Many parents know acetaminophen: in the form of suppositories or juice, it helps with fever and pain. But not only children benefit from this well-tolerated drug. At the end of the 19th century, English and German chemists in particular researched alternatives to natural painkillers used to date, such as willow bark. The 1886 newly developed substances acetanilide and phenacetin proved to be pain-relieving and even fever-reducing.

Effect of paracetamol

In addition to acetylsalicylic acid and ibuprofen, paracetamol is one of the most commonly used analgesics worldwide. Paracetamol is used for mild to moderately severe pain and is included in the group of so-called cyclooxygenase inhibitors (non-opioid analgesics). Since paracetamol simultaneously reduces fever (antipyretic) and is particularly well tolerated, it is mainly used in children.

However, unlike the other two active ingredients, acetaminophen does not work well with pain caused by inflammation, such as rheumatic diseases.

Function of the active substance

Paracetamol is also referred to chemically as N-acetyl-para-aminophenol (abbreviated to: APAP), 4'-hydroxyacetanilide or 4-acetamidophenol. Although paracetamol has been used for decades, the exact mechanism of action was - as with many other drugs - unknown for a long time.

Even today, not every detail is unraveled. Although it is now known that acetaminophen inhibits the cyclooxygenase Cox-2 - an endogenous substance that is activated in cell damage and stimulates the production of pro-inflammatory and pain-enhancing prostaglandins. But since the inhibitory effect of paracetamol is only comparatively weak, other mechanisms must be involved in its effectiveness. These are not yet decrypted.

Paracetamol is often used in combination products offered together with caffeine. This is intended to increase the analgesic effect of paracetamol.

5 Facts About Paracetamol - © istockphoto, Magone

Paracetamol: dosage

Paracetamol is available in various dosage forms. In children suppositories or juices or syrups are usually used, in adults more tablets and capsules. Also infusions are available.

Paracetamol can be taken once or in three to four single doses per day. Between taking the single doses should be at least six to eight hours.

Important in the dosage of paracetamol, the recommended Not to exceed the maximum quantity because overdosing can lead to life-threatening liver damage.

  • adults You must not take more than eight tablets of 500 milligrams each, for a total of four grams per day.
  • With children is the dose of paracetamol - depending on the age - including. It is recommended to use 10 to 15 milligrams of paracetamol per kilogram of body weight per single dose with a daily upper limit of 50 milligrams per kilogram of body weight.

Side effects of acetaminophen

In the range of the recommended dosage paracetamol is poor at possible side effects and well tolerated. Rare to very rare, the following side effects occur:

  • Disorders of blood formation
  • allergic reaction
  • stomach pain
  • nausea
  • an increase in liver enzymes
  • a cramping of the airways with shortness of breath

Overdose: danger to the liver

A Overdose however, acetaminophen can cause serious side effects. In particular, the liver can be severely damaged if one adult takes more than ten to twelve grams or over a longer period daily more than 7.5 grams (in children correspondingly smaller amounts).

For this reason, paracetamol in Germany since July 2008 in larger packages (from ten grams of the drug) prescription, smaller quantities can still be purchased over the counter in the pharmacy.

Also critical for the liver is the concomitant use of potentially liver-damaging substances (such as anticonvulsant drugs) or alcohol abuse.

Interactions of paracetamol

Paracetamol may interfere with the elimination of other liver metabolised drugs such as the antibiotic chloramphenicol. It should also be noted that the onset of action by drugs that affect gastric emptying can be accelerated or slowed down.

In the case of blood tests, the doctor should be informed about the use of acetaminophen, as this may affect certain laboratory values ​​(eg blood sugar, uric acid).

In the pregnancy and breast feeding period Paracetamol may be taken at short notice and only after consultation with the doctor.

Research on paracetamol

Paracetamol was synthesized for the first time in 1893, but it was not until 1948 that Brodie and Axelrod discovered that this white, odorless powder with a bitter taste is a breakdown product of the two aforementioned substances acetanilide and phenacetin and responsible for their action. In 1956, acetaminophen was introduced as a painkiller in the market.




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