Paracetamol, also known as acetaminophen or para-hydroxyacetanilide, is a medication used to treat fever and mild to moderate pain. Common brand names include Tylenol and Panadol.
para-acetylaminophenol, which is commonly known as paracetamol or acetaminophen. It is an analgesic and antipyretic medication used to relieve pain and reduce fever.
Paracetamol works by inhibiting the production of prostaglandins, which are responsible for causing pain and inflammation in the body. It is commonly used to treat headaches, menstrual cramps, arthritis, and other types of mild to moderate pain. It is also used to reduce fever associated with various illnesses and conditions.
Paracetamol is generally considered safe and effective when taken as directed. However, it can cause side effects in some people, such as liver damage when taken in high doses or for extended periods of time. It is important to follow the recommended dosage and to talk to a healthcare provider before taking paracetamol, especially if you have a pre-existing medical condition or are taking other medications.
Para Acetyl Aminophenol, also known as Paracetamol or acetaminophen, is a common pain reliever and fever reducer that is used worldwide. It belongs to the class of drugs known as analgesics and antipyretics, which means it can relieve pain and reduce fever.
Technical details:
- Chemical formula: C8H9NO2
- Molecular weight: 151.16 g/mol
- Melting point: 168-172 °C (334-342 °F)
- Solubility in water: 14 g/L
- CAS number: 103-90-2
Paracetamol works by blocking the production of prostaglandins, which are chemicals in the body that cause pain and inflammation. It is often used to relieve mild to moderate pain caused by headaches, toothaches, menstrual cramps, arthritis, and other conditions.
Paracetamol is generally considered safe when taken as directed, but it can cause side effects such as nausea, vomiting, and stomach pain if taken in high doses. In rare cases, it can cause severe liver damage if taken in overdose.
In addition to its pain-relieving properties, Paracetamol is also used in combination with other drugs to treat colds, flu, and other respiratory infections. It is often found in over-the-counter medications such as Tylenol, Panadol, and other generic brands.
Overall, Para Acetyl Aminophenol (Paracetamol) is a commonly used and effective pain reliever and fever reducer with a relatively low risk of side effects when used as directed. However, it is important to follow the recommended dosage and consult a healthcare provider if you have any concerns about its use.
At a standard dose, paracetamol only slightly decreases body temperature; it is inferior to ibuprofen in that respect, and the benefits of its use for fever are unclear. Paracetamol may relieve pain in acute mild migraine but only slightly in episodic tension headache. However, the aspirin/paracetamol/caffeine combination helps with both conditions where the pain is mild and is recommended as a first-line treatment for them. Paracetamol is effective for post-surgical pain, but it is inferior to ibuprofen. The paracetamol/ibuprofen combination provides further increase in potency and is superior to either drug alone. The pain relief paracetamol provides in osteoarthritis is small and clinically insignificant. The evidence in its favor for the use in low back pain, cancer pain, and neuropathic pain is insufficient.
In the short term, paracetamol is safe and effective when used as directed. Short term adverse effects are uncommon and similar to ibuprofen, but paracetamol is typically safer than NSAIDs for long term use. Paracetamol is also often used in patients who cannot tolerate NSAIDs like ibuprofen. Chronic consumption of paracetamol may result in a drop in hemoglobin level, indicating possible gastrointestinal bleeding, and abnormal liver function tests. Some epidemiological studies have linked paracetamol to cardiovascular, renal, and gastrointestinal diseases, but are largely due to confounding biases and of insignificant relevance with short-term use of paracetamol. Paracetamol may slightly increase systolic blood pressure in hypertensive patients at a dose of 4 grams a day. Elevated frequency of asthma and developmental and reproductive disorders is observed in the offspring of women with prolonged use of paracetamol during pregnancy, although whether paracetamol is the true cause of this increase is unclear. Some studies suggest that there is evidence for the association between paracetamol during pregnancy and autism spectrum disorder and attention deficit hyperactivity disorder, while making clear further research is required to establish any causal link, which has prompted some calls to limit its use in pregnancy to the lowest effective dosage for the shortest possible time.
The recommended maximum daily dose for an adult is three to four grams. Higher doses may lead to toxicity, including liver failure.[48] Paracetamol poisoning is the foremost cause of acute liver failure in the Western world, and accounts for most drug overdoses in the United States, the United Kingdom, Australia, and New Zealand.
Paracetamol was first made in 1877 or possibly 1852. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization’s List of Essential Medicines. Paracetamol is available as a generic medication, with brand names including Tylenol and Panadol among others. In 2020, it was the 118th most commonly prescribed medication in the United States, with more than 5 million prescriptions.
Medical uses
Fever
Paracetamol is a drug of choice for reducing fever. However, there has been a lack of research on its antipyretic properties, particularly in adults. The most recent review on paracetamol and management of fever in the general practice (2008) argued that its benefits are unclear. In addition, when used for the common cold, paracetamol may relieve a stuffed or runny nose, but not other cold symptoms such as a sore throat, malaise, sneezing, or cough; however, these data are of poor quality.
