Paracetamol: instruction manual for adults and children

Paracetamol is one of the most common analgesic and antipyretic drugs. It is a part of many different drugs-analgesics and a number of drugs used for colds.

Effectively lowers the temperature and eliminates pain syndrome. In addition, it copes well with headache, dental, menstrual pain, symptoms of neuralgia. The main advantage of the drug is low toxicity.

As defined by WHO, it is considered one of the safest and most effective medicines and is widely used to treat children.

Clinical and pharmacological group

Analgetic-antipyretic. Has analgesic, antipyretic and weak anti-inflammatory effect.

Conditions of leave from pharmacies

Released without a doctor's prescription.

Price list

How much does Paracetamol cost in pharmacies? The average price is at the level of10 rubles.

Form of issue and composition

The following dosage forms of Paracetamol are available:

Tablets: white with a creamy hue or white, flat-cylindrical, with a risk and facet (10 pcs. in contour mesh or cell-free packages; 2 or 3 packs in a pack of cardboard);

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Suppositories rectal for children: torpedo, from white with a yellowish or creamy hue to white (5 pcs. in packs of cell contour; 2 packs in a pack of cardboard);
Syrup (100 ml in vials, 1 bottle in a cardboard box);
Suspension for oral administration (100 ml in bottles of dark glass with a dosage spoon in the kit, 1 set in a pack of cardboard).

1 tablet contains:

Active substance: paracetamol - 200 or 500 mg;
Auxiliary components: lactose (milk sugar), stearic acid, potato starch, gelatin.

In 5 ml of syrup contains:

Active substance: paracetamol - 24 mg;
Auxiliary components: water, sodium benzoate, aromatic additives, riboflavin, ethyl alcohol, propylene glycol, sodium citric acid trisubstituted, citric acid, sorbitol, sugar.

In 5 ml of the suspension contains:

Active substance: paracetamol - 120 mg;
Auxiliary components: purified water, orange or strawberry flavor, sorbitol food (sorbitol), glycerol (glycerin), sucrose (sugar), propylene glycol, methylparahydroxybenzoate (nipagin), xanthan gum (xanthan gum), avicel RC-591 (microcrystalline cellulose, sodium carmellose).

In 1 suppository contains:

Active substance: paracetamol - 100 mg;
Auxiliary components: a solid fat base.

Pharmacological effect

Paracetamol belongs to the drugs of the group of analgesics-antipyretics, that is, analgesics and antipyretic agents. In addition to analgesic and antipyretic effect, the drug also has a mild anti-inflammatory effect.

The mechanism of pharmacological action of Paracetamol is related to its ability to slow down the synthesis of prostaglandins and to affect the center of thermoregulation in the hypothalamus. When using the drug, the maximum concentration of the drug in the blood plasma is observed after 10-60 minutes.

Indications for use

What helps? Paracetamol is prescribed for the symptomatic treatment of pain syndrome of mild or moderate severity, of different origin and localization.

However, the most common indication for the beginning of taking this medicine is an increase in body temperature (hyperthermia) against the background of catarrhal and viral diseases, as well as pain (ache) in the bones and muscles of influenza and other acute respiratory viral infections.

Diseases, and pathological conditions in which acetaminophen is recommended:

neuralgia;
fever, unspecified genesis;
sciatica;
arthrosis;
toothache;
headache (incl. migraine);
arthralgia (joint pain);
myalgia (muscle pain);
algodismenorea (painful periods).

Contraindications

Contraindications include:

individual hypersensitivity (hypersensitivity) to the active substance;
"Aspirin triad" (combination of intolerance to NSAIDs, bronchial asthma and recurrent polyposis of the nose and paranasal sinuses);
inflammatory diseases, erosion and ulcers of the gastrointestinal tract;
gastrointestinal bleeding;
pronounced functional kidney failure;
diagnosed hyperkalemia;
age to 6 years for taking tablets;
state after coronary artery bypass grafting.

