Paracetamol (Acetaminophen)

Indications & Dose:

Analgesia, antipyresis; mild to moderate pain.

Adult

By mouth, 0.5-1g every 4-6 hours to a max of 4g daily.

Inj: 2mg,

Children : 2 months 60mg for post immunisation apraxia; otherwise under 3 months (on doctor’s advice only), 10 mg/kg (5mg/kg if jaundiced); 3 months-1year 60-120mg, 1-5 years 120-250mg, 6-12 years 250-500mg, these doses may be repeated every 4-6 hours when necessary (max. of 4 doses in 24 hours)

Inj: 1/2 of the adult i/m or 6mg/kg body weight.

Contraindications:

Side Effects:

Cautions:

Precautions:

Hepatic disease, renal disease, chronic alcoholism (>3 drinks/day), elderly

Interaction:

Drugs

Anticoagulants: Enhanced hypoprothrombinemic response

Anticonvulsants, Barbiturates, Rifabutin, Rifampin: Enhanced hepatoxic potential in overdose

Cholestyramine/Colestipol: Reduced acetaminophen levels and response

Ethanol: Increased hepatoxicity in chronic, excessive alcohol ingestion Isoniazid: Increased acetaminophen levels & hepatotoxicity

OVERDOSAGE

• Specific antidote is acetylcysteine; administer as serum level of acetaminophen indicates high risk of hepatotoxicity. Minimal toxic dose 10g (140 mg/ kg), can occur with less, >20 25g potentially fatal

Labs

• False decrease: Amylase

• False increase: Urine 5 HIAA

• Interference: Cannot assay ticarillin levels

Warnings:

Adverse Effects:

Lactations:

Low concentrations in breast milk (1 %-2% of maternal dose); compatible with breast feeding

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

HEME: Hemolytic anemia (longterm use), leukopenia, neutropenia, pancytopenia, thrombocytopenia MISC: Overdosage: acute hepatic and renal failure, confusion, delirium followed by vascular collapse, convulsions, coma, death, drowsiness, jaundice, nausea, vomiting

SKIN: Angioedema, rash, urticaria

Patient And Carer Advice: