Paracetamol – dosage, action. Can paracetamol be overdosed?

Proven content

Paracetamol is one of the most popular antipyretic and analgesic drugs. It is generally considered safe and can be used even by pregnant women and young children. Although it is very easy to buy, it turns out that in too high doses it can be poisonous and even lead to death.

What is paracetamol?

Paracetamol is a very popular pain reliever and antipyretic drug that is available over the counter. It is very easy to buy, which has its drawbacks. The drug may have a detrimental effect on health in the event of an overdose of paracetamol, which is also a component of many complex drugs.

Paracetamol, the alternative name of which is acetaminophen, is a medicinal substance known in the world for over 100 years. It was created in the USA in the nineteenth century, and reached Poland in the nineties of the twentieth century. Paracetamol is a derivative of phenacitin, it has an analgesic and antipyretic effect. The drug has a central effect, and in the case of an analgesic effect, it may also increase the threshold of perceived pain. It is available in the form of tablets, soft capsules, syrups, oral suspension, and suppositories.

After administration, the drug works for about 6–8 hours, suppressing fever, while the analgesic effect lasts for 4–6 hours. For patients using paracetamol, it is important to know that the drug does not have an anti-inflammatory effect.

When to use paracetamol?

Due to its action, the indication for the use of paracetamol is:

1. high fever;
2. acute and chronic pains of varying severity;
3. when severe pain occurs, it can be combined and given together with codeine and morphine.

The use of paracetamol is recommended by the World Health Organization for the treatment of pain caused by cancer. In addition, it can be taken for migraine, earache, menstrual pain, neuralgia, rheumatic, myofascial and bone pain. It is also recommended for toothache (also after dental procedures) and for pain after surgery and surgery.

How to safely use paracetamol?

The drug used in therapeutic doses is considered safe and is approved for use by pregnant and lactating women, as well as newborns and infants. It can also be used by people with peptic ulcer disease, blood clotting disorders, allergy to acetylsalicylic acid and other non-steroidal anti-inflammatory drugs and with aspirin-induced asthma.

Remember, however, that the safety of paracetamol depends mainly on the dose we take or give. A safe daily dose for adults is 4 g, and a dose of 2,5 g for chronic therapy should not be exceeded. Particular care should be taken in children whose doses are adjusted according to body weight. Exceeding the doses recommended by the manufacturer may result in symptoms paracetamol poisoning.

Currently, due to the creation of various complex painkillers or cold medications, it is increasingly difficult to control the amount of paracetamol consumed by patients. Unfortunately, the names of individual agents are not associated with a specific active substance. As a result, the patient can take several different paracetamol-containing drugs in a short time, hoping for a quick relief of symptoms and a better well-being. Unfortunately, we are often unaware that it is very easy to cross this way a safe dose of paracetamol and get poisoned.

To avoid paracetamol poisoning, always read the package leaflets of the medicines you are taking. The pharmacist will play an important role here, as he should warn the patient and help in choosing the right preparation. Always inform the seller about the currently used painkillers and antipyretics, so as not to buy a product with a similar composition. If we buy drugs outside the pharmacy, we have to check the ingredients ourselves. Fortunately, more and more drug manufacturers put information about the paracetamol content on the packaging.

What are the consequences of an overdose of paracetamol?

The toxicity of paracetamol is related to its site of metabolism, i.e. the liver. After taking the drug, 5 percent. paracetamol is converted into very toxic to the liver, N-acetyl-p-benzoquinimine. It is immediately transformed by the powerful antioxidant glutathione into non-toxic compounds. Unfortunately, the activity of this oxidant in the liver is limited, therefore higher doses exceeding 10 g per day lead to the accumulation of the toxin in the liver.

Due to the toxic effect of paracetamol, people with chronic liver diseases and systemic diseases should be careful. People who are hungry and emaciated should also be careful, because they are deficient in cysteine ​​(necessary for the production of glutathione in the liver). The resulting glutathione deficiency prevents the toxin from being neutralized.

How to recognize paracetamol poisoning?

The first symptoms of paracetamol overdose can be seen 4-5 hours after administration. First it is nausea and vomiting, then there is abdominal pain and pain in the liver area. The next day, you may notice symptoms of liver damage, i.e. jaundice and a hemorrhagic diathesis. The next day, the patient develops hepatic failure, resulting in coma and multi-organ disorders, followed by death.

Paracetamol poisoning can only be stopped with timely hospitalization. Treatment requires the administration of the antidote, N-acetylcysteine ​​(a mucolytic drug used in bronchitis). It allows you to maintain the proper concentration of glutathione in the liver and protects the liver.

1. Read more about acetaminophen poisoning

Paracetamol for children

Although paracetamol is a safe substance when used as prescribed, the proper selection of the preparation and dosage are key. Some medications contain high concentrations of paracetamol in a single dose and should not be given to children under 6 years of age. In children from 6 to 12 years of age, the maximum allowable daily dose is 2 g of paracetamol. The youngest are usually given this drug in the form of suppositories.

As for single-use doses and how often they are administered, it all depends on the specific drug and manufacturer. Always read the leaflet, but it is best to follow your pediatrician’s instructions on administering the medications. The doctor’s opinion is also important in the case of children under three years of age – they should not be given paracetamol without the explicit recommendation of a specialist.

1. Read more: Paracetamol for children. When to use and how to dose?

Paracetamol in pregnancy

The use of paracetamol during pregnancy is allowed, but a pregnant woman should always consult a doctor before taking the drug. This is a necessary precaution as any medicinal substances can lead to complications or impair the development of the fetus. This applies primarily to the first trimester of pregnancy, as well as frequent and long-term use of the drug, which may increase the risk of malformations in a child. Your doctor may recommend reaching for painkillers with paracetamol in the case of, for example, headache, migraine, bone and joint and muscle pains.

1. See also the article: Should paracetamol be used during pregnancy and how? Indications, dosage and side effects

Paracetamol – contraindications

Preparations based on paracetamol should not be used:

1. in people with severe renal or hepatic insufficiency;
2. in people who are hypersensitive to paracetamol or any of the excipients present in the preparation;
3. in alcohol dependent patients;
4. depending on the selected preparation, a contraindication may be the patient’s age below 12 or 6 years, and in the case of high doses of paracetamol, medical consultation may also be necessary in the case of adolescents up to 16 years of age;
5. manufacturers may also indicate other contraindications to the use of some paracetamol products, so always read the leaflet.

Side effects of paracetamol

Adverse reactions of the body to paracetamol are not common, but if they occur, stop using the drug and consult a doctor. Signs of an allergic reaction include itching, rash and reddening of the skin and sometimes swelling of the throat, tongue and face. Breathing difficulties, an asthma attack and anaphylactic shock are also possible.

The rare and very rare side effects of taking paracetamol include:

1. sweating;
2. deterioration of well-being;
3. drop in blood pressure;
4. nausea and vomiting;
5. jaundice;
6. increase in the values ​​of hepatic indicators;
7. kidney problems, including failure;
8. decrease in the level of granulocytes;
9. symptoms of liver damage.

Source: Register of Medicinal Products