Home Medicines Paracetamol: effect, areas of application, side effects

Paracetamol: effect, areas of application, side effects

by Josephine Andrews
