Paracetamol information ppt

By: Milan Padariya
http://paracetamol-
information.blogspot.in
PARACETAMOL INFORMATION

WHAT IS PARACETAMOL?
Generic Name: Paracetamol
Commonly called as: PCM
Alternate Name: Acetaminophan
How it is pronounce?
Paracetamol: par + RA + cet + a + MOL
Acetaminophan: a + SEET + a + MIN + oh + fen
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Paracetamol is commonly prescribed to relieve pain and
fever. Proper mechanism of action is not know for
Paracetamol.
Paracetamol treats following condition/s:
1. Headache
2. Fever and Cold
3. Muscle ache
4. Arthritis
5. Backache
6. Toothache

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Important Note: It is not used to treat
Inflammation and Swelling of joints.
Paracetamol has poor evidence to relieve fever in
children. It is mainly sold in combination with other
ingredients in cold medicines. It is most common
medicine for fever and pain in USA, Europe and
Asia.

IMPORTANT INFORMATION
ABOUT PARACETAMOL
So many companies are producing paracetamol
under various brand names. It is not possible to
mention whole list of brand name in this post.
WHO has recommended dosage of paracetamol.
Dose would be different for adult and children. It is
dangerous to take this medication more than
recommended dosage.
For ADULT: 1 gram (1000 mg) per dose, 4 gram
(4000 mg) per day

ABOUT PARACETAMOL Continue
More use of Paracetamol leads to serious injury to
your liver. While taking paracetamol consult
your doctor if you are alcohol addicted. Alcohol with
paracetamol cause alcoholic liver diseases faster
than only alcohol do.
Currently in market Paracetamol is blended with
other medicines. Without consulting your doctor or
pharmacist do not take any medicines having
Paracetamol as one of the ingredients.

ABOUT PARACETAMOL Continue
Sometime intentionally or Accidentally multiple
dose of those medicines leads to overdose
of Paracetamol. Overdose of Paracetamol causes
severe liver damage.
Important Note: Taking more than 4000 mg daily
dose of Paracetamol cause severe damage of
liver and kidney functions.

HOW TO USE PARACETAMOL?
Use Paracetamol as directed in label on strip. you can
consult your doctor or pharmacist about it.
This product is available in following dosage form:
Tablet (Normal): Take with water and swallow whole tablet
at once.
Tablet (Disintegrating): First disintegrate whole tablet in
glass of water and drink it. Make sure your hand must be dry
while handling disintegrating tablet.
Tablet (Chew-able): Chew tablet throughly till it disappear in
mouth.
Tablet (Extended Release): Swallow whole tablet with
water. Do not break extended release tablet while taking it.

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Tablet (Effervescent): Dissolve whole tablet in glass of
water and drink it.
Effervescent Granules: Dissolve one packet of
granules in glass of water and drink it.
Syrup/Suspension/Solution: Take directed dose in
teaspoon or tablespoon. if you need water, drink half
glass of water after taking medicine. if your dosage form
is suspension, you need to "SHAKE WELL BEFORE
USE". if it is in syrup or solution form do not need to
shake.
Powder: Dissolve powder in glass of water and drink it.

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Suppository (Rectal): Put suppository into rectum.
it will melt on body temperature. Clean your hand
before or after handle suppository.
Capsule: Swallow whole capsule at once with
water. Do not take of powder from capsule.
Intra-Venous (I.V.) Injection: This dosage form will
be given by Registered Medical Practitioner only.

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There are many brands of Paracetamol available in
Pharmaceutical market. Before taking paracetamol read
dosing leaflet carefully. If you need to give paracetamol
to the child make sure that medicine must be meant for
pediatric (child) use only.
Important Note 1: Do not break tablet and use.
Important Note 2: Do not touch capsule if your
hand/s are wet.
Important Note 3: Self injection may create serious
problems.

PARACETAMOL USED IN
CHILDREN
As I earlier said that before using paracetamol in
children make sure that product must be meant for
pediatric (Child) use only. Use paracetamol to treat
fever and pain in children over two months old.
High dose (650 mg) not recommended for patient
younger than 16 years.
Before giving paracetamol to the children read
information leaflet carefully comes along with
medication.

