Paracetamol

What is the drug group?

Analgesic.

What is the legal classification?

P, POM & GSL, depending on pack size and quantity.

What are the clinical indications?

• Mild to moderate pain, pyrexia,

• Mild to moderate pain in patients with risk factors for hepatotoxicity.

• Pyrexia in patients with risk factors for hepatotoxicity.

• Pain - Pyrexia with discomfort.

• Post immunisation pyrexia in infants. 

• Acute migraine. 

What is the usual child dose?

60-1000mg 4-6 hours by mouth. 

60-500mg 4-6 hours by rectum. 

What is the usual adult dose?

0.5-1g 4-6 hours by mouth. 

What is monitored to check the drug is working?

All paracetamol orders should be reviewed at 48 hours, except IV orders which should be reviewed at 24 hours. Where risk factors are present and treatment is to continue beyond 48 hours, monitoring of liver function tests (LFTs), including International Normalised Ratio (INR), is recommended.

What are some important side effects?

• Anorectal erythema.

• angioedema.

• liver injury.

• severe cutaneous adverse reactions (SCARs).

• skin reactions.

• Hypersensitivity.

• hypotension.

• leucopenia.

• malaise.

• neutropenia.

What is monitored to check for side effects?

Liver damage and less frequently renal damage can occur following overdose. Nausea and vomiting, the only early features of poisoning, usually settle within 24 hours.

What are some important drug interactions?

Alcohol - Induced liver disease increases the risk of hepatotoxicity in those taking Paracetamol. Manufacturer makes no recommendation.

Bemiparin - Paracetamol might increase the risk of hepatotoxicity when given with Bemiparin (high-dose).

What important information can be given to patients?

Never supply a double dose.