Paracetamol acid instructions for use. What helps paracetamol? How to take adults and children? Dangerous combinations and dosages

A well-known and very popular medicine in the Russian and foreign markets is Paracetamol. The tool is sold in any pharmacy without any prescription, can be used to eliminate many ailments. There is medicine in every home. Find out what Paracetamol treats, how it affects the body, in what forms it is produced.

What is Paracetamol

The medicine appeared on the domestic market in the 80s of the last century, replacing the then banned aspirin. The tool immediately became popular due to its effectiveness, affordable price, wide range of effects, excellent tolerance by children and adults. As its popularity grew in pharmacies, drug options appeared in suppositories, capsules, syrup, powder for solution, rectal suppositories.

What is paracetamol for? The medicine is included in the group of painkillers, helps with mild, moderate pain, eliminates syndromes of various origins. The remedy relieves spasm, fever associated with infectious and inflammatory diseases, fever from 37 degrees and above. The drug is recommended for toothache, headache, myalgia, discomfort during menstruation. In addition, the medicine normalizes blood pressure, helps with acne, hangovers.

The action of Paracetamol

The drug is a weak inhibitor of prostaglandin biosynthesis, its blocking effect mainly falls on the central nervous system. How does Paracetamol work? Due to the effect on the central nervous system, the drug has the main effect on the centers of thermoregulation, pain: it blocks the production of prostaglandins, acts on the brain area responsible for fever, chills. Evenly distributed, the drug begins to act in 20-30 minutes. after taking. At the same time, the tablets do not have any effect on the gastrointestinal tract, water-salt balance.

paracetamol for toothache

The drug is known for its ability to eliminate various types of pain, but you need to remember that it can not be taken regularly. Does paracetamol help with toothache? Yes, if you strictly follow the instructions, do not have contraindications. Paracetamol for toothache should be taken after meals with water or milk drinks. If a person takes the medicine on his own, without a doctor's prescription, it is recommended to take no more than 1 g at a time.

The drug eliminates the symptom, but does not eliminate the cause of the pain. If the drug does not have the desired effect, you should not combine the drug with similar drugs - it is better to consider stronger analgesics. Tablets should be given to children with caution, preferably after consulting a doctor. Otherwise, the duration of treatment should not exceed 3 days.

Does paracetamol help headaches?

The analgesic does an excellent job with aching, sharp, lingering headaches. Paracetamol is very effective for pressure: after taking the medicine, it begins to dilate the blood vessels, making them elastic, flexible, restoring blood flow. With migraine and other types of pain, the remedy anesthetizes by reducing the synthesis of cells responsible for discomfort. The drug is washed down only with water. Tea, coffee, carbonated drinks can lead to liver problems.

The recommended dosage is no more than 1000 mg per dose. It is allowed to take no more than 4 times a day, unless otherwise prescribed by a doctor. The tool is convenient to use for any category of patients: for children from 3 years old, candles, syrup are suitable, for adolescents and adults - tablets. It is better to contact a specialist so that he picks up the form of the medicine, prescribes the dosage in accordance with age, weight category.

paracetamol for hangover

If after drinking an excessive amount of alcohol you have a headache, excessive sweating, dry mouth, these tablets will help to cope with these symptoms. The drug should be taken as an emergency measure, because it is able to eliminate the unpleasant manifestations of a hangover, but cannot neutralize the effects of acetaldehyde or help the body cope with the consequences of poisoning. The mechanism of action of Paracetamol is such that it causes an analgesic effect, improving well-being. It is important that the remedy does not cause nausea, does not irritate the stomach.

paracetamol for colds

The drug is known for its anti-inflammatory effect and a minimum of side effects. Paracetamol for colds helps to reduce the temperature as quickly as possible by acting on the central nervous system, activating thermoregulation processes in the brain. In addition, it relieves cough, soothes the throat, and helps activate the body's defense mechanisms. It is important to remember: the specified medicine is not an antibiotic, not a dietary supplement and not a vitamin. Being a symptomatic drug, it eliminates the symptoms, but it does not cure ARVI, a cold.

Paracetamol at temperature

Does paracetamol help with fever? Is always! It is recommended to reduce the temperature with medicine, if the numbers on the thermometer show above 38, the person feels satisfactory. Paracetamol is an antipyretic, it should be used to prevent fever, improve well-being. The medicine does not contain additional chemicals, therefore it is relatively safe for adults and children. It is better to use in tablets once at a dose of 500 mg, per day - no more than 4 g.

Paracetamol during menstruation

If menstruation is painful every time, the woman feels extremely ill, it is better to use non-steroidal anti-inflammatory drugs. Paracetamol for pain during menstruation is recommended to start drinking 2-4 days before the start to prevent discomfort. The use during menstruation will help to significantly reduce pain, have an anti-inflammatory effect, and relax the internal muscles.

paracetamol for acne

To cure acne, it is not enough to clean the pores and wash your face often. A simple remedy can be used to treat skin problems. What does Paracetamol do? The drug has a slight anti-inflammatory effect, but the use inside will not have the desired effect. It is better to use the substance externally. To do this, crush a couple of tablets, dilute with water, stir everything into a liquid slurry and apply to problem areas.

Video: why they drink Paracetamol

Systematic (IUPAC) name: N-(4-hydrophenyl)ethanamide
N-(4-hydrophenyl)acetamide
Trade names: Tylenol (USA), Panadol (Australia) and many others
Legal status: unregulated substance (Australia); allowed for free sale (UK); available without a prescription (USA)
Method of application: oral; rectal; intravenous
Bioavailability: 63-89%
Protein binding: 10-25%
Metabolism: Primarily in the liver
Half-life: 1-4 hours
Excretion: urinary (85-90%)
Paracetamol, also known as acetaminophen, is a drug with the chemical name N-acetyl-p-aminophenone that is widely used as an over-the-counter analgesic (pain reliever) and antipyretic. Paracetamol is an international generic name also approved in Australia and the UK, while acetaminophen is an adapted name common in the US and Japan. Paracetamol is classified as a mild analgesic. It is often used to relieve headaches and other mild pains and is the main ingredient in various flu and cold medicines. In combination with opioid analgesics, paracetamol can also be used to relieve more severe pain such as postoperative pain and to relieve pain in cancer patients. Although paracetamol is used to treat inflammatory pain, it is not always classified as an NSAID (non-steroidal anti-inflammatory drug) because paracetamol shows only weak anti-inflammatory activity. Paracetamol is safe to use at recommended doses, but even a small overdose of the drug can be fatal. Compared to other over-the-counter pain relievers, paracetamol is significantly more toxic in overdose, but may be less toxic when used consistently at recommended doses. Paracetamol is an active metabolite of phenacetin and acetanilide (formerly popular analgesics and antipyretics). However, unlike phenacetin, acetanilide, and combinations thereof, paracetamol is not considered carcinogenic when taken at therapeutic doses. The words acetaminophen (used in the US, Canada, Japan) and paracetamol (used worldwide) come from the chemical name of the compound, para-acetylaminophenol. In some cases, for example, when prescribing painkillers that include this drug, it is abbreviated as APAF (acetyl-para-aminophenol). The drug is included in the list of vital means of the World Health Organization.