PARACETAMOL USED IN
CHILDREN Continue
The correct dose of paracetamol on children based on
following three things.
1. Child's Age
2. Child's Weight
3. Strength of Paracetamol in medicine
Recommended dose for children is 10-15 mg per kg of
body weight. For example: If weight of children is 10
kgs. dose should be within 100 to 150 mg (10 X 10 to
15 X 10 mg). this dose can be given for every 4-6 hours
and maximum 4 times a day.

PARACETAMOL USED IN
CHILDREN Continue
Important Note 1: Do not give paracetamol to child
below 2 months.
Important Note 2: First prefer syrup or suspension
while giving to the children.
Important Note 3: Consult your doctor or
pharmacist before given to the children.
Important Note 4: If wight of child is less than 5 kgs
or more than 40 kgs, consult your doctor or
pharmacist before given to the child.

RECOMMENDED DOSE OF
PARACETAMOL
WHO has recommended dose for paracetamol in adults
and children of all ages. following are the standard
dose:
For Adult:
500 mg to 1 gram. this dose is required after every 4-6
hour. Maximum 4 dose during day. (2 gram to 4 gram
per day).
For Children:
Aged 12-16 years: 480 - 750 mg required after every 4-
6 hours. Maximum 4 dose during day.
Aged 10-12 years: 480 - 500 mg required after every 4-
6 hours. Maximum 4 dose during day.

RECOMMENDED DOSE OF
PARACETAMOL Continue
Aged 8-10 years: 360 - 375 mg required after
every 4-6 hours. Maximum 4 dose during day.
Aged 6-8 years: 240 - 250 mg required after every
4-6 hours. Maximum 4 dose during day.
Aged 4-6 years: Up to 240 mg required after every
Aged 2-4 years: Up to 180 mg required after every

RECOMMENDED DOSE OF
Aged 6 months-2 years: Up to 120 mg required
after every 4-6 hours. Maximum 4 dose during day.
Aged 3-6 months: 50-70 mg required after every
Aged 2-3 months: 40-60 mg required after every
Below 2 years: Not Recommended

RECOMMENDED DOSE OF
For Example:
Children's marketed paracetamol comes in
suspension form. it has 250 mg paracetamol in 5
ml. If age of child is between 6-8 years and weight
is 18-20 kgs. Recommended dose for child aged 6-
8 years is 240-250 mg per 4-6 hours, hence 18-20
X 10-15mg = 180-300 mg per one dose.
Each 5 ml contains 250 mg of paracetamol, So
dose will be 5 ml required for every 406 hours and
maximum 4 times per day.

RECOMMENDED DOSE OF
Child’s Weight 120 mg per 5 mL 250 mg per 5 mL
5 kgs or less Consult Doctor Consult Doctor
6.5 kgs 4 mL 2 mL
8 kgs 5 mL 2.5 mL
10 kgs 6 mL 3 mL
15 kgs 9 mL 4.5 mL
20 kgs 12 mL 6mL
30 kgs 18 mL 9 mL
40 kgs 25 mL 12 mL
More than 40 kgs Consult Doctor Consult Doctor

RECOMMENDED DOSE OF
Important Note: For fever and pain management
dose of Paracetamol will be same for children
and adult.
If you take paracetamol in regular basis and miss
the dose, either consult your doctor or pharmacist
or skip the missed dose.
Important Note: If you missed dose, don't take
missed dose with next dose. It may cause
heartburn, Nausea and Vomiting.

RECOMMENDED DOSE OF
Following are the first sign of paracetamol
overdose:
Loss of appetite
Nausea
Vomiting
Stomach pain
Confusion
Weakness
Sweating

RECOMMENDED DOSE OF
Also you will suffer from some later symptoms
like,
Pain in upper stomach
Dark urine
Yellowing of skin
Whitening your eyes

SIDE EFFECTS OF
PARACETAMOL
If paracetamol is taken in recommended dose, it is
safe medicine for adult but if dose exceed to limit it
will cause some of side effects as following.
Liver Damage:
Overdose of paracetamol often causes liver
damage (Moderate to Severe). In western world,
Paracetamol toxicity is the foremost cause of liver
failure. According to US FDA during 1990's 56000
emergency room visit, 26000 hospitalization and
458 death were reported in United States of
America due to overdose of paracetamol.

