BECAUSE of its broad tolerability, paracetamol (acetaminophen) is a first-line choice for fever reduction and pain management.  

Available over the counter (OTC), the drug can be safely taken by adults, children, and pregnant women. It is also recommended as part of the home care treatment for mild to moderate coronavirus disease 2019 (COVID-19).  

As with any medicine, OTC or otherwise, caveats exist.  

“It is contraindicated for those with a paracetamol allergy,” said Dr. Beaver R. Tamesis, president of the Pharmaceutical and Healthcare Association of the Philippines (PHAP), in an e-mail. “It is also advised to consult a doctor or pharmacist if a patient has liver or kidney problems, or is taking warfarin or coumarin [blood thinners] or medicines for epilepsy or tuberculosis.”  

Serious harm can occur if more than the maximum amount (1,000 grams per dose, or 4,000 mg per day, for adults) is ingested, and if the minimum time interval of four hours between doses is not observed. For pediatric patients, the use of paracetamol depends on factors such as age and weight.   

Overdosing on paracetamol can result in nausea, vomiting, yellowing of the skin, or loss of consciousness.  

“Paracetamol overdose causes liver toxicities that may lead to liver failure and acute pancreatitis,” added Dr. Tamesis.   

This possible harm is also the reason why it is not advisable to take drugs that both count paracetamol as a key component at the same time (e.g., Bioflu and Neozep, or Tempra and Alaxan).  

“We ask patients to be vigilant and look at the generic names of the products they are taking to know if they are taking the same medicine ingredient,” Dr. Tamesis told BusinessWorld, noting the helpfulness of reading the leaflet found on each medicine box.  

Paracetamol first appeared commercially in 1950 in the US. Its painkilling properties were discovered by accident when a similar molecule was added to a patient’s prescription about a century ago, The Imperial College of London said. Since the molecule was deemed toxic in moderate doses, chemists modified its structure and found a compound, N-acetyl-para-aminophenol, that was less harmful but still had pain reliever properties.   

In the Philippines, the Food and Drug Administration has a record of 989 paracetamol products in its portal. – Patricia B. Mirasol