Paracetamol Arrow (Paracetamol)

Paracetamol is an analgesic and antipyretic that acts centrally to relieve discomfort and lower elevated body temperature.

• Pain: Provides relief of mild to moderate acute pain such as headache, toothache, or musculoskeletal discomfort.
• Fever: Reduces elevated body temperature associated with infections or inflammatory conditions.
• Osteoarthritis: Alleviates pain and improves functional comfort in mild to moderate osteoarthritis.
• Post‑operative discomfort: Helps manage short‑term pain after minor surgical procedures.

• Paracetamol exerts its effect primarily by inhibiting cyclooxygenase enzymes (COX‑1 and COX‑2) in the central nervous system, which decreases the synthesis of prostaglandins involved in pain signalling and thermoregulation. It also modulates activity in the hypothalamic heat‑regulating centre, contributing to fever reduction. The exact peripheral mechanisms remain incompletely understood, but the central COX inhibition is considered the principal pathway for its clinical effects.

Paracetamol is generally well tolerated, but some individuals may experience adverse reactions ranging from mild to serious.

Common Side Effects

• Nausea: mild stomach upset that usually resolves without treatment.
• Skin rash: transient erythema or mild itching, often limited to the trunk.
• Elevated liver enzymes: mild, reversible changes detected in routine blood tests, typically asymptomatic.

Serious or Rare Side Effects

• Hepatotoxicity: severe liver injury that can progress to failure, most often linked to overdose or chronic high‑dose use.
• Stevens‑Johnson syndrome: rare severe skin reaction characterized by blistering, mucosal involvement, and systemic symptoms.
• Anaphylaxis: immediate hypersensitivity reaction causing airway swelling, hypotension, and potentially life‑threatening shock.
• Blood disorders: rare occurrences of agranulocytosis or thrombocytopenia, presenting with increased infection risk or bleeding.

When using Paracetamol, certain precautions help minimize risks and ensure safe administration.

• Dose limitation: Do not exceed the maximum daily amount recommended by a healthcare professional.
• Liver disease: Avoid use or use only under medical supervision in patients with existing hepatic impairment.
• Alcohol consumption: Limit alcohol intake while taking Paracetamol to reduce risk of liver toxicity.
• Age considerations: Use pediatric formulations for children and adjust dosing according to weight and age.
• Drug interactions: Review concomitant medications for potential interactions, especially other hepatotoxic agents.
• Store at ambient temperature: Keep below 25°C, in the original packaging, protected from moisture and direct sunlight.

Paracetamol may interact with several medicines, altering its efficacy or safety profile.

Major Interactions (Avoid)

• Acetaminophen‑containing combination products: Risk of cumulative overdose leading to hepatotoxicity.
• Strong CYP2E1 inducers (e.g., rifampicin): May increase metabolism, reducing analgesic effect.
• Warfarin: Enhanced anticoagulant effect, requiring closer INR monitoring.

Moderate Interactions (Monitor Closely)

• Alcohol: Combined use heightens liver injury risk.
• Isoniazid: May increase risk of liver toxicity.
• Antiepileptics (e.g., carbamazepine, phenytoin): May lower plasma levels of Paracetamol.
• Oral contraceptives: Slightly increased hepatic metabolism, monitor for reduced efficacy.