Paracetamol

What Does Paracetamol Do?

Paracetamol, also recognised as acetaminophen, is a popular over-the-counter medicine popular for pain relief and reducing fever. It targets various types of discomfort, such as headaches, muscle aches, menstrual cramps, toothaches, and arthritis. Off-label applications may comprise treatment for migraines, sore throats, and nasal congestion.

How Does Paracetamol Work? (the complicated stuff)

Paracetamol primarily functions by inhibiting the synthesis of prostaglandins within the central nervous system, which play key roles in transmitting the sensation of pain and inducing fevers. Its exact operational mechanism remains unclear as, unlike nonsteroidal anti-inflammatory drugs, it does not markedly reduce inflammation. Additionally, this drug influences the hypothalamus, the brain's temperature-controlling centre, thus aiding in fever reduction.

Drug Type and Category of Paracetamol

Paracetamol is classified as an over-the-counter and prescription analgesic and antipyretic medication.

What dosage of Paracetamol should you be taking?

NHS Recommendations ¹

The usual dose of paracetamol for adults is either 500mg or 1g, taken up to 4 times per day with a maximum of 8 tablets (4g) in 24 hours.

Specifically:

• Adults can take 1 or 2 tablets (500mg) every 4-6 hours, up to 4 times per day (maximum of 8 tablets/4g in 24 hours).
• If you weigh less than 50kg (8 stone), check the maximum dose with your doctor or pharmacist as you may need a lower dose.
• Paracetamol comes in different formulations like tablets, capsules, syrups, powders, and suppositories. Follow the instructions on the packaging.
• It's important to leave at least 4 hours between doses and not to exceed the daily maximum.
• Paracetamol is generally safe to take during pregnancy and breastfeeding at the recommended doses.

Taking more than the recommended amount of paracetamol can be dangerous and cause liver damage, so it's important to follow the dosage instructions carefully.

What are the side-effects of Paracetamol?

Common side effects:

• Nausea 
• Vomiting 
• Diarrhoea 
• Increased sweating 
• Loss of appetite 
• Stomach cramps or pain 

Serious side effects (rare):

• Allergic reaction (swelling of face/throat, trouble breathing) 
• Liver damage or failure 
• Bloody or black stools 
• Bloody or cloudy urine 
• Fever 
• Pinpoint red spots on skin 
• Sore throat 
• Sores or ulcers in mouth 
• Unusual bleeding or bruising 
• Yellowing of eyes or skin 
• Overdose symptoms:
• Nausea, vomiting 
• Abdominal pain 
• Diarrhea 
• Increased sweating 
• Loss of appetite 

Drug Interactions

Major interactions

• Paracetamol metabolism can be increased by drugs like abatacept, leading to lower paracetamol levels, while paracetamol levels can be increased by drugs like abiraterone, increasing the risk of toxicity.

Moderate interactions

• Paracetamol may decrease the clearance of drugs like abacavir, leading to higher drug levels, and is metabolised by CYP enzymes, so inducers like carbamazepine and inhibitors like ciprofloxacin may alter its metabolism.

There is controversy over whether paracetamol can increase warfarin's anticoagulant effects, with conflicting evidence from observational studies and volunteer studies.

Alcohol may increase the risk of paracetamol-induced liver toxicity, especially with overdose.

In summary, while paracetamol has many potential interactions, most are not clinically significant at normal therapeutic doses in the absence of alcohol use or overdose.

Natural Alternatives to Paracetamol

Turmeric: Turmeric contains curcumin, which has powerful anti-inflammatory and pain-relieving properties. Studies show it can be effective for reducing pain and inflammation associated with conditions like arthritis. ²

Ginger: Ginger has strong anti-inflammatory effects and can help alleviate muscle and joint pain. It may be particularly useful for menstrual cramps and osteoarthritis pain. ³

Boswellia: A derivative of frankincense, boswellia contains compounds that can reduce inflammation and ease joint and muscle pain. It has been used in Ayurvedic medicine for centuries. ³

Cloves: Cloves contain eugenol, a natural pain reliever that can help soothe toothaches and other localised pain when applied topically. ⁴

Acupuncture: This ancient Chinese practice involves inserting thin needles into specific points on the body to stimulate the body's natural pain-relieving mechanisms. ⁵

Essential Oils: Oils like lavender, peppermint, and rosemary have analgesic and anti-inflammatory properties that may provide natural pain relief. ^6,7

Capsaicin: The compound that gives chili peppers their heat can also desensitise pain receptors when applied topically as a cream or ointment. ⁸ 

Interesting facts about Paracetamol

It was first made in 1878 by Harmon Northrop Morse, an American chemist, and was later used by German physician Joseph von Mering on his patients in 1887. ⁹

Paracetamol is generally safe and effective when used as directed, but overdose can lead to potentially fatal liver damage in very large doses. ¹⁰

Paracetamol is generally safe for use during pregnancy and breastfeeding when taken at recommended doses. ¹¹ However, long-term use can lead to side effects like tiredness, breathlessness, anemia, and liver/kidney damage. ¹⁰

Paracetamol is available in various forms like tablets, capsules, syrups, and suppositories. ¹¹ Some brands are introducing higher-strength 1000mg tablets with sustained and immediate release for potentially better efficacy. ⁹

Disclaimer

This article is generated for informational purposes only. It was created in December 2024. Medications and medical guidance can change over time. Therefore, it is essential to consult with your general practitioner or healthcare provider before making any decisions regarding medications or treatment plans. Your GP can provide personalised advice based on your specific health needs and conditions.

References

1. https://www.nhs.uk/medicines/paracetamol-for-adults/how-and-when-to-take-paracetamol-for-adults/
2. https://www.bonanza.com/listings/Paracetamol-Biofarm-500-mg-50-tablets-pain-fever-reliever/1357025114?goog_pla=1
3. https://www.truegether.com/listing.html?id=USER.398c96d5-039b-4850-9877-09f7d5486ede
4. https://usaherbalmart.com/kottakkal-ayurveda-ashtavargam-kwatham-tablet.html
5. https://www.healthline.com/health/pain-relief/surprising-natural-pain-killers
6. https://arjunanatural.com/natural-pain-relievers/
7. https://www.hollandandbarrett.com/the-health-hub/conditions/pain-relief/guide-natural-pain-relief/
8. https://draxe.com/health/natural-painkillers/
9. https://lucentbiotech.com/top-10-facts-about-paracetamol/
10. https://www.healthdirect.gov.au/paracetamol
11. https://www.nhs.uk/medicines/paracetamol-for-adults/about-paracetamol-for-adults/