PARACETAMOL (ACETAMINOPHEN)

Let us start with ACETAMINOPHEN, also known as PARACETAMOL.

What are the forms in which this medicine is available?

   Paracetamol is available as Tablet, capsule, soluble tablet, oral liquid, suppository and injection.

Common brand names of this medicine are DOLO, TYLENOL, PANADOL, CALPOL etc.

Apart from used alone, Paracetamol is also used in combination with many other medicines.

Why should I take this medicine?

   This tablet is generally taken as a fever reducer and for pain relief.

You are considered to be feverish if your temperature goes above 98.60F. This can occur in case of infections (viral or bacterial).

However an important point to be noted is that Paracetamol DOES NOT reduce normal temperature to below normal except in case of overdosing/poisoning. So if you were caught in the rain or suspect an impending flu, taking the tablet as a precautionary measure DOES NOT work. Take the tablet ONLY if you have raised temperature.

How much should I take?  

   Recommended adult dose (above 12 years) is  500mg to 1gm every 4 to 6 hours ( maximum of 4gm per day ie, maximum 4 doses per day)

As for kids and those with kidney or liver failure, the dose is adjustment as per age, laboratory tests and body weight. Hence a direct consultation with a doctor is necessary.

When should I take this medicine?

   The tablet can be taken before or after food. Most prefer to take it after food to reduce any mild discomfort that the drug may cause.

 When should I NOT take this medicine?

·       If you are pregnant or breast feeding. Though paracetamol is considered to be a safe medicine in pregnancy, always consult your gynecologist before taking any medication during pregnancy

·       If you are a chronic alcoholic or have liver diseases, the medicine can cause dangerous effects due to its accumulation in the body.

·       If you are already on other medications, consult your pharmacist or doctor before adding paracetamol too.

·       If you ever had an allergic reaction to the medicine

Can this medicine cause any side effects?

Paracetamol is one of the safer drugs with minimal side effects.

Rarely you can get an allergic reaction to this medicine with symptoms like skin rash, flaking skin, boils, sore lips and mouth, swelling of the face, fever.

However, if symptoms of sudden wheezing, fluttering or tightness of the chest or collapse. bruising more easily, sore throat or other signs of infection, severe pain in the abdomen and back, with fever are seen, consult a doctor ASAP.

What happens if I overdose on this medicine?

   If you take more than 4 gm of paracetamol within a 24 hour interval, it can cause harm to your liver and even death.

Symptoms of overdose may include:

·       Abdominal pain

·       Appetite loss

·       Coma

·       Convulsions

·       Diarrhea

·       Irritability

·       Jaundice

·       Nausea

·       Sweating

·       Upset stomach

·       Vomiting

Note: Symptoms may not occur until 12 or more hours after the acetaminophen was swallowed. So seek immediate help if you ingested more than 4 gm of this medicine in a day, EVEN if u feel well.

What can I do if I miss a dose?

   As paracetamol is a “take when needed medicine”, you can take it as soon as you remember or if it is time for your next dose, you can skip the missed one altogether.

How should I store this medicine?

·       Keep all medicines out of the reach and sight of children.

·       Store in a cool, dry place, away from direct heat and light.

·   Do not use after the expiry date (month, year) on the label and carton

Just a note

I’ll be talking about the content name of medicines i.e, if u see the medication strip or bottles, you’ll be able to find the name of the content that the particular tablet or syrups contain. These will be written usually under the brand name of the medicine along with how much of the main content is present in it.

Generic name : Name of the content of the medication available that provides the desired medical effect

Dose: Amount of this content present in the particular tablet, capsule etc

General information for taking medicines...

·        You have a major role in your own treatment.

·     Take tablets as advised. The timing and duration till which you’ve to take the medication are not guesses. These are well researched and proved before the information is given to you.