For patients in critical care, paracetamol decreased body temperature by only 0.2–0.3 °C more than control interventions; there was no difference in mortality. It did not change the outcome in febrile patients with stroke. The results are contradictory for paracetamol use in sepsis: higher mortality, lower mortality, and no change in mortality were all reported. Paracetamol offered no benefit in the treatment of dengue fever and was accompanied by a higher rate of liver enzyme elevation: a sign of a potential liver damage. Overall, there is no support for a routine administration of antipyretic drugs, including paracetamol, to hospitalized patients with fever and infection.
The efficacy of paracetamol in children with fever is unclear. Paracetamol should not be used solely with the aim of reducing body temperature; however, it may be considered for children with fever who appear distressed. It does not prevent febrile seizures and should not be used for that purpose. It appears that 0.2 °C decrease of the body temperature in children after a standard dose of paracetamol is of questionable value, particularly in emergency situations. Based on this, some physicians advocate using higher doses that may decrease the temperature by as much as 0.7 °C. Meta-analyses showed that paracetamol is less effective than ibuprofen in children (marginally less effective, according to another analysis), including children younger than 2 years old, with equivalent safety Exacerbation of asthma occurs with similar frequency for both medications. Giving paracetamol and ibuprofen together at the same time to children under 5 is not recommended, however doses may be alternated if required.
Pain
Paracetamol is used for the relief of mild to moderate pain such as headache, muscle aches, minor arthritis pain, toothache as well as pain caused by cold, flu, sprains, and dysmenorrhea. It is recommended, in particular, for acute mild to moderate pain, since the evidence for the treatment of chronic pain is insufficient.
Musculoskeletal pain
The benefits of paracetamol in musculoskeletal conditions, such as osteoarthritis and backache, are uncertain.
It appears to provide only small and not clinically important benefits in osteoarthritis. American College of Rheumatology and Arthritis Foundation guideline for the management of osteoarthritis notes that the effect size in clinical trials of paracetamol has been very small, which suggests that for most individuals it is ineffective. The guideline conditionally recommends paracetamol for short-term and episodic use to those who do not tolerate nonsteroidal anti-inflammatory drugs. For people taking it regularly, monitoring for liver toxicity is required. Essentially the same recommendation was issued by EULAR for hand osteoarthritis. Similarly, European algorithm ESCEO for the treatment of knee osteoarthritis recommends limiting the use of paracetamol to short-term rescue analgesia only.
Paracetamol is ineffective for acute low back pain. No randomized clinical trials evaluated its use for chronic or radicular back pain, and the evidence in favor of paracetamol is lacking.
Headaches
Paracetamol is effective for acute migraine: 39% of people experience pain relief at one hour compared with 20% in the control group. The aspirin/paracetamol/caffeine combination also “has strong evidence of effectiveness and can be used as a first-line treatment for migraine.” The German, Austrian, and Swiss headache societies and the German Society of Neurology recommend the combination as a “highlighted” one for self-medication of migraine, and paracetamol alone as a first choice.
Paracetamol on its own only slightly alleviates episodic tension headache in those who have them frequently. However, the aspirin/paracetamol/caffeine combination is superior to both paracetamol alone and placebo and offers meaningful relief of tension headache: 2 hours after administering the medication, 29% of those who took the combination were pain-free as compared with 21% on paracetamol and 18% on placebo. The German, Austrian, and Swiss headache societies and the German Society of Neurology recommend this combination as a “highlighted” one for self-medication of tension headache, with paracetamol/caffeine combination being a “remedy of first choice”, and paracetamol a “remedy of second choice”.
Dental and other post-surgical pain
Pain after a dental surgery provides a reliable model for the action of analgesics on other kinds of acute pain. For the relief of such pain, paracetamol is inferior to ibuprofen. Full therapeutic doses of non-steroidal anti-inflammatory drugs (NSAIDs) ibuprofen, naproxen or diclofenac are clearly more efficacious than the paracetamol/codeine combination which is frequently prescribed for dental pain. The combinations of paracetamol and NSAIDs ibuprofen or diclofenac are promising, possibly offering better pain control than either paracetamol or the NSAID alone. Additionally, the paracetamol/ibuprofen combination may be superior to paracetamol/codeine and ibuprofen/codeine combinations.
A meta-analysis of general post-surgical pain, which included dental and other surgery, showed the paracetamol/codeine combination to be more effective than paracetamol alone: it provided significant pain relief to as much as 53% of the participants, while the placebo helped only 7%.
Other pain
Paracetamol fails to relieve procedural pain in newborn babies. For perineal pain postpartum paracetamol appears to be less effective than non-steroidal anti-inflammatory drugs (NSAIDs).
The studies to support or refute the use of paracetamol for cancer pain and for neuropathic pain are lacking. There is limited evidence in favor of the use of the intravenous form of paracetamol for acute pain control in the emergency department. The combination of paracetamol with caffeine is superior to paracetamol alone for the treatment of acute pain.