Particular care when taking this drug should be observed in the following diseases and pathological conditions:

chronic alcoholism and alcoholic liver damage;
ischemic heart disease and chronic heart failure;
cerebrovascular disease;
lesions of peripheral arteries;
renal and hepatic insufficiency.

At a diabetes it is not recommended to accept Paracetamol in the form of a syrup.

Use in pregnancy and lactation

If you need to use during pregnancy and lactation (breastfeeding), you should carefully weigh the expected benefit of therapy for the mother and the potential risk to the fetus or child.

Paracetamol penetrates the placental barrier. To date, there has been no adverse effect of paracetamol on the fetus in humans.
Paracetamol is excreted in breast milk: the content in milk is 0.04-0.23% of the dose taken by the mother.

In experimental studies, embryotoxic, teratogenic and mutagenic effects of paracetamol have not been established.

Dosage and route of administration

The instructions for use indicate that the tablets Paracetamol is prescribed orally.

Adults and children over 15 years of agesingle dose inside - 500 mg; the maximum single dose is 1000 mg. The maximum daily dose is 4000 mg.
Ages over 12 years old(with a body weight of more than 40 kg), a single dose of 500 mg, the maximum daily dose of 2000-4000 mg.
At the age of 9-12 years(body weight up to 40 kg), a dose of 500 mg, a maximum daily dose of 2000 mg.
Children from 6 to 9 years(with a body weight of 22-30 kg: single dose depends on the weight of the child and is 250 mg, the maximum daily dose of 1000-1500 mg.

The recommended interval between doses of the drug is 6-8 hours (not less than 4 hours).

Duration of treatment is no more than 3 days as an antipyretic agent and not more than 5 days as an anesthetic.

The need to continue treatment with the drug is decided by the doctor.

Side effects

The action of the drug in violation of the instructions, dosage provokes side effects. Overdose can cause:

dysfunction of the liver or kidneys;
rashes, redness, "urticaria". Allergy to a drug most often has such external manifestations;
stomach ache. The stomach reacts so to improper intake or excess of the dose;
sleepiness, I want to sleep. The cause of the condition is low pressure;
a sharp drop in the level of glucose, hemoglobin in the blood.

If the dosage is disturbed or improperly taken, immediately call an ambulance.

Overdose

With prolonged use of tablets in large doses, the patient quickly develops symptoms of overdose, which clinically manifested in the form of strengthening of the above-described side effects and the development of hepatic insufficiency.

If you randomly ingest a large number of tablets, the patient should rinse the stomach as soon as possible and deliver it to the hospital. If necessary, symptomatic treatment is performed. Paracetamol antidote is H-acetylestein, it is administered orally or intravenously.

special instructions

With prolonged use of paracetamol, monitoring of the peripheral blood pattern and the functional state of the liver is necessary.

Caution is used in patients with impaired liver and kidney function, with benign hyperbilirubinemia, as well as in elderly patients.

It is used for the treatment of premenstrual tension syndrome in combination with pamabrom (diuretic, xanthine derivative) and mepirin (histamine H1 receptor blocker).

Drug Interactions

With simultaneous application:

activated carbon decreases the bioavailability of paracetamol.
with uricosuric means their effectiveness decreases.
with diazepam, a decrease in the excretion of diazepam is possible.
with carbamazepine, phenytoin, phenobarbital, primidone decreases the effectiveness of paracetamol, which is due to increase of its metabolism (processes of glucuronization and oxidation) and excretion from the body. The cases of hepatotoxicity with simultaneous application of paracetamol and phenobarbital are described.
for a period of less than 1 hour after paracetamol administration, a decrease in absorption of paracetamol is possible.
lamotrigine moderately increases the excretion of lamotrigine from the body.
with anticoagulants, a slight or moderate increase in prothrombin time is possible.
with anticholinergic agents, a reduction in paracetamol absorption is possible.
with oral contraceptives, the excretion of paracetamol from the body is accelerated and its analgesic effect may decrease.
with metoclopramide, it is possible to increase the absorption of paracetamol and increase its concentration in the blood plasma.
with probenecid, a decrease in paracetamol clearance is possible; with rifampicin, sulfinpyrazone - it is possible to increase the clearance of paracetamol due to an increase in its metabolism in the liver.
with inducers of microsomal liver enzymes, agents that have a hepatotoxic effect, there is a risk of intensifying the hepatotoxic effect of paracetamol.
With ethinyl estradiol, paracetamol is absorbed from the intestine.