Medical use of paracetamol

Paracetamol and high fever

Paracetamol is a drug approved as an antipyretic for people of all ages. The World Health Organization (WHO) recommends that paracetamol be used in children only at temperatures above 38.5°C (101.3°F). Meta-analysis shows that the drug is less effective than ibuprofen.

paracetamol and pain

Paracetamol is used to relieve pain of various origins. Its analgesic characteristics are similar, while the anti-inflammatory effect is weaker. Compared with , paracetamol shows better tolerability in patients at risk of excessive secretion of gastric acid or prolonged bleeding time. Since 1959, the drug has been sold without a prescription. Paracetamol has a relatively weak anti-inflammatory activity, unlike other popular analgesics such as NSAIDs and ibuprofen, however, ibuprofen and paracetamol have a similar effect in the treatment of headaches. Paracetamol may reduce arthritis pain but does not affect inflammation, redness, or swelling. Studies show that compared to NSAIDs, paracetamol shows conflicting results. A randomized controlled trial of adult patients with chronic osteoarthritis pain found paracetamol and ibuprofen to be equally effective. In 1996 and 2009, studies were conducted on the effectiveness of drugs that combine paracetamol and weak opioids such as codeine. Such drugs are 50% more effective than paracetamol alone, but have more side effects. The combination of paracetamol and strong opioids such as morphine helps to reduce the amount of opioids in the formulation and increase the analgesic effect. A randomized controlled trial of children with musculoskeletal pain found that, at standard doses, ibuprofen was more effective than paracetamol in reducing pain.

Side effects of paracetamol

Paracetamol and liver damage

Acute overdose of paracetamol can cause potentially fatal liver damage. According to the US FDA, "Acetaminophen can cause serious liver damage when taken at higher than recommended doses." In 2011, the FDA required manufacturers to relabel all products containing acetaminophen and warn users of potential risks of serious liver damage. In addition, a public education program has been launched in the United States to prevent overdose in patients. In chronic alcoholism, the risk of overdose increases. Paracetamol poisoning is the leading cause of liver damage in the Western world, and the leading cause of drug poisoning in the United States, United Kingdom, Australia and New Zealand. According to the FDA, in the 1990s in the United States, “there were 56,000 emergency room visits, 26,000 hospitalizations, and 458 deaths per year associated with acetaminophen overdose. Unintentional acetaminophen overdose is associated with 25% of emergency room visits, 10% of hospital admissions, and 25% of deaths.” Paracetamol is metabolized in the liver and is a hepatotoxic substance; when taken in combination with alcohol, side effects are increased and are often seen in chronic alcoholics or patients with liver damage. Some studies show that chronic use of paracetamol in high doses increases the risk of complications associated with the upper gastrointestinal tract, such as stomach bleeding. In rare cases, damage to the kidneys is observed, especially often with an overdose. The FDA does not recommend that physicians prescribe paracetamol in doses above 325 mg in combination with narcotics due to the risks of hepatotoxicity outweighing the therapeutic benefit.

Skin reactions

On August 2, 2013, the US FDA issued a new warning regarding paracetamol stating that the drug may cause rare, and possibly fatal, skin reactions such as Steven-Johnson syndrome and toxic epidermal necrolysis. The FDA has required manufacturers to put information about possible skin reactions of drugs on the labels of their products.

Asthma

There is an association between the use of paracetamol and the development of asthma, but data from controlled studies suggest that this association may depend on other causes. As of 2014, the American Academy of Pediatrics and the National Institute of Health and Clinical Excellence continue to recommend paracetamol for pain and discomfort in children, however, some experts recommend avoiding the use of paracetamol in children with or at risk of asthma.

Other factors

The history of the discovery of paracetamol

Society and culture

Paracetamol is available as tablets, capsules, liquid suspension, suppositories, intravenous and intramuscular solutions, and effervescent tablets. The standard adult dose is 500 to 1000 mg. The recommended maximum daily dose is 4000 mg for adults. When taken at recommended doses, paracetamol is considered safe for children and adults, but there are reports of cases of acute liver injury when taken at doses below 2500 mg per day. Some drugs combine paracetamol with the opioid codeine, sometimes called co-codamol. In the United States, these combinations are available by prescription only, but in Canada, similar combinations with a smaller amount of substance are available from pharmacies freely. In other countries, these drugs are also available without a prescription. Paracetamol is also combined with other opioids such as dihydrocodeine, also called co-dydramol, oxycodone, or hydrocodone. Another common combination includes paracetamol and propoxyphene napsilate. There is also a combination of paracetamol, codeine, and the sedative doxylamine succinate. New studies have challenged the effectiveness of combinations of paracetamol with codeine. Paracetamol is often used in multi-ingredient headache formulas that include butalbital and paracetamol with or without and sometimes codeine. Paracetamol is sometimes combined with phenylephrine hydrochloride. Sometimes a third active ingredient is added to this combination, such as chlorpheniramine maleate or guaifnesin.

Veterinary use of paracetamol

cats

Paracetamol is a particularly toxic substance for cats, since their bodies lack the enzyme glucuronyl transferase, which is necessary for the safe breakdown of paracetamol. Symptoms of poisoning include vomiting, excessive salivation, and discoloration of the tongue and gums. Liver injury is a rare cause of death in cats from paracetamol poisoning. Instead, there is the formation of methemoglobin and the production of Heinz bodies in red blood cells, inhibiting the transport of oxygen in the bloodstream and causing asphyxia (methemoglobinemia and hemolytic anemia). An effective treatment for poisoning when taking small doses of paracetamol is the use of N-acetylcysteine, methylene blue, or the simultaneous use of these drugs.

