Paracetamol

What is paracetamol?

Paracetamol is a medicine used for mild to moderate pain. It can be bought over the counter in pharmacies, supermarkets and other shops.

You can also take paracetamol for:

• fever (high temperature)
• stronger pain — used with other pain relievers such as codeine

Paracetamol doesn’t treat the cause of your pain, it just eases the feeling of pain.

Paracetamol can be used for:

• backache
• headache
• migraine
• muscle strains
• period pain
• toothache
• aches and pains due to colds and flu

How does paracetamol work?

Paracetamol has been in use for more than 70 years. The way it works to reduce pain and fever is not fully understood.

Paracetamol begins to ease pain and lower a high temperature about 30 minutes after a dose is taken. Its effects usually last for about 4 to 6 hours.

Types of paracetamol

Paracetamol comes in the following forms:

• tablets
• capsules
• suppositories
• soluble powders
• liquids

Paracetamol is made by lots of different companies and sold using different names. It’s also often combined with other medicines and found in:

• cold and flu medicines
• headache tablets

This makes it very easy to take too much paracetamol by mistake.

Modified release paracetamol

Modified release paracetamol has a higher dose of paracetamol than standard paracetamol tablets. This can also be called:

• controlled release paracetamol
• extended-release paracetamol
• slow-release paracetamol
• sustained release paracetamol

This type of paracetamol is often used to help manage pain associated with osteoarthritis.

Modified release paracetamol is released into your body more slowly than normal paracetamol products.

Modified release paracetamol is designed to be taken less often than normal paracetamol. You take a dose every 8 hours (3 times a day).

How much paracetamol can I take?

The suggested dose of paracetamol for adults and children 12 years and over is:

• no more than 1g every 4 to 6 hours
• a total of 4g daily

It’s dangerous to take more than the recommended dose of paracetamol. This may damage your liver, which can be fatal (cause death).

Paracetamol is sold under a variety of brand names. This can be confusing and lead to you taking more paracetamol than advised. Always check the packet before taking any medicine.

Children aged 1 month to 12 years

Dosing for children is 15 mg per kg. Paracetamol can be given every 4 to 6 hours as required, with no more than 4 doses in 24 hours.

The label on your liquid paracetamol product will have clear dosing instructions.

What should I do if I forget to take a dose of paracetamol?

If you forget to take your dose of paracetamol, you should:

• take the dose as soon as you remember
• unless it’s within 4 hours of your next dose — in which case you should skip that dose

Doses of paracetamol should be taken at least 4 hours apart.

Don’t take more than the recommended dose over a 24-hour period.

Check the directions on your medicine package. It should tell you what to do.

Can I take paracetamol with my other medicines?

DO NOT take paracetamol if you are also taking other medicines that contain paracetamol. These might be:

• paracetamol/ibuprofen combinations
• migraine preparations
• some cough and cold remedies
• medicines prescribed by your doctor

This is because of the risk of overdosing on paracetamol. This may damage your liver and can be fatal (cause death).

Paracetamol won’t interact with many other medicines if only taken for a few days for pain or fever. It’s also safe to take paracetamol if you are on antibiotics.

If you take other medicines, it is important to:

• check with your doctor or pharmacist that you can take your medicine with paracetamol
• read the information leaflet that comes with your medicine

Warfarin and paracetamol

Paracetamol is the suggested painkiller for people taking warfarin.

You should take the lowest dose that helps your pain. If you’re still in pain after taking paracetamol for 3 or 4 days, speak with your doctor.

Long-term use of paracetamol may increase the effect of warfarin. This can increase your chance of bleeding. However, this is unlikely to happen if you take paracetamol occasionally.

When should I not take paracetamol?

DO NOT take paracetamol if you have:

• an allergy to paracetamol
• taken other medicines that contain paracetamol
• already taken the recommended dose within a 24-hour period

Check with your doctor or a pharmacist before taking paracetamol if you have:

• liver problems
• kidney problems
• drink more than the recommended amounts of alcohol
• you are very underweight

Paracetamol, food, alcohol and driving

Will paracetamol affect my driving?

Paracetamol is unlikely to affect your driving.

Is it okay to drink alcohol when I’m taking paracetamol?

Drinking a small amount of alcohol is unlikely to be harmful if you are taking paracetamol.

Are there any foods I should avoid?

You can eat normally when taking paracetamol.

What are the possible side effects of paracetamol?

Use of any medicine always carries some chance of unwanted side effects.

The most common side effects of paracetamol are:

• drowsiness and tiredness
• rashes and itching

People react differently to medicines. Just because a side effect is listed doesn’t mean you will get the side effect. It’s important to be careful when taking any medicine.

Can I use paracetamol often?

You should talk to your doctor about using paracetamol for a long time.

Long-term use of paracetamol can cause:

• tiredness
• breathlessness
• your fingers and lips to go blue
• anaemia (low red blood cell count)
• liver and kidney damage
• heart disease and stroke if you have high blood pressure

What happens if I take too much paracetamol?

Liver failure can happen if you take too much paracetamol and don’t get help. This can lead to death.

Symptoms of paracetamol overdose are:

• abdominal pain, nausea, vomiting
• liver problems
• seizures
• coma and death

These symptoms usually happen 24 hours after taking the drug.

You can be given an antidote if you get medical help soon after taking paracetamol.

How can I avoid taking too much paracetamol?

You can make sure that you don’t take too much paracetamol by:

• carefully following the directions for using paracetamol-containing medicines
• learning how to identify paracetamol as the active ingredient in medicines

Paracetamol and life stages

Can paracetamol be given to children?

You can give your child paracetamol if they have a high temperature, and this is making them uncomfortable. Get medical advice if the fever does not get better.

You can give paracetamol to your child after their vaccinations (shots) to treat pain and fever.

Don’t give paracetamol to babies younger than one month old.

How much paracetamol should I give my child?

Paracetamol comes in different strengths for different ages. It’s important to choose the right paracetamol product for your child’s age.

Make sure that you:

• always read the medicine label and packaging before use
• know your child’s weight — the recommended dose of paracetamol is based on their body weight

When giving your child paracetamol, never:

• give more than the maximum recommended dose
• give more doses than recommended in a 24-hour period

When giving your child medicines, you should:

• measure liquid medicines accurately using the syringe that comes with the medicine
• write down all the medicines your give them, and when you give them

Don’t give your child paracetamol for more than 48 hours unless told to do so by a doctor.

Always keep medicines in a safe place, out of the reach of children.

Can I take paracetamol if I’m pregnant?

Paracetamol is widely used during pregnancy. Paracetamol readily crosses the placenta, but doesn’t appear to raise the chance of birth differences or bad pregnancy outcomes.

As with any medicine taken during pregnancy, you should get medical advice before taking paracetamol.

If you take paracetamol when pregnant, make sure that you take it:

• at the lowest effective dose
• for the shortest possible time

Can I take paracetamol if I’m breastfeeding?

If you take paracetamol when breastfeeding, make sure you take the recommended dose, for the shortest possible time.

It appears in breast milk in very small amounts which are very unlikely to harm your baby.

Paracetamol is the first choice of painkiller if you are breastfeeding.