Medicines, as we should know!!

Back in 1928, a chance event led to the discovery of “Penicillin” which changed the course of medicine and human health.

After this accidental discovery, within such a short span of human history, we have come to a stage where to date more than 15000 drugs are discovered, of which nearly 4000 are approved for human use.

The discovery of Penicillin led to the start of the modern medicine era, which has played a pivotal role in improving our quality of life and eventually extending our lifespan.

Today these medicines have become integral to our daily routine, and often we casually consume them without paying much attention to their label claims. In a country like India the problem gets even worse, wherein factors like ignorance, self-medication, and over-prescription add fuel to this burning issue.

Moreover, the highly technical language used in these labels/ prescribing information leaflets renders a touch of alienness to medicines making them least understood among the masses.

This space is my effort to introduce you to this world of medicines in a language that most of us understand and help you make better decisions with your medicines and eventually with your health.

To begin, let me start with Paracetamol; your go-to fever & pain reliever & the most commonly used medicine in this country. You would probably know paracetamol by these names; Dolo, Crocin, Calpol, Sumo L, T-98, Pyrigesic, and many more (there are more than 150 brands of paracetamol available in India)

What is paracetamol?

Paracetamol is a commonly used medication to reduce pain and fever when you catch a cold or flu.

It is mostly available in various Over-the-Counter formulations (OTC medications that can be taken without a doctor’s prescription), combined with allergy medications, cold medications, sleep medications, pain relievers, and other products. It is also known as acetaminophen, so some medicine labels will use this name.

The drug was approved by USFDA (considered stringent & highest authority for drug approval) in 1951, thus its has a long history of usage in humans. It is available in a variety of forms like tablets, dispersible tablets, syrups, injections, suppositories and more.

Can Paracetamol / Acetaminophen relieve all types of pain?

It’s typically used to relieve almost all types of mild to moderate pain from headaches, muscle aches, backaches, toothaches, menstrual period, sore throat etc. It may also be used to relieve pain in osteoarthritis (commonly called arthritis).

Paracetamol may not be useful in relieving peripheral neuropathic pain, as this pain is due to nerve damage in the peripheral regions of your body like arms / legs (one such example is diabetic patients feel numbness, tingling sensation, pain in their arms or legs)

What is the dose of paracetamol?

Paracetamol is available in various formulations & concentrations (strengths) thus reading the manufacturer’s leaflet is advisable. Also, if your doctor prescribes, please follow his advice as the dose of paracetamol depends on your age, body weight and severity of pain & fever.

If you are giving paracetamol to your child then first read the label carefully, brands generally give recommended doses depending on the concentration of the formulation. Like, for one of the popular brands Calpol (company: GSK) children's oral drops formulation available in a concentration (commonly also known as strength) of 100 mg/ml these instructions are given on their label;

3 - 3.9 kg weight take 0.4 ml

4 - 4.9 kg weight take 0.6 ml

5 - 5.9 kg weight take 0.7 ml

6 - 6.9 kg weight take 0.9 ml

7 - 7.9 kg weight take 1.0 ml

8 - 8.9 kg weight take 1.2 ml

9 - 10 kg weight take 1.3 ml

Taken from Calpol paediatric drops label on 19/04/2023 with each 1 ml = 20 drops

Remember, in children aged 1 month to 5 years for relieving fever the recommended dose is 10-15 mg/ kg of body weight at one time and should be given a maximum of 4 times a day.

For example, if the child's weight is 5 kg then one recommended dose can be between 10*5 = 50mg to 15*5= 75mg which can be given a maximum of 4 times in a day i.e. 300 mg

Remember it as the rule of 4 : one recommended dose maximum 4 times in a day with a minimum gap of 4 hours!!

"Word of caution: in children aged between 1 -3 months, if you are using paracetamol to relieve fever after vaccination then give maximum 2 recommended doses"

For children in the age group of 6-8 years the one recommended dose is 250 mg (typically 1/2 tablet of paracetamol 500mg tablet) & between 9-11 years this is 1 tablet of 500 mg. Note, in both these age groups the maximum daily dose of paracetamol should be 60mg/kg body weight.

Looks like you need a calculator for all this, don't worry generally paracetamol syrup labels give one time recommended dose in ml or drops, after you know that just follow the rule of 4.

In adults (>=12 years in this case) the dose would be 500 to 1000 mg at one time for every 4-6 hours with maximum dose of 4000 mg / day.

If you are taking medicine without doctor's advice, do not take for more than 3 days. Yes, you can take paracetamol before or after food!!!

What if you forget to take paracetamol or missed one dose?

If you take paracetamol regularly and miss a dose, take it as soon as you remember, unless it’s within 4 hours of your next dose. In this case, skip the missed dose and take your next dose at the usual time.

Do not take an extra dose to make up for a missed one.

Is it safe to take paracetamol regularly to relieve pain & fever?

If you’re taking paracetamol for a short-lived pain like a headache, you may only need to take it for a day or two.

You may need to take paracetamol for longer if you have a long-term health problem that causes pain.

It’s safe to take paracetamol regularly for many years, as long as you do not take more than the recommended dose & under the supervision of your physician.

What are the common side effects of Paracetamol?

Paracetamol rarely causes side effects when it is taken as recommended but if you take more than the recommended dosage it can cause liver damage. There is a nice video from the US FDA showing common mistake that leads to overdosage of paracetamol (or acetaminophen as commonly known in the US): https://www.youtube.com/watch?v=cBDOx85Ywc

Paracetamol may lead to serious skin reactions (swelling of face, mouth and throat, difficulty in breathing, itching or rash) thus as soon as you get these, stop consuming paracetamol and consult your doctor.

That’s it from my side, if you have any queries on paracetamol or want to know your medicine do leave your message in the box below