Paracetamol

• Paracetamol acts as an analgesic and antipyretic to manage common pain and fever conditions.
• Pain: provides relief of mild to moderate pain such as headache, dental or musculoskeletal discomfort.
• Fever: reduces elevated body temperature associated with infections or inflammatory states.
• Headache: alleviates tension‑type and migraine‑associated headache pain.
• Dental pain: eases discomfort after dental procedures or toothache.

• Paracetamol inhibits cyclooxygenase enzymes, primarily COX‑2, within the central nervous system, decreasing prostaglandin synthesis. This reduction lowers the pain signalling threshold and resets the hypothalamic heat‑regulation set point, producing analgesic and antipyretic effects without significant peripheral anti‑inflammatory activity.

Paracetamol is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Nausea: mild stomach upset may be reported.
• Abdominal discomfort: occasional stomach pain or dyspepsia.
• Rash: transient skin redness or mild itching.
• Elevated liver enzymes: mild, reversible changes in laboratory tests.
• Headache: paradoxical headache in a small subset of users.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver injury, especially with overdose or chronic high‑dose use.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis: rare severe skin reactions.
• Blood dyscrasias: agranulocytosis or thrombocytopenia reported infrequently.
• Anaphylaxis: rare immediate hypersensitivity reaction.
• Renal impairment: possible acute kidney injury in susceptible individuals.

Paracetamol should be used with awareness of specific safety considerations.

• Assess liver function: avoid use in patients with existing severe hepatic disease.
• Limit alcohol intake: concurrent alcohol increases risk of liver toxicity.
• Monitor for allergy: discontinue if rash, swelling, or breathing difficulty develop.
• Use caution in renal impairment: adjust use in patients with reduced kidney function.
• Avoid exceeding recommended daily amount: follow prescriber guidance to prevent overdose.
• Store at ambient temperature: keep below 25°C in the original packaging, protect from moisture and direct sunlight.

Paracetamol can interact with several medicines, requiring attention to avoid adverse outcomes.

Major Interactions (Avoid)

• Alcohol: combined use heightens risk of hepatotoxicity.
• Warfarin: may enhance anticoagulant effect, increasing bleeding risk.
• Rifampicin: can reduce paracetamol plasma levels, diminishing efficacy.

Moderate Interactions (Monitor Closely)

• Oral contraceptives: may increase plasma concentrations of paracetamol.
• Isoniazid: potential for additive liver stress.
• Phenytoin: may alter metabolism, requiring monitoring of liver enzymes.