Dogs

Although paracetamol does not have a pronounced anti-inflammatory activity, it is equally effective in the treatment of musculoskeletal pain in dogs. In the UK, Pardale-V is available, which includes paracetamol and codeine. It is used to treat dogs only with a doctor's prescription and in case of emergency. The main symptoms of paracetamol poisoning in dogs are liver damage and sometimes esophageal ulcers. Taking N-acetylcysteine ​​2 hours after taking paracetamol is an effective measure to treat overdose.

snakes

Paracetamol is also deadly to snakes and its use has been proposed as a population control measure for the invasive brown boiga (Boiga irregularis) on Guam. Doses of 80 mg are administered to dead mice, which are then dropped from a helicopter.

controversy

In September 2013, the "Strictly As Assigned" episode of This American Life highlighted the issue of acetaminophen overdose deaths. This was followed by two reports from ProPublica stating that “The FDA has long been aware of studies confirming the risks of acetaminophen. The manufacturer, McNeil Consumer Healthcare, a division of Johnson & Johnson, was also aware of this, and "McNeil, the manufacturer, has repeatedly rejected the need for safety warnings, dose restrictions, and other measures to protect users of the drug." A report prepared by an internal FDA working group describes the history of FDA initiatives to educate users about the risks of acetaminophen overdose and notes that "one of the Agency's goals was to communicate the safety of acetaminophen, especially when compared to other over-the-counter pain relievers ( such as other NSAIDs). The report also states that “long-term use of NSAIDs is also associated with significant morbidity and mortality. NSAIDs adversely affect the gastrointestinal tract. One article cited the following data: 3,200 deaths and 32,000 hospitalizations per year. In addition, the risks of cardiovascular toxicity have also recently been discussed. The aim of the program is not to limit the use of acetaminophen or encourage the use of NSAIDs, but to educate users to avoid unnecessary and unjustified health risks.”

Paracetamol classification

Paracetamol is part of a group of drugs known as "analine analgesics"; and this drug is the only one of this group used today. It is not considered an NSAID because it does not have significant anti-inflammatory activity (and is a weak COX inhibitor), despite data on similar pharmacological activity of paracetamol and NSAIDs.

Paracetamol is an analgesic with anti-inflammatory and antipyretic properties. The drug is used for symptomatic therapy, reducing the severity of inflammatory processes and pain. The drug is not intended for long-term treatment. Before taking the drug, study what paracetamol helps with, instructions for use, what contraindications and side effects it has.

Description

Many people think that Paracetamol is an antibacterial agent, but it is not an antibiotic. Through its use, the following therapeutic effects are achieved:

• anesthesia;
• decrease in body temperature;
• inhibition of the synthesis of prostaglandins and their effect on thermoregulation;
• anti-inflammatory action;
• increase in heat transfer.

The components are rapidly distributed in all tissues, excreted by the kidneys. A quarter of the taken dose of the drug penetrates into the blood plasma.

How quickly does the medicine work? The action develops 15 minutes after its application. The therapeutic effect lasts 4-5 hours.

How long does the painkiller take to work? The analgesic effect appears half an hour after the penetration of the components into the body.

How long does it take to bring down the temperature? The indicator decreases 2 hours after the use of the drug.

Release form

The drug is made in the form of tablets, suspensions, suppositories, syrup and infusion solution. The most common tablets. Consider all dosage forms.

suppositories

The tool has a torpedo shape, is made in white. May have a yellow or cream tint. The packages contain 5 suppositories.

Suspension

The dosage form is intended for internal use. 5 ml of Paracetamol suspension contains 120 mg of the active substance. The medicine is packaged in vials and bottles of 100 ml. The package contains a dosing spoon.

Infusion solution

The solution is clear, colorless, may have a pinkish or light yellow color. The container contains 100 ml of the product.

Tablets

The drug in tablets is usually white. The presence of a cream shade is the norm. The medicine is produced with a different content of the active substance. Tablets contain 500 mg, 325 and 200 mg of the main component. The minimum dosage of the active substance in Paracetamol is 200 mg. Cardboard packs contain 1-5 packs of medication, each containing 10 tablets. Packing is carried out in jars and bottles - 10, 20, 30 pcs. The drug with a dosage of the active ingredient of 325 mg is packaged in packs of 6, 12 pcs.

Syrup

The medicine is packaged in vials of 50 and 100 ml. Each milliliter of syrup contains 25 active substances. The package contains a dosing spoon.

Consider the composition of Paracetamol in tablets and other dosage forms.

Candles (1 pc.)

One suppository may contain a different amount of paracetamol - 50, 100, 250, 500 mg. Additionally, solid fat is used in the amount of 1250, 2250 mg.

Suspension (1 ml)

The active ingredient in the indicated amount of the drug contains 24 mg. In addition to water, flavoring and dye, glycerol, sucrose, sorbitol in a liquid state are added to the medicine. Also, the composition is supplemented with xanthan gum and methyl parahydroxybenzoate.

Infusion solution (1 ml)

In the indicated amount of the drug 10 mg of the main substance. In addition to water for injection, the composition contains mannitol. Supplemented with sodium hydrogen phosphate dihydrate. The manufacture of the drug is carried out using hydrochloric acid or sodium hydroxide in the form of a solution.

Tablets (1 pc.)

The dose of the active substance was previously indicated. Among the additional substances are povidone, starch obtained from potatoes, gelatin. The instructions note the presence of milk sugar, primogel, calcium stearate and stearic acid in the composition.

Syrup (1 ml)

Paracetamol for the indicated amount of the drug in the composition of 25 mg. The composition is supplemented not only with water and flavoring, but also with other substances, the list of which is presented in the instructions.

What does paracetamol help with?

The drug is prescribed for acute colds. The tool is used for influenza, the development of post-vaccination reactions. The use of Paracetamol is also recommended for other conditions that are accompanied by high body temperature.

What does paracetamol help with?

1. The drug is a good pain reliever, it is used if necessary to eliminate mild or moderate pain.
2. Paracetamol helps to get rid of headaches, pain after burns and injuries.
3. For toothache and migraine.
4. The drug is effective for menstrual pain, myalgia, neuralgia, pain in the muscles, back and ears.

