Non-opioid analgesics. BNF 51. www.bnf.org, accessed 14 July 2006
- Aspirin and paracetamol. Prescribing Nurse Bulletin, 1999, Volume 1, No. 7.
www.npc.co.uk
accessed 14 July 2006 - Updated patient information leaflets and labelling for painkillers. The Medicines and Healthcare products Regulatory Agency (MHRA).
www.mhra.gov.uk
accessed 14 July 2006
Publication date: March 2007
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