Paracetamol Noridem Enterprises (Paracetamol)

Paracetamol is an analgesic and antipyretic that reduces pain and fever by inhibiting prostaglandin synthesis.

• Pain: provides relief of mild to moderate pain such as headache or musculoskeletal discomfort.
• Fever: lowers elevated body temperature in febrile conditions.
• Headache: alleviates tension‑type and migraine‑associated headache.
• Musculoskeletal pain: reduces pain from strains, sprains and arthritis.
• Post‑operative pain: offers short‑term analgesia after surgical procedures.

• Paracetamol acts primarily by inhibiting cyclooxygenase (COX) enzymes, especially COX‑2, within the central nervous system. This inhibition reduces the synthesis of prostaglandins, which are mediators of pain and fever. The decreased prostaglandin levels lead to analgesic and antipyretic effects without significant peripheral anti‑inflammatory activity.

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

Common Side Effects

• Injection site pain: mild discomfort at the IV site.
• Nausea: transient feeling of queasiness.
• Vomiting: occasional emesis following administration.
• Transient liver enzyme elevation: mild, reversible increase in ALT/AST.
• Rash: mild skin erythema or itching.
• Hypotension: brief drop in blood pressure after rapid infusion.

Serious or Rare Side Effects

• Anaphylaxis: severe allergic reaction with airway compromise.
• Severe hypotension: profound blood pressure fall requiring intervention.
• Stevens‑Johnson syndrome: rare, life‑threatening skin reaction.
• Hepatic failure: acute liver injury, especially with overdose.
• Blood dyscrasias: agranulocytosis or thrombocytopenia.
• Severe skin reactions: toxic epidermal necrolysis.

Paracetamol should be used with attention to patient‑specific factors and monitoring.

• Liver function assessment: evaluate hepatic enzymes before and during therapy.
• Allergic history: avoid in patients with known hypersensitivity to paracetamol.
• Hepatic impairment: use cautiously or avoid in severe liver disease.
• Renal impairment: adjust dosing or monitor renal function in compromised patients.
• Concomitant hepatotoxic drugs: avoid or closely monitor when combined with other liver‑affecting agents.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Paracetamol may interact with several medicines, requiring vigilance.

Major Interactions (Avoid)

• Other hepatotoxic agents (e.g., high‑dose acetaminophen, isoniazid): risk of liver injury.
• Warfarin: increased anticoagulant effect, heightened bleeding risk.
• Carbamazepine: may reduce paracetamol efficacy.

Moderate Interactions (Monitor Closely)

• Alcohol: additive hepatic toxicity, especially with chronic use.
• Enzyme inducers (e.g., rifampicin, phenobarbital): may lower plasma concentrations.
• Oral contraceptives: possible reduction in contraceptive effectiveness.