Contraindications

The use of the drug is refused in case of excessive sensitivity to the substances present in the composition and in the presence of pronounced disorders in the functioning of the kidneys and liver.

1. Syrup is not used when carrying a child (1st trimester), alcoholism, anemia.
2. Patients with impaired functioning of the blood system are not prescribed a suspension.
3. Neither syrup nor suspension is used to treat children under one month of age.
4. Suppositories are not used for therapy when the child is less than six months old.
5. Tablets are not prescribed for up to three years.

Patients who have a hereditary disorder, such as the absence of glucose-6-phosphate dehydrogenase in the body, are prohibited from using the suspension and suppositories, it is permissible to use tablets, but under the supervision of a specialist.

In the presence of such conditions during the treatment period, constant medical supervision is required:

• hepatitis of viral etiology;
• renal, hepatic insufficiency;
• elderly age;
• disorders in the blood system;
• childbearing, breastfeeding;
• violations in the liver due to exposure to alcohol, alcoholism;
• hyperbilirubinemia, which is hereditary.

Side effects

When using the drug in properly selected doses, negative reactions occur in rare cases. Usually the components are well tolerated, side effects develop only in some patients and depend on the dosage form used.

During the period of therapy, side effects are presented:

• sleep disorders;
• allergy, manifested by angioedema, urticaria, itching and rash;
• erythema;
• anemia
• nausea;
• Lyell's syndrome;
• dizziness;
• agranulocytosis;
• thrombocytopenia;
• epigastric pain.

If the drug is used in large quantities for a long time, there is a high risk of disturbances in the hematopoietic system and the functioning of the kidneys and liver.

As a result of the use of the drug, disturbances in the activity of the following body systems may occur:

• nervous;
• endocrine;
• cardiovascular;
• excretory;
• digestive.

Paracetamol tablets: instructions for use

To get rid of high fever, the medicine is used for no more than three days, for headaches and other pain - a maximum of 5 days. Such information is indicated in the instructions, but the doctor may give other recommendations.

Tablets

How to use? The drug in tablets is consumed after meals - after 1-2 hours, washed down with water. Patients over 12 years of age are prescribed 350-1000 mg of the drug, which corresponds to a single dose. It is required to perform 4-6 doses of the medicine per day, observing an interval of 4-6 hours.

Tablets for adults with a cold are prescribed in a daily dosage of not more than 4000 mg. For elderly patients and patients with diseased kidneys, the dose is halved or the frequency of taking the tablets is reduced by increasing the intervals between doses.

How to take in childhood

Tablets for children at a temperature are given according to age:

• if a child is from 3 to 6 years old - 1000 mg, but only with a body weight of 15 to 22 kg;
• children under 9 years old weighing no more than 30 kg - 1500 mg;
• patients under 12 years old with body weight up to 40 kg - 2000 mg.

The indicated amount of medication is divided into four parts and consumed every four hours or less.

How many tablets can you take per day

The permissible number of tablets is determined depending on the content of the active substance in one tablet. It is forbidden to exceed the maximum daily dosage. With a content of 200 mg of paracetamol, adults are prescribed 7-20 tablets per day, children - 5-10, depending on age.

If you take 10 tablets, what will happen? What matters is only the allowable size of single and daily doses of the active ingredient. Patients of different ages are prescribed different amounts of the drug in tablets. If the amount of the active ingredient is more than 200 mg, the number of tablets is reduced. Due to the excess of the recommended doses, an overdose is possible. In large quantities, they adversely affect the kidneys and liver.

Instructions for the use of paracetamol tablets, which is given in a pharmacy, contain information about other possible negative consequences for the body.

Suppositories are inserted after a bowel movement naturally or with an enema. The drug is given to children 2-3 times a day. The recommended interval is 4-6 hours. Per kilogram of body weight take 60 mg of the drug. This dosage is provided for one day of treatment. A single dose is 10-15 mg of the drug per kilogram of weight.

For young patients, the drug is prescribed taking into account age. Children older than six months and younger than a year are prescribed one suppository per day containing 100 mg of the active ingredient, but on condition that the child's weight is at least 8 kg. For children under three years old weighing 10-15 kg, the drug is prescribed in the same dosage of the main component, 1-2 suppositories are allowed.

Patients over three years old with a body weight of 15-20 kg per day are prescribed two suppositories containing 100 mg of paracetamol. A child aged 5-10 years with the same weight is prescribed different suppositories - one with 50-100 mg of paracetamol and one with 250 mg of the active ingredient.

Children under 12 years old with a weight ranging from 28 to 40 kg are prescribed 2 suppositories, which include 250 mg of the active ingredient, or act according to the scheme provided for children aged 5-10 years.

Adults use candles more often - 1-4 times a day. The recommended dosage is 500 mg. A single dose of the active substance can be increased to 1000 mg. Do not use more than 4000 mg of paracetamol per day.

You need to know what Paracetamol helps from, study the instructions for use, regardless of the visit to the doctor and the chosen dosage form.

Suspension

Before opening the vial, shake it thoroughly.

How to take the suspension: after meals or before meals? The drug in this form is intended for ingestion, it is not diluted, taken before eating, washed down with water. To determine the right amount of the drug in the package, there is a double-sided spoon or a spoon with marks. Focusing on the lower mark, the spoon is filled with 2.5 ml of the product containing 60 mg of paracetamol. When using the upper mark in the spoon, there is twice as much medication, the dose of the active ingredient also increases to 120 mg.

Children are given medicine, focusing on their weight - 10-15 mg per kilogram of body weight. Frequency of application - 3-4 times a day. The intervals between doses are 4-6 hours. Do not exceed the dosage of 60 mg / kg, calculated per day.

For the smallest patients aged from one to three months, 2 ml of the drug (50 mg) are used, up to a year - 2.2-5 ml (60-120 mg). Children under six years of age are given 5-10 ml of the drug (120-240 mg), a child under the age of 14 is prescribed 10-20 ml of the drug (240-480 mg).

Solution for infusion

Carry out intravenous administration within 15 minutes. A suitable dosage is determined individually, taking into account body weight and body condition.

