What is paracetamol?
Paracetamol (Acetaminophen) is one of the most used pain and fever agents worldwide. It has a pain-relieving and fever-reducing effect, but unlike NSAR it has no significant anti-inflammatory effect.
The great advantage of Paracetamol is the good gastric compatibility. It neither affects blood clotting nor the gastrointestinal tract and is also in pregnancy the means of choice in pain.
In low dosages, Paracetamol is free from prescription. Higher individual doses and combination preparations (e.g. Talvosilen forte® with codein) are subject to prescription.
Active Ingredients & Mechanism of Action
Active ingredient: Paracetamol
The precise mechanism of action of Paracetamol has not yet been fully clarified:
Suggested mechanisms:
- Inhibition of prostaglandin synthesis in the central nervous system (CNS)
- Influence of serotonin system
- Activation of descending, pain-inhibiting tracks
- Possibly participation of the endocannabinoid system
Wirkprofil:
- Analgesic: Pain relief (light to moderate pain)
- Antipyretic:
- Not antiphlogistic: No relevant inhibition of inflammation
Pharmacokinetics:
- Effect entry: 30–60 minutes
- duration of action: 4–6 hours
- metabolized in the liver
Who is it suitable for?
Paracetamol is suitable for:
- Light to moderate pain
- Headaches
- toothache
- fever
- Cold complaints
- Pain in pregnancy (means of choice)
- Patients with stomach diseases (no GI toxicity)
- Anticoagulants (no bleeding risk)
Not suitable:
- In severe liver failure
- In alcohol dependence (increased liver toxicity)
- With severe inflammation pain (no antiphlogistic effect)
Available Dosages
Tablets:
- 500 mg, 1000 mg
Chapters:
- 500 mg, 1000 mg
Use dosage (adults):
- Maximum daily dose: 4000 mg (4 g)
For liver disease or underweight:
- Maximum daily dose: 2000 mg (2 g)
Important: The maximum daily dose must not be exceeded – threatening liver damage!
How to Take
Intake:
- Take tablets with water
- Independent meals
- Minimum distance between single doses: 4–6 hours
Important notes:
- Maximum daily dose of 4 g never exceed
- Pay attention to hidden paracetamol sources (colds, combination preparations)
- No alcohol while taking
- Low dose in liver problems
Overdose – Emergency! From about 6 g (adults) there is a risk of severe liver damage. Call emergency doctor! Antidote: N-acetylcysteine (must be given early).
Contraindications
**Paracetamol must not be taken at:* *
- Heavy liver failure
- hypersensitivity to paracetamol
Preview at:
- Low to moderate liver failure
- Chronic alcohol consumption
- Kidney failure
- Underweight / malnutrition (lower glutathione reserves)
- Gilbert Syndrome
pregnant: Paracetamol is the painkiller of choice in pregnancy. Applicable in therapeutic dose in all trimesters.
Style time: Can be taken. Low amounts are converted into breast milk, but are harmless.
Possible Side Effects
For the intended use: Paracetamol is very well tolerated in therapeutic dosage.
Selten:
- Allergic skin reactions
- Blood-image changes
- Bronchospasmus (at predisposition)
For overdose (> 4 g/day):
- Heavy liver damage (leverage failure possible!)
- nausea, vomiting
- Symptoms often occur only after 24–48 hours
- Emergency emergency treatment required
Important: The toxicity in overdose is the greatest risk of paracetamol. The therapeutic range is narrow.
Interactions
Relevant interactions:
- Warfarin/Marcumar – with regular intake the INR can increase
- Carbamazepine, phenytoin, rifampicin – accelerated paracetamol degradation, increased toxicity
- Alcohol – increased risk for liver damage
- Metoclopramide – accelerated paracetamol intake
Advantage: In contrast to NSAR, no relevant interactions with blood pressure media, no increased GI blood pressure risk, no influencing of the thrombocyte function.
Frequently Asked Questions
Similar Medications
Is paracetamol right for you?
A licensed doctor will review your information and issue a prescription if suitable. Discreet and secure.
Important Notice
This information does not replace medical advice. If you have questions about your health or the suitability of this medication, please consult a doctor. Read the package leaflet before use.