Paracetamol B. Braun (Paracetamol)

Paracetamol is used as an analgesic and antipyretic in acute care settings.

• Pain: provides rapid relief of mild to moderate pain.
• Fever: lowers elevated body temperature in febrile patients.
• Post‑operative pain: helps manage discomfort after surgical procedures.

• Paracetamol inhibits cyclooxygenase enzymes (COX‑1 and COX‑2) in the central nervous system, decreasing prostaglandin synthesis. This reduction diminishes the perception of pain and resets the hypothalamic temperature set‑point, leading to antipyretic effects without significant peripheral anti‑inflammatory activity.

Paracetamol may be associated with a range of adverse reactions.

Common Side Effects

• Nausea: mild to moderate upset stomach.
• Injection site discomfort: pain or irritation at the IV site.
• Transient hypotension: brief drop in blood pressure during infusion.
• Headache: occasional mild headache.
• Elevated liver enzymes: mild, reversible changes in laboratory tests.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction requiring immediate medical attention.
• Stevens‑Johnson syndrome: rare severe skin reaction.
• Hepatotoxicity: potential liver injury, especially with overdose or pre‑existing liver disease.
• Blood dyscrasias: rare cases of agranulocytosis or thrombocytopenia.

When using intravenous paracetamol, several safety considerations apply.

• Dose verification: ensure the prescribed dose matches the patient’s age, weight, and liver function.
• Liver monitoring: avoid use in patients with severe hepatic impairment or active liver disease.
• Concomitant hepatotoxic drugs: limit use with other medications that affect liver function.
• Allergy assessment: confirm no known hypersensitivity to paracetamol or formulation excipients.
• Infusion rate: administer at the recommended rate to reduce risk of hypotension.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

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

Major Interactions (Avoid)

• Warfarin: may increase anticoagulant effect and bleeding risk.
• Rifampicin: can enhance hepatic metabolism, reducing paracetamol efficacy.

Moderate Interactions (Monitor Closely)

• Carbamazepine: may increase hepatic enzyme activity, lowering plasma levels.
• Alcohol: concurrent use can heighten risk of liver toxicity.
• Other hepatotoxic agents: combined use may exacerbate liver injury.