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Paracetamol

Box of paracetamol tablets

Introduction

Paracetamol (acetaminophen) is a widely used anti-pyrexic and analgesic, with similar efficacy in these areas to aspirin, however, unlike aspirin and NSAIDs it has virtually no anti-inflammatory properties.

It is the first analgesic recommended on the WHO Pain Ladder. It is often used in combination with opiates, and can reduce the opiate requirement.

At doses of <4g/day (usually in 1g four times per day) it is considered very safe, even in those with existing liver disease.

At doses higher than this, it can cause hepatotoxicity, which is dose and age dependent. Older patients metabolize paracetamol more slowly.

Metabolism

 

In overdose

Management of overdose is covered in Paracetamol Overdose

 

Risks of overdose

 

In Liver Disease

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