Paracetamol also called as acetaminophen, is most commonly used over-the-counter pain reliever and fever reducer. It is widely used for the reducing headaches, body ache and other minor pains such as toothache, joint ache etc. Paracetamol granules are the key ingredient in several cold and flu remedies. In amalgamation with opioid (the drugs that act on the nervous system to relieve pain) analgesics, this drug can also be used in the treatment of more severe pain like post-surgical pain and offering soothing relief in advanced cancer patients. After the oral administration of paracetamol, the onset of analgesia is about 11 minutes. It is generally safe at recommended doses- for adults 1,000 mg per single dose and up to 4,000 mg per 24 hours and up to 2,000 mg per day if consuming alcohol. The high overdose of this drug can cause fatal liver damage and sometimes in rare persons, a normal dose can do the harm; the risk is increased by alcohol consumption.
In the Western world, Paracetamol toxicity is the key reason for acute liver failure, and also accounts for maximum drug overdoses in the United Kingdom, the United States, New Zealand and Australia.The paracetamol drug is placed on the WHO analgesic ranking, what exactly defines the rules for use of analgesic drugs. This painkiller has been placed on all the three steps of analgesic intensity. In diverse pains of medium intensity, paracetamol tablet as a weak analgesic together with nonsteroidal painkiller drugs or analgesics such as caffeine is a basic non-opioid painkiller. When pain increases or maintains, paracetamol granules are used as an additional painkiller with strong and weak or opioids from the 2nd and 3rd step of the analgesic ladder, respectively. Paracetamol, if effective, is a suggested oral analgesic of a prime choice to be taken for a longer time. For example, in case of slight and moderate pain during osteoarthritis as well as in ligament or muscle pains. Furthermore, it is a medicine of choice for patients in those use of non-steroidal anti-inflammatory medicines are contraindicated, e.g., in the case of hypersensitivity to aspirin, gastric ulcers, impairments in blood coagulation, in pregnant women, kids with fever associated a disease and nursing mothers. In children, the use of paracetamol needs special care. It is also important to maintain an adequate dosage depending on their age and weight, which significantly different than adults. The suggested dosage for children considers the metabolism of paracetamol drug, that determines the harmfulness of the drug, especially hepatotoxicity. With age paracetamol metabolism differs; in small children the sulfation path is the subjugated route of paracetamol eradication that is developed at birth and the glucuronidation path that takes around 2 years to develop. The paracetamol oxidation that happens primarily with the contribution of the enzyme CYP2E1 in neonates is less; this is because the reaction of CYP2E1 rises with age, approaching the adult value at the age (1-10) years.