Syrup

Assign from three months, use regardless of food intake. A child younger than a year is prescribed from 2.5 to 5 ml of syrup (60-120 mg). Children from one year to 5 years old are given 5-10 ml of the therapeutic composition (120-240 mg). Other patients weighing at least 60 kg are recommended to take 20-40 ml of syrup (480-960 mg). In the indicated amount, the medication is taken 3-4 times a day.

paracetamol for colds

The tool is used to get rid of the temperature, which rises with colds. In such cases, paracetamol is the safest option. The need to lower the temperature exists only with indicators of 37.5, 38 degrees or more in children and adults, respectively. If within three days the temperature has not decreased, it is necessary to inform the doctor. In some cases, it is allowed to increase the duration of therapy up to seven days. In order to maintain the results obtained, the intervals between the use of the drug are increased to 12 hours.

Elimination of headache, toothache

Paracetamol for headache is used in cases where its severity is moderate. The remedy eliminates discomfort, regardless of the reasons for which they arose. Adults are prescribed in a single dose of 500 mg or more at intervals between taking tablets of at least four hours.

Paracetamol for toothache is not used in an amount of more than 8 tablets.

Toothache can be relieved only for a while, in any case, you will have to go to the dentist. The drug eliminates only the pain, but not the cause of its appearance.

Arterial pressure

Does the drug lower or increase blood pressure? The instructions do not report on the ability of the drug to change the pressure. However, in some patients, an individual reaction of the body is observed for a short time. Tell your doctor if you have high or low blood pressure.

Application during pregnancy

What helps Paracetamol for pregnant women, can it be used during pregnancy? During this period, the drug allows you to reduce high body temperature and get rid of pain of moderate severity without significant consequences for the body and the fetus. It is forbidden to use the medication without consulting a doctor.

A negative effect on the fetus has not been established, however, according to the results of the studies performed, it was possible to draw certain conclusions - the components penetrate the placenta. Therefore, when prescribing a medicine, the intended benefit must significantly exceed the possible harm.

An increase in body temperature is dangerous not only for a woman, but also for an unborn baby, so there is a need to use antipyretics. It is worth noting that during early pregnancy, you can use paracetamol only with the permission of a doctor!

Despite the conclusions made by British scientists (there is a possibility of developing allergies in a child, respiratory disorders, asthma, wheezing), many women use Paracetamol as an anesthetic, they use it at a temperature that exceeds normal levels. To avoid harm, it is necessary to study in detail what Paracetamol helps and its instructions for use.

Can paracetamol be used during lactation?

Is it possible to be treated with the drug while breastfeeding? You can use paracetamol during lactation. This is a proven remedy that doctors often prescribe to nursing mothers. When used correctly, the concentration of the active ingredient in breast milk is minimal.

Alcohol compatibility

It is important to know about the compatibility of Paracetamol and alcohol. Even small doses of alcohol are not taken during the treatment period.

Price

How much does a drug cost in a pharmacy? The price depends on the dosage form.

1. For tablets, the cost ranges from 3-18 rubles.
2. For suppositories - about 30 rubles.
3. The suspension can be purchased for 70-130 rubles.
4. Candles - about 40 rubles.
5. Solution for infusion - for 90 rubles.

Analogues

Can paracetamol be replaced with ibuprofen?

The anti-inflammatory effect of Paracetamol is not as pronounced as that of ibuprofen, but the latter is easier to tolerate, which is its important advantage. The analogue can cause bronchial asthma. Apply in the absence of the desired effect and contraindications to the use of Paracetamol.

Citramon

Citramon from a headache can not be used at high pressure, hypertension. Both drugs cope with headache, regardless of the causes of its occurrence. However, with high blood pressure, citramon will only worsen the condition. Therefore, it is better for hypertensive patients to give preference to paracetamol.

Combination with No-shpa and Suprastin

Suprastin + No-shpa + Paracetamol - this combination of drugs is prescribed to effectively reduce the temperature when other drugs do not have the desired effect.

Combination with Aspirin and Analgin

In cases where it is difficult to bring down the temperature, the indicator practically does not change, the doctor may recommend a triad of temperature: Analgin + Aspirin + Paracetamol. This combination of medicines is highly effective, since the action is combined. Sometimes it is pierced by an adult when calling a doctor at home.

Combination with No-shpa and Analgin

If the temperature is high and stays at the same level for a long time, Paracetamol, Analgin, No-shpa in doses selected by the doctor will help to cope with such a problem. Usually, the composition is pierced once by ambulance doctors when they call home.

general information

Paracetamol is the main metabolite of phenacetin with chemically similar properties. When taking phenacetin, it is quickly formed in the body and causes the analgesic effect of the latter. In terms of analgesic activity, paracetamol does not differ significantly from phenacetin, like it, it has a weak anti-inflammatory activity. The main advantages of paracetamol are low toxicity and less ability to cause the formation of methemoglobin. However, long-term use of this drug, especially at high doses, can also cause side effects, in particular, have nephrotoxic and hepatotoxic effects. However, paracetamol remains a safe and appropriate choice of analgesic for children and is included by the WHO, along with ibuprofen, in the list of "most effective, safe and cost-effective medicines".

Properties

According to physical properties: white or white with cream or pink tint crystalline powder. Easily soluble in alcohol, insoluble in water. Solubility of paracetamol g/100 g of solvent: water - 1.4; boiling water - 5; ethanol - 14.4; chloroform - 2; acetone - soluble; diethyl ether - slightly soluble; benzene is insoluble.

History of the drug

Acetanilide was the first aniline derivative to be accidentally discovered to have analgesic and antipyretic properties. It was quickly introduced into medical practice under the name Antifebrin in 1886. But its toxic effects, the most dangerous of which was cyanosis due to methemoglobinemia, led to the search for less toxic aniline derivatives. Harmon Northrop Morse synthesized paracetamol at Johns Hopkins University in a reduction reaction R-nitrophenol with tin in glacial acetic acid as early as 1877, but it was not until 1887 that clinical pharmacologist Joseph von Mering tested paracetamol on patients. In 1893, von Mehring published an article reporting the clinical results of paracetamol and phenacetin, another aniline derivative. Von Mering argued that, unlike phenacetin, paracetamol has some ability to cause methemoglobinemia. Paracetamol was then quickly abandoned in favor of phenacetin. Bayer began selling phenacetin as a leading pharmaceutical company at the time. Introduced to medicine by Heinrich Dreser in 1899, phenacetin has been popular for many decades, especially in the widely advertised over-the-counter "headache potion" typically containing phenacetin, an aminopyrine derivative of aspirin, caffeine, and sometimes barbiturates.

