Paracetamol

Paracetamol

Analgesics Over the counter ATC code: N02BE01

What it is

Paracetamol is a non-opioid painkiller and fever reducer. It acts mainly within the central nervous system, raising the threshold at which pain is felt and resetting the body's temperature set point; unlike anti-inflammatory painkillers it does little for inflammation in the tissues themselves. It is used for everyday pain and for fever.

Typical dose
500–1000 mg
4× a day

Used for

  • Pain
  • Fever

What to know while taking it

Food makes no real difference to it, so it can be taken with a meal or without one. The whole caution around paracetamol is the liver: it is broken down there, the daily maximum exists because the margin between a useful amount and a harmful one is narrower than with most household medicines, and regular heavy drinking narrows that margin further, which makes keeping within the maximum matter all the more. Many combination cold and flu remedies already contain paracetamol, and that is the usual way the maximum gets exceeded without anyone noticing. ALT, AST and total bilirubin are the lab values that move if the liver is under strain, and with warfarin regular use can strengthen the blood-thinning effect, so anticoagulation is watched more closely.

When to see a doctor

Nausea, vomiting, pain under the right ribs, unusual tiredness, dark urine, or yellowing of the skin or eyes after taking it means see a doctor promptly. The same applies to any suspicion that the daily maximum was passed, even while feeling well, because liver injury can stay silent at first.

Worth knowing

  • Do not combine with alcohol
  • Watch liver enzymes
  • Do not exceed the daily maximum

Interacts with

Markers to watch

Reference information, not medical advice. Discuss any change with your doctor.