Paracetamol (Acetaminophen) 120mg/5ml is a widely used, non-prescription oral suspension analgesic and antipyretic. It is a first-line agent for the management of mild to moderate pain and fever across all age groups, particularly favored in pediatric populations due to its palatable liquid formulation, precise dosing, and established safety profile when used as directed. It acts centrally by inhibiting prostaglandin synthesis in the hypothalamus and peripherally through weak inhibition of cyclooxygenase enzymes.
Adult: Not the primary strength for adults. For reference, adult dose is 325-650 mg every 4-6 hours or 500-1000 mg every 6-8 hours. Max 4g/day.
Note: Shake the bottle well before use. Use only the calibrated measuring cup, dropper, or oral syringe provided. Do not use a household teaspoon. Can be taken with or without food. If stomach upset occurs, take with food. Do not mix with other liquids unless advised. Rinse measuring device after use.
The exact mechanism is complex and not fully elucidated. Paracetamol's analgesic and antipyretic effects are primarily mediated centrally in the brain and spinal cord. It is a weak inhibitor of prostaglandin (PG) synthesis in peripheral tissues but a potent inhibitor in the central nervous system. It is believed to act on the cyclooxygenase (COX) pathway, with a preferential inhibition of the COX-2 isoform, especially in an environment of low peroxide tone (like the brain). It also modulates the endogenous cannabinoid and serotonergic systems, contributing to its pain-relieving effects.
Pregnancy: Pregnancy Category A (Australian categorization) / Category B (US FDA). Considered safe for short-term use at recommended doses during all trimesters. Does not appear to increase risk of major congenital malformations. Chronic use or high doses in third trimester should be avoided due to theoretical risk of premature ductus arteriosus closure.
Driving: No known effects on driving ability. However, if drowsiness or dizziness occurs (rare), driving should be avoided.
| Warfarin and other Coumarin Anticoagulants | Chronic high-dose paracetamol (>2g/day for several days) may potentiate anticoagulant effect, increasing INR and risk of bleeding. | Major |
| Isoniazid | Increases the formation of toxic metabolite NAPQI via CYP2E1 induction, raising risk of hepatotoxicity, especially in fast acetylators. | Major |
| Enzyme Inducers (Phenobarbital, Phenytoin, Carbamazepine, Rifampicin) | Increase metabolism via CYP450 pathway, increasing NAPQI formation and risk of hepatotoxicity, particularly with overdose. | Major |
| Probenecid | Inhibits glucuronidation, may slightly increase and prolong paracetamol levels. | Moderate |
| Metoclopramide, Domperidone | May increase absorption rate of paracetamol. | Minor |
| Cholestyramine | Reduces absorption of paracetamol if taken within 1 hour. Administer at least 1 hour apart. | Moderate |
| Other Hepatotoxic Drugs (e.g., high-dose NSAIDs, Antitubercular drugs, Azole antifungals, Statins) | Additive risk of liver damage. | Major |
| Alcohol (Chronic, heavy use) | Induces CYP2E1, depletes glutathione, significantly increases risk of severe hepatotoxicity even at therapeutic doses. | Major |
| Fluvoxamine | Inhibits metabolism, may increase paracetamol levels. | Moderate |