For half a century, the results of Mering's work were not in doubt, until two teams of researchers from the United States analyzed the metabolism of acetanilide and paracetamol. In 1947, David Lester and Leon Greenberg found strong evidence that paracetamol was one of the main metabolites of acetanilide in human blood, and in subsequent studies they reported that large doses of paracetamol given to white rats did not cause methemoglobinemia. In three articles published in September 1948 in the Journal of Pharmacology and Experimental Therapeutics, Bernard Brodie, Julius Axelrod and Frederick Flynn, using more precise methods, confirmed that paracetamol is the main metabolite of acetanilide in human blood. and found that it has the same effective analgesic effect as its predecessor. They also suggested that methemoglobinemia occurs in humans mainly under the influence of another metabolite, phenylhydroxylamine. In 1949, it was found that phenacetin is also metabolized to paracetamol. This led to the "rediscovery" of paracetamol. It has been suggested that contamination of paracetamol with 4-aminophenol (the substance from which it was synthesized by von Mehring) may have led to false conclusions.

Paracetamol was first marketed in the US in 1953 by the Sterling-Winthrop Co., which marketed it as safer for children and people with ulcers than aspirin. In 1955 in the USA the company McNeil Laboratories began selling paracetamol under one of the most famous in the US brand name "Tylenol", as an analgesic and antipyretic medicine for children (Tylenol Children's Elixir)- the word "tylenol" comes from the abbreviation para-ace tyl aminoph enol. In the UK, paracetamol went on sale in 1956, then it was produced by the division Sterling Drug Inc. companies Frederick Stearns & Co under the brand name "Panadol". At that time, "Panadol" was dispensed from pharmacies only by prescription (currently it is an over-the-counter drug), but it was advertised as a remedy safe for the gastric mucosa, while Aspirin, popular in those years, irritated the mucous membrane. Currently, the drug "Panadol" in various forms (tablets, soluble tablets, suppositories, suspension) is produced by the GlaxoSmithKline group of companies.

Paracetamol began to be used relatively widely after the withdrawal of amidopyrine and phenacetin from circulation. Many paracetamol-containing combined dosage forms have appeared, including in combination with acetylsalicylic acid, analgin, codeine, caffeine and other drugs.

Studies of complications caused by paracetamol have been conducted in the United States for several years. The issue was brought under the control of the FDA in connection with the increasing cases of overdose causing liver damage. According to official data, the use of paracetamol is the most common cause of liver damage in the United States. Every year, 56,000 people come to the doctors with this diagnosis, on average 458 cases end in death. The poisoning was not prevented even by a long-term educational campaign conducted by the authorities. Americans drink paracetamol more often than other painkillers, as they believe that it does less harm to the digestive system.

pharmachologic effect

It blocks both forms of the cyclooxygenase enzyme (COX1 and COX2), thereby inhibiting the synthesis of prostaglandins (Pg). It acts mainly in the central nervous system, affecting the centers of pain and thermoregulation. In peripheral tissues, cellular peroxidases neutralize the effect of paracetamol on COX, which explains the almost complete absence of an anti-inflammatory effect. The absence of a blocking effect on the synthesis of prostaglandins in such tissues determines the absence of a negative effect on the mucous membrane of the gastrointestinal tract and water-salt metabolism (retention of Na + ions and water).

It is also assumed that the drug selectively blocks COX3, which is located only in the central nervous system, and does not affect COX1 and COX2 located in other tissues. This explains the pronounced analgesic and antipyretic effect and low anti-inflammatory.

Pharmacokinetics

Application

Dosing regimen

Inside, with a large amount of liquid, 1-2 hours after a meal (taken immediately after a meal leads to a delay in the onset of action), or rectally.

For adults and adolescents over 12 years of age (body weight over 40 kg): the maximum single dose is 1 g, the maximum daily dose is 4 g. For children: the maximum single dose is 10-15 mg / kg, the maximum daily dose is up to 60 mg / kg. Multiplicity of appointment - up to 4 times a day.

The maximum duration of treatment is 5-7 days. With ongoing febrile syndrome against the background of the use of paracetamol for more than 3 days and pain for more than 5 days, a doctor's consultation is required.

To reduce the risk of developing unwanted side effects, the minimum effective dose should be used for the shortest possible course.

Alcohol should be avoided while taking paracetamol.

Side effects

The use of non-narcotic painkillers (aspirin, ibuprofen and paracetamol) during pregnancy increases the risk of developmental disorders of the genital organs in newborn boys in the form of a manifestation of cryptorchidism. The results of the study showed that the simultaneous use of two of the three listed drugs during pregnancy increases the risk of having a child with cryptorchidism by up to sixteen times compared with women who did not take these drugs.

Victoria Persky from the University of Illinois, who deals with this problem, writes directly that a significant increase in the incidence of asthma in children from the 1970s to the mid-1990s is associated with paracetamol. During these years, children were banned from aspirin - rare but fatal cases of Reye's syndrome were associated with it. Paracetamol took his place. Richard Besley, who led the study in New Zealand, estimates that 41% of all asthma in children may be related to paracetamol.

However, the English Health and Medicines Regulatory Authority (engl. Medicines and Healthcare products Regulatory Agency ) expressed concern about the interpretation of data in studies on the effects of paracetamol on asthma and eczema and offers the following advice for healthcare professionals, parents and caregivers: “The results of this new study do not imply any changes to the current guidelines for use in children. The evidence from this study is not sufficient to change the guidelines for the use of antipyretics in children.”

Paracetamol toxicity

In recent years, data have appeared on the hepatotoxic effect of paracetamol with its moderate overdose, with the appointment of paracetamol in high therapeutic doses and the simultaneous intake of alcohol or inducers of the microsomal enzyme system of the liver P-450 (antihistamines, glucocorticoids, phenobarbital, ethacrynic acid).

Simultaneous administration of paracetamol at a dose of more than 10 g in adults or more than 140 mg / kg in children leads to poisoning, accompanied by severe liver damage. The reason is the depletion of glutathione reserves and the accumulation of intermediate products of the metabolism of paracetamol, which have a hepatotoxic effect. A similar picture can also be observed when taking normal doses of the drug in the case of the concomitant use of inducers of cytochrome P-450 enzymes and in alcoholics, as well as in persons who systematically consume alcohol (for men - a daily intake of more than 700 ml of beer or 200 ml of wine, for women - doses are 2 times less), especially if paracetamol was taken after a short period of time after drinking alcohol.