SIDE EFFECTS OF
Skin Reaction:
A new warning about paracetamol was issued by
US FDA on 2nd August, 2013 that it may cause
skin reaction very rare but overdose of paracetamol
may convert it in to moderate to severe.
Except normal skin reaction it was reported that
following two problems may be occurred due to
overdose of paracetamol.
Steven-Johnson Syndrome
Toxic Epidermal Necrosis

SIDE EFFECTS OF
Other some usual side effects are as follow:
Nausea
Vomiting
Stomach pain
Loss of appetite
dark urine
Yellowish skin
Some studies state that there is a relationship found between
paracetamol and slight increase in kidney cancer.
Important Note: If you found any of these symptoms after
having paracetamol, consult your doctor or
pharmacist immediately

PRECAUTION SHOULD BE TAKEN
BEFORE USING PARACETAMOL
Do not give paracetamol to children below 2
months without asking doctor. Paracetamol in
children is weight based dosing so special
precaution should be taken in calculation of dose.
Paracetamol is safe for old age patients but still you
should take care about dose calculation of
paracetamol in old age patient.
Paracetamol by oral route categorized in Category
B by FDA during pregnancy. so it is safe to use
paracetamol during pregnancy but you should take
care about dose and you should consult your
doctor or pharmacist before taking it.http://paracetamol-information.blogspot.in

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Paracetamol by intravenous (I.V.) route categorized in
Category C by FDA during pregnancy. Studies state that it
will cause harmful effect to unborn child during pregnancy.
you should take care about dose and route of administration
of paracetamol use during pregnancy.
You should take precaution if you are lactating woman
(Breastfeeding Woman). Paracetamol excreted in breast milk
but in small quantity. American Society of Pediatrics
categorized as safe drug for lactating woman. But you should
take care before having paracetamol.
Precaution should be taken if you are alcoholic and having
liver related diseases.
If you are currently associated with use of other medicines,
while taking paracetamol you should take care about it.

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Do not take dose of paracetamol if you are allergic to it.
If you have any other allergies like of food,
preservatives, or animals, consult your doctor or
pharmacist before taking paracetamol.
Special precaution should be taken if you have kidney
related problems while taking paracetamol.
Some brand of paracetamol contains aspartame so if
you have Phenlyketonuria (PKU), you should take
special precaution.
Important Note: Do not take paracetamol without
asking your doctor or pharmacist. Hence it is
practiced as OTC product in some countries, it is
harmful to take it without asking your doctor or
Pharmacist. http://paracetamol-information.blogspot.in

PARACETAMOL INTERACTION
WITH OTHER MEDICINES
Paracetamol interactions with other medicines have
been classified into three following categories:
1. Major Drug Interaction: It is suggested that it may
be harmful if paracetamol taken with other medicines. It
is highly clinically significant. Avoid this combination.
Risk is very high
2. Moderate Drug Interaction: It is moderately
clinically significant. Studies suggest that you should
usually avoid this combination. Risk is moderate.
3. Minor Drug Interaction: It is minimally clinically
significant. Risk is very low if paracetamol taken with
medicines.

WITH OTHER MEDICINES Continue
Following 12 drugs have been found to have Major Drug
Interaction with Paracetamol:
1. Alcohol (Ethanol)
2. Alcohol 5% in Dextrose 5%
3. Alcohol and Dextrose Injection USP
4. Amyl Nitrate / Sodium Nitrate
5. Leflunomide
6. Teriflunomide
7. Epinephrine
8. Cyanide Antidote Kit
9. Prelocaine
10. Lidocaine Topical
11. Mipomersen
12. Lomitapide

Some Anti-Convulsant drugs having interaction
with Paracetamol like:
1. Amobarbital
2. Butalbital
3. Pantobarbitol
4. Phenobarbital
5. Secobarbital
6. Carbamazepine
With these Anti-Convulsant drugs paracetamol will
increase risk of liver damage.