Besides:

Cases of toxic effects of paracetamol when used with isoniazid are described.
There are reports of the possibility of enhancing the myelodepressant effect of zidovudine when used concomitantly with paracetamol. A case of severe toxic liver damage is described.

Reviews

We picked up some reviews of people who used the drug Paracetamol:

Igor. Paracetamol is always with me, I often am on the road, work is connected with traveling and this drug is constantly available in the car kit. He saved me many times. I take it with headache and toothache, with a cold. Good temperature, quickly improves well-being and unlike aspirin does not have a harmful effect on the stomach. It is quite inexpensive and is sold in any pharmacy.
Margarita. On the problem skin I know firsthand. I treat acne with a bolt, which I do on the basis of paracetamol and boric acid. In combination, these drugs perfectly relieve inflammation, remove redness and dry the rash. I heard that very good tablets eliminate toothache and stomach cramps with menstruation.
Sasha. Tablet Paracetamol and do not need additional medicine for the temperature, and all these powders, which he enters, just bullshit, diluted with any additional chemistry to sell more expensive. All these Nurofens, Teraflu and others. Drink pure Paracetamol and there will be happiness and health.

Analogues

Paracetamol has many analogues containing the same active substance. They are produced by many pharmaceutical companies under different brands. Here we give only some analogues of Paracetamol:

Acetophene
Aminadol
Aminofen
Apamid
Apanol
Biocetamol
Valadol
Valorine
Deminofen
Dolamine
Metamol
Mialgin
Paramol
Panadol Junior
Pirinazine
TempraMol
Febridol
Hemcetaphene
Celiphane
Efferalgan

Before using analogues, consult your doctor.

Which is better: Paracetamol or Ibuprofen?

Ibuprofen (Nurofen) has a broader spectrum of action and more favorably, in comparison with Paracetamol, affects the temperature curve. The effect from its application comes faster (already in 15-25 minutes) and lasts longer (up to 8 hours), in addition, the drug is considered less harmful and less likely to provoke allergic reactions. Ibuprofen better than its counterpart removes the critically high temperature. Repeatedly (to control hyperthermia) it is used much less often than Paracetamol.

The power of antipyretic action is comparable, however, ibuprofen, in addition to anesthetic and antipyretic action, also effectively removes inflammation in peripheral tissues. This is due to the fact that paracetamol acts primarily in the central nervous system, and ibuprofen - suppresses the synthesis of Pg not so much in the central nervous system as in inflamed peripheral tissues. That is, with expressed peripheral inflammation, the choice should be made in favor of Nurofen and other drugs based on ibuprofen.

Answering the question "What to choose, Paracetamol or Nurofen?", Doctors recommend starting treatment of young children with monotherapy with Ibuprofen. If you need to urgently reduce the temperature, you can use any of the drugs. Follow-up treatment should be agreed with the doctor. It should be noted that suppositories with ibuprofen are contraindicated in children weighing up to 6 kg, and suspension for children up to 3 months.

Storage conditions and shelf life

The drug in any dosage forms is released without the appointment of a doctor. Shelf life of Paracetamol is:

Suppositories - 2 years at a temperature of up to 15 ° C;
Tablets - 3 years at a temperature of up to 25 ° C;
Syrup, solution for oral administration and suspension - 2 years at a temperature of up to 25 ° C.

Keep away from children!