·  Some medicines are given for a particular duration of time. Do not take beyond or less than the duration prescribed

·        Medicines like antibiotics require full course treatment. Do not stop taking the tablets as soon as you start to feel better. The complete course of tablets is required to completely remove the bacteria from your body

·     The medicines are usually given with an interval like twice a day or thrice a day. The correct therapy is to divide 24 hours by the number of times you have to take the medication. For example: twice daily tablets should be taken once every twelve hours ( 24 divided by 2= 12) while thrice daily tablets are to be taken every 8 hours (24 divided by 3 = 8). This is to be strictly followed in case of antibiotics.

·         Tablets taken for long term diseases like hypertension are best taken at the same time every day.

·         Also, there are specific instructions for certain tablets like take them before food, with food, after food or with water etc. You can ask your physician or pharmacist if the tablets you are taking require any such requirements and take them accordingly.

·         Overdosing of medicines DOES NOT provide more relief. They are just toxins beyond the prescribed levels. You may seem okay while taking higher doses but they are doing more harm than you know now.

·     DO NOT give your medicines to someone with the same problem nor take someone else’s medicines. Medicine for each individual is determined not just based on your symptoms. It requires expert opinion which the clinicians obtain through years of nerve wrecking studies.

·        Children are NOT young adults. Do not give smaller doses of the medication that you take to treat them. Their organs are less developed than yours. They CANNOT handle all the medications you are taking.

·    Be very careful while taking OTC medications if you are a liver or kidney patient. Toxicity can occur because the medicines cannot be flushed out of the body easily.

·      Check the medicines each type you refill a prescription and while taking the medicine too.

·     Do not store medicines in direct sun light or too humid conditions. It can alter their efficacy. Also medicines like insulin are to be stored in refrigerator. Confirm if your pharmacist if there are any specific storage condition for your medicine.

·   Do not hesitate to talk to your doctor or pharmacist about any matter regarding the difficulties in taking a medicine. We have alternatives and are trained to sort out your problems.

·        Do not chew or crush tablets unless advised so. Many tablets are coated with layers of special ingredient that increases it efficacy. This could be lost if you break the tablets.

·      Do not keep the medicines and ointments where they could be mistaken for any other items (lotions, toothpaste etc) or where your children can reach them. It is always better to be safe than sorry.

·    If cost is a concern, talk to your doctor or pharmacist about it as they can provide you with cheaper medicines that work almost the same as the prescribed ones. But in no case should you discontinue a medication without physician consent.

·    Medicines like seizure tablets, some blood pressure tablets, anti-psychotic drugs etc should not be missed or suddenly stopped. As they cause side effects on sudden withdrawal.

·    Always try not to take other OTC medications while you are already on a prescription. The medicines could interact and though most interactions are moderate, you might get unlucky and get a serious one. These serious drug interactions can reduce the efficacy of either or both drugs or even cause toxic effects.

·    Do not try to refill prescriptions when they are not meant to be. Certain medications can cause dependence or serious side effects when taken for a long time.

·      Taking medicines alone does not cure you of diseases. Life style changes like exercise or food habit alterations can go a long way in effective management of diseases.

·       Avoid taking alcohol while on medications as alcohol can interact with many medicines and prove to be detrimental in effect.

·     Some foods may affect the action of the tablets you are taking. So if your doctor or pharmacist tells you to restrict or avoid any food, kindly do so.

·         Special care is to be taken if you are in the following categories:
 ü  Pregnant
 ü  Lactating mother
 ü  Kidney patient
 ü  Cardiac patient
 ü  Liver patient
 ü  On multiple medicines already
 ü  Children
 ü  Older citizen
These people should not take medicines without consulting a doctor as their body working is altered from normal.

·    Always tell your doctor if you have any discomfort or allergies while taking any medication. P.S: Even small rashes count.

·         Discard unused medicines safely and away from kids and pets.

INTRODUCTION

I am Ann Jacob, a Pharm.D student with a vision to improve healthcare as much as I can. This blog is written with an aim to provide medicine information in common language for the non-medical people without the medical jargon that they find difficult to deal with. I’d love to have your feedback and questions. However no answer is to be taken as final medical advice as variations between individual patients (especially in children and elderly) are seen and only a doctor who personally sees to you can decide on the appropriate treatment for you. Thank you.