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Paracetamol (Acetaminophen)

Analgesic / Antipyretic

Nigerian brand names:PanadolEmzor ParacetamolM&B ParacetamolHedexAlabukun (with caffeine)

Reviewed by the PMC Medical Team · Promise Medical Centre

Overview

Paracetamol (also known as acetaminophen) is one of the most widely used medications in the world and the most commonly taken drug in Nigeria. It relieves mild-to-moderate pain and reduces fever. Unlike NSAIDs (such as ibuprofen), paracetamol does not significantly reduce inflammation. It is generally well tolerated at recommended doses and is safe for most people including children and pregnant women. However, paracetamol is dangerous in overdose — even small amounts above the recommended dose can cause serious and potentially fatal liver damage.

Uses

Paracetamol is used for: • Mild-to-moderate pain relief: headache, toothache, muscle aches, back pain, period pain • Fever reduction in adults and children • Pain relief in osteoarthritis • Pain and fever during colds and flu • Post-vaccination fever in children • Relief of minor aches after surgery or injury It is often the preferred first-line pain reliever for people who cannot take NSAIDs (aspirin, ibuprofen) due to stomach problems, kidney disease, or blood-thinning medications.

How to Use

Adults and children over 12 years: • 500 mg to 1,000 mg (1–2 standard tablets) every 4–6 hours as needed • Maximum dose: 4,000 mg (4 grams / 8 standard 500 mg tablets) in 24 hours: do not exceed this under any circumstances • Allow at least 4 hours between doses Children (weight-based dosing — always check the label or ask a pharmacist): • Standard dose: 10–15 mg per kilogram of body weight every 4–6 hours • Do not give to babies under 2 months without medical advice Important: • Take with or without food • Use the lowest effective dose for the shortest possible time • Do not take paracetamol from multiple sources at the same time (many cold/flu remedies already contain paracetamol)

Side Effects

At recommended doses, paracetamol has very few side effects. Rare side effects include: • Skin rash or allergic reaction (stop immediately) • Nausea (uncommon at normal doses) • Blood disorders (very rare with long-term use) Signs of overdose (seek emergency care immediately): • Nausea, vomiting, and stomach pain • Sweating • Pale skin • Symptoms of liver failure (jaundice, severe abdominal pain) appearing 1–4 days after overdose Note: overdose may feel mild at first but liver damage progresses silently — treat all suspected overdose as an emergency.

Warnings & Precautions

IMPORTANT — Liver damage risk: • NEVER exceed 4,000 mg (4 grams) in 24 hours for adults; 2,000 mg for adults who drink alcohol regularly • Alcohol significantly increases the risk of liver damage from paracetamol: if you drink alcohol regularly, consult your doctor before using paracetamol regularly • Liver disease: use with caution and at lower doses; consult a doctor Other precautions: • Do not use with other paracetamol-containing products simultaneously (many combination cold remedies, Alabukun) • Kidney disease: paracetamol is generally preferred over NSAIDs but use at lowest effective dose • Pregnancy: paracetamol is the safest pain reliever in pregnancy; avoid ibuprofen especially in the third trimester • Do NOT use aspirin for fever in children under 12: paracetamol is the correct choice Counterfeit drug warning: buy only from licensed pharmacies and check for NAFDAC registration numbers on packaging.

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Drug Interactions

• Warfarin (blood thinners): regular high-dose paracetamol can slightly increase bleeding risk: monitor INR closely • Alcohol: increases liver toxicity risk significantly • Other paracetamol-containing medicines: taking both simultaneously causes overdose: check all combination products (cold remedies, Alabukun) before taking additional paracetamol • Enzyme-inducing drugs (carbamazepine, rifampicin, phenytoin, phenobarbital): increase the conversion of paracetamol to its toxic metabolite: use with caution • Isoniazid (TB treatment): may increase hepatotoxicity risk

Storage

• Store below 30°C in a cool, dry place away from sunlight and moisture • Keep away from children — paracetamol poisoning in children is a medical emergency • Do not store in the bathroom (humidity degrades tablets) • Keep in original packaging to preserve the NAFDAC number for verification

Buy only NAFDAC-registered medications

Nigeria has a significant problem with counterfeit and substandard drugs. Always purchase medications from a licensed pharmacy and check the NAFDAC registration number on the package — verify at nafdac.gov.ng.