In young children, the hepatotoxic effect of acetaminophen is less pronounced than in adults due to a different metabolic pathway.

There is evidence that with prolonged use of paracetamol more than one tablet per day (1000 or more tablets per life), the risk of developing severe analgesic nephropathy, leading to terminal renal failure, doubles. It is based on the nephrotoxic effect of paracetamol metabolites, especially para-aminophenol, which accumulates in the renal papillae, binds to SH-groups, causing severe violations of the function and structure of cells, up to their death. At the same time, the systematic use of aspirin does not cause toxic effects on the kidneys (however, it has other side effects).

When intoxicated with paracetamol, it must be borne in mind that forced diuresis is ineffective and even dangerous, peritoneal dialysis and hemodialysis are ineffective. In no case should you use antihistamines, glucocorticoids, phenobarbital and ethacrynic acid, which can have an inducing effect on the cytochrome P-450 enzyme systems and increase the formation of hepatotoxic metabolites.

Dosage forms

As of July 2008, the following dosage forms of paracetamol are registered in Russia:

Notes

1. Paracetamol. Register of medicines. ReLeS.ru (04.05.1999). Archived
2. Search in the drug database, search options: INN - Paracetamol, flags "Search in the register of registered drugs", "Search TKFS", "Show Lecforms" . Circulation of medicines. Federal State Institution "Scientific Center for Expertise of Medicinal Products" of Roszdravnadzor of the Russian Federation (24.07.2008). - A typical clinical and pharmacological article is a by-law and is not protected by copyright in accordance with part four of the Civil Code of the Russian Federation No. 230-FZ of December 18, 2006. Archived from the original on August 22, 2011. Retrieved August 23, 2008.
3. Acetaminophen - Compound Summary . PubChem. The National Library of Medicine (16.09.2004). Archived from the original on August 23, 2011. Retrieved August 23, 2008.
4. WHO Model List of Essential Medicines, 16th list (eng.) (pdf). WHO (March 2009). Archived from the original on 3 February 2012. Retrieved 6 January 2012.
5. Decree of the Government of the Russian Federation of December 7, 2011 N 2199-r, Moscow // Russian newspaper. - Federal issue, 2011. - No. 5660.
6. Drug Safety Update: Volume 2, Issue 4, November 2008
7. WHO Model List of Essential Medicines for Children, 3rd list, March 2011
8. WHO Model List of Essential Medicines for Children, First List, October 2007 (Russian)
9. Solubility data from Toxicological Analysis /ed. by R.K. Muller. Leipzig, 1995/-846 p., p.372
10. Cahn, A; Hepp P (1886). "Das Antifebrin, ein neues Fiebermittel". Centralbl. Klin. Med. 7 : 561–64.
11. Bertolini A, Ferrari A, Ottani A, Guerzoni S, Tacchi R, Leone S (Fall/Winter 2006). "Paracetamol: new vistas of an old drug" (PDF). CNS drug reviews 12 (3–4): 250–75. DOI:10.1111/j.1527-3458.2006.00250.x . PMID 17227290 .
12. Morse HN (1878). "Ueber eine neue Darstellungsmethode der Acetylamidophenole" (German). Berichte der deutschen chemischen Gesellschaft 11 (1): 232–3. DOI:10.1002/cber.18780110151.
13. Milton Silverman, Mia Lydecker, Philip Randolph Lee Bad Medicine: The Prescription Drug Industry in the Third World. - Stanford University Press, 1992. - P. 88–90. - ISBN 0804716692
14. Von Mering J. (1893) Beitrage zur Kenntniss der Antipyretica. Ther Monatsch 7: 577-587.
15. Sneader Walter Drug Discovery: A History. - Hoboken, N.J.: Wiley, 2005. - P. 439. - ISBN 0471899801

Paracetamol is a drug related to analgesics, which is characterized by anti-inflammatory and antipyretic effects. Often it is used for colds, but this is not the only thing paracetamol helps with, it can be used for adults and for children.

The medicine is not designed for long-term use and is used when specific symptoms occur. Paracetamol reduces pain and fights inflammation.

The advantage of the drug is low toxicity and low probability of formation of methemoglobin. The drug has fewer side effects compared to other NSAIDs.

Paracetamol does not have a negative effect on the gastric mucosa, does not provoke a failure of the water-mineral balance.

Analgesic Paracetamol with anti-inflammatory and antipyretic properties. The drug is used for symptomatic therapy, reducing the severity of inflammatory processes and pain.

pharmachologic effect

Paracetamol is easily and quickly absorbed by the gastric mucosa, beginning to act 15 minutes after ingestion. The maximum concentration of the substance is determined 40 minutes after taking the medicine, and the action lasts for 3-4 hours.

Taking the drug leads to suppression of the production of prostaglandins. The production of prostaglandins accompanies any inflammatory process, leading to the development of fever and pain. The main effect of Paracetamol tablets is on the central nervous system - the substance affects thermoregulation and pain centers. It should be noted that the anti-inflammatory effect of the drug is mild.

Paracetamol has the following therapeutic effects:

• anesthesia;
• decrease in temperature;
• suppression of prostaglandin production;
• elimination of inflammation;
• increase in heat transfer.

The half-life is from 1 to 4 hours. The substance is excreted in the form of inactive metabolites in the urine.

Indications for use

Paracetamol can be used in various situations: it is recommended for babies to give it during teething, the development of inflammatory processes in the oral cavity.

What does paracetamol help with?

• and pain in the gums;
• acne rashes;
• hangover.

Forms of release and composition

Paracetamol is available in several forms:

• tablets;
• syrup;
• suspension;
• candles.

With any form of release of paracetamol, it contains one active substance, they differ only in its quantity.

In Paracetamol tablets contains 200 or 500 mg of the active substance. Tablets are white or cream in color, separated by a chamfer. 5 ml of syrup and suspension contains 120 mg of the active substance.

paracetamol syrup It is a pink viscous liquid with a raspberry flavor and a sweet taste. The bottle can contain 50 or 100 ml of syrup.

Paracetamol in suspension available with raspberry flavor in a volume of 100 or 200 ml.