Non Narcotic Analgesic like Diflunisal having
interaction with paracetamol. it increase level of
paracetamol in plasma by 50%.
Isoniazid, A typical Anti-Tuberculosis drug having drug
interaction with paracetamol.
Warfarin, A blood thinner interact with paracetamol and
increase risk of uncontrollable bleeding.
Certain cholesterol lowering agent
like Cholestyramine decrease the pharmacological
effect of paracetamol.

OVERDOSE OF
PARACETAMOL
When paracetamol is taken under direction of doctor or
under recommendation it is extremely safe medicine.
Paracetamol overdose may be due to single intentional
or accidental one time overdose. one main reason
behind it is multiple consumption of medicines having
paracetamol. Specially in over the counter product.
Some drug like Carbamazepine, Phenobarbital,
Primidone, Rifampicin etc. alter the metabolism of
paracetamol and it may cause overdose of
paracetamol. A person who is taking more or more of
these drugs. avoid use if paracetamol.

OVERDOSE OF
Simply 10-15 gm indigation of paracetamol may cause
overdose and it may cause severe effects as following:
1. Anorexia
2. Paleness
3. Nausea
4. Vomiting
5. Irritability
6. Sweating
7. Stomach Pain
8. Abdominal Pain
9. Liver Damage
10. Kidney Damage

OVERDOSE OF
Treatment of Overdose of Paracetamol
If you think you had multiple dose of paracetamol
more than recommended dose, you should inform
to your doctor or pharmacist or do immediate
contact of nearest hospital.
Immediate action towards paracetamol overdose is
necessary. if you see symptoms of nausea and
vomiting, not consider as overdose of paracetamol.

OVERDOSE OF
N-Acetylcystein may be prescribed for primary
treatment of paracetamol overdose. Mark my words
this antidote only effective before 24 hours of
overdose. After 24 hours it will not effective.
If case is severe than Hepatic functions failure may
be reported and supportive care for liver will be
started. In case of liver failure transplantation may
be necessary.

PARACETAMOL USES
1. Fever
It is widely prescribed to relieve fever in person of all ages.
Paracetamol is prescribed in children if temperature is
greater than 38. 5 Celsius or 101.3 Fahrenheit.
2. Pain
It is also prescribed to relieve mild to moderate pain.
3. Osteoarthritis
Some studies state that paracetamol is also used to treat
arthritis pain of knee, hand or hips.
4. Lower Back Pain
It is first line treatment of lower back pain.

PARACETAMOL USES Continue
5. Headache
Swiss, Austrian and German headache societies state that
Paracetamol with caffeine is also used in Headache. In India
paracetamol is also prescribed to relieve headache. Paracetamol is
also used to relieve migraine in some countries.
6. Toothache
Some studies show that paracetamol is also used in pain of tooth.
7. Menstrual Period Pain
Paracetamol is often prescribe with Dicyclomine Hydrochloride or
Mefenamic Acid to relieve pain during menstrual period.
8. Cold / Flu Pain
Paracetamol is also prescribed with Anti-Cold medicine to relieve
Cold / Flu Pain.

PARACETAMOL MARKETED WITH
OTHER DRUGS
1. Paracetamol + Diclofenac Sodium +
Serratiopeptidase
2. Paracetamol + Aceclofenac
3. Paracetamol + Ibuprofen
4. Paracetamol + Nimesulide
5. Paracetamol + Dicyclomine Hydrochloride
6. Paracetamol + Mefenamic Acid

OTHER DRUGS Continue
7. Paracetamol + Caffeine
8. Paracetamol + Aceclofenac + Tizanidine
9. Paracetamol + Domperidone
10. Paracetamol + Promethazine
11. Paracetamol + Diclofenac Sodium
12. Paracetamol + Tramadol

OTHER DRUGS Continue
13. Paracetamol + Cetrizine + Phenylpropanolamine
14. Paracetamol + Diclofenac Potassium +
Serratiopeptidase + Magnesium Trisilicate
15. Paracetamol + Diclofenac Potassium +
Chlorzoxazone
16. Paracetamol + Chlorpheniramine Maleate +
Phenyleprine
17. Paracetamol + Tramadol + Domperidone
18. Paracetamol + Ibuprofen + Serratiopeptidase

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