Paracetamol (Acetaminophen)

Paracetamol is a widely used pain reliever and fever reducer suitable for many adults and children when used according to the label.

Primary uses

• Temporary relief of mild to moderate pain (headache, toothache, muscle ache, menstrual cramps)
• Comfort during fever from common viral illnesses

Other uses

• Support after routine vaccinations for fever comfort

Believed to reduce pain and fever signals in the brain and reduce prostaglandin production centrally. Unlike NSAIDs it has minimal anti-inflammatory effect.

• Tablet — 500 mg, 650 mg (Oral)
• Oral suspension — 120 mg / 5 mL, 250 mg / 5 mL (Oral) · Common paediatric strengths
• Suppository — 125 mg, 250 mg (Rectal)
• Effervescent — 500 mg (Oral)

Do not use if

• Known allergy to paracetamol
• Severe active liver disease (discuss with a clinician first)

Pregnancy

Generally considered safe. Often preferred for short-term pain or fever comfort during pregnancy at the lowest effective amount. Discuss with a clinician for regular use.

Breastfeeding

Generally considered safe. Excreted in breast milk in very small amounts; considered compatible with breastfeeding.

Kidney considerations

• Usually safe in kidney disease at standard amounts — no dose adjustment for occasional use.
• Very high or prolonged use can affect kidneys; discuss with a clinician for chronic pain.

Liver considerations

• Overdose can cause severe liver injury.
• Discuss with a clinician if you have liver disease, hepatitis, drink alcohol regularly, or are undernourished.
• Never combine multiple products that contain paracetamol.

Paediatric use

Suitable from infancy in the correct paediatric strength. Follow weight-based instructions and use a proper measuring device.

Older adults

Well tolerated at standard amounts. Watch out for hidden paracetamol in combination cold products.

• Usually well tolerated when used as directed
• Rare mild allergic skin reactions

• Severe skin reactions (very rare) — stop and seek help for widespread rash, blistering, or peeling
• Liver injury from overdose — seek urgent help for suspected overdose even without symptoms
• Serious allergic reaction — swelling of the face or trouble breathing

Alcohol

• Avoid regular alcohol while taking paracetamol — combined use increases liver injury risk.

Storage

Store below 25 °C in a dry place, away from direct sunlight and out of reach of children.

If a dose is missed

Paracetamol is taken as needed for symptoms. If used on a schedule, take the missed amount when remembered unless the next scheduled time is close.

Overdose

Overdose can cause serious liver injury and may show few early symptoms. Seek emergency care immediately if an overdose is suspected — antidote treatment is time-sensitive.

What to monitor

• Track how many paracetamol-containing products you are taking in a day.
• Review with a clinician if you need it more than a few days in a row.

• WHO Essential Medicines List — World Health Organization
• British National Formulary — Paracetamol — BNF (NICE)
• FDA drug information — Acetaminophen — U.S. Food & Drug Administration

Content last reviewed: 2025-01-01