Paracetamol in suppositories Available in dosages of 100 or 500 mg. Paracetamol suppositories are light cream suppositories. One pack contains 2 packs of 5 suppositories.

Next, we will take a closer look at what paracetamol helps with, what ailments it will help you or your child with, and not harm, and in what dosages. In any case, you need to take paracetamol only after a doctor's prescription.

Paracetamol helps as an antipyretic

It is not recommended to bring down the temperature below 37.5 degrees. This temperature indicates the active struggle of the body with viruses and bacteria. Adults can easily tolerate such an increase in temperature, but it is difficult for kids to cope with it. For children, starting from 3 months, the use of Paracetamol suppositories is recommended to eliminate fever. Put them 4 times during the day. You can give children from one to 6 years of age syrup with paracetamol.

Paracetamol from temperature is used no more than 5 times a day. The maximum amount of the active substance that can be taken once is 500 mg. The drug can be used as a syrup or injected.

Paracetamol tablets should not be given to children until they are 2 years of age.

Important! Undesirable take an antipyretic (Paracetamol) along with an antibiotic at the same time. It is necessary to withstand a break between taking at least half an hour to an hour.

Paracetamol as a pain reliever

Often, the drug is used to relieve pain of various etiologies. What Paracetamol helps with:

Paracetamol helps with toothache

For pain accompanying inflammation in the oral cavity, gums, periodontium, adults take 1 tablet of paracetamol with a dosage of 0.5-1 g of the active substance no more than 5 times a day. When teething in young children, they put candles or give children's paracetamol (syrup) - a single dose should not exceed 100 mg. Paracetamol is a pain reliever, but not a problem, so a visit to the dentist is a must.

Pain during menstruation

Pain during menstruation occurs in many women and in such cases, paracetamol can also be used. However, you should not use more than 8 tablets per day, as this will lead to an overdose and complications.

Paracetamol relieves headaches

To eliminate migraines, you can take the drug several times a day with a maximum dosage of 500 mg. It is forbidden to exceed the daily dose of 4 grams. substances.

Note. The duration of treatment with paracetamol should not exceed 4 days, as addiction may develop and the drug will no longer be effective.

Paracetamol for acne

Paracetamol can be used not only inside, but also externally, for this purpose it is used to treat acne and. On the basis of paracetamol, compresses are prepared for the affected areas of the skin.

Application of tablets: it is necessary to thoroughly crush them in a mortar, add a little water and apply to the inflamed area. The duration of the procedure is only 5 minutes. During this time, the drug will remove hyperemia, stop the inflammatory process. During the day, it is recommended to repeat the procedure 4 times. Visible results can be achieved in 3-4 days.

paracetamol for hangover

Paracetamol is effective against alcoholic beverages. An additional plus in comparison with the usual is that paracetamol does not have a negative effect on the stomach, so such consequences can not be expected. You can take no more than 500 g of the drug at a time, and no more than 4 g per day, this should help to reduce the temperature.

Contraindications to the use of Paracetamol

The instructions for paracetamol indicate only 2 cases in which the agent cannot be used. This is an individual intolerance to the drug, as well as the treatment of babies up to 1 month.

However, there are a number of restrictions under which the drug should be taken with caution:

• benign forms of hyperbilirubinemia;
• viral;
• liver failure;
• pregnancy;
• lactation;
• age up to 3 months;

Pregnancy and lactation

Paracetamol during pregnancy is not forbidden to take and it also helps to cope with the temperature. However, the decision on whether it is possible to drink paracetamol during this period should be made by a doctor. It should be borne in mind that the substance passes through the placenta. Negative effects on the fetus when using paracetamol according to the instructions for use have not been identified. Paracetamol also passes into breast milk.

Paracetamol is not recommended during pregnancy that has passed into the third trimester.

Paracetamol for children - instructions

How much paracetamol can be given to children so as not to harm, but to help is a very important issue. The dosage of paracetamol for children in tablets, syrup, suspension is approximately the same.

The calculation of the dosage of paracetamol does not depend on age. How much Paracetamol to give to children is determined depending on the body weight of the child. For 1 kg of weight should be 10-15 mg of the active substance. A safe daily dosage for a child is considered to be no more than 60 mg per 1 kg of weight.

The next dose of the drug is possible after 4-5 hours.

• do not give paracetamol to children under 6 years of age for more than 3 days;
• a child over 6 years old - no more than 5 days.

Important! Paracetamol should not be mixed with when treating a child. Analgin is not recommended for children under 12 years of age, and the wrong dosage in a combination of drugs can lead to dangerous consequences.

drug overdose

Taking paracetamol at a dosage exceeding 150 mg / kg leads to severe liver damage and can be fatal.

There are 3 stages of paracetamol poisoning:

• on the 1st day - laboratory tests do not reveal abnormalities, but vomiting appears;
• on the 2nd day - the level of liver enzymes increases;
• 3-4 days - the level of bilirubin increases significantly, the acid-base balance of the blood is disturbed, and the level of glucose decreases.

Symptoms of liver failure:

• disorders of the neuropsychic plan (may be manifested by hallucinations, speech disorders, drowsiness);
• pain under the ribs on the right side of the body;
• swelling, an increase in the abdomen in size;
• jaundice;
• bleeding;
• dysfunction of other organs.

Important! Death can occur in 3-5 days.

At the first sign of an overdose, you must take activated charcoal and call an ambulance. Paracetamol's antidote is acetylcysteine.

Treatment for liver failure involves hospitalization. In severe cases, a liver transplant may be required.

Side effects of paracetamol

When taking the drug, the following side effects may develop:

• on the part of the hematopoietic system: a decrease in the concentration of leukocytes and platelets, methemoglobinemia;
• from the nervous system: increased excitability or, conversely, drowsiness;
• from the side of the cardiovascular system: dysfunction of the heart muscle;
• from the digestive system: pain and nausea.

In addition, allergic reactions may develop: urticaria, itching, angioedema. Patients complain of colic in the kidneys, and tests reveal pus in the urine.

Paracetamol is safe when used infrequently, however, there is evidence that when taken frequently in children from 1 to 3 years old, allergies developed by 6-7 years old.

The cost of paracetamol tablets, suspension, syrup and suppositories

The price of paracetamol is different depending on the form of release and dosage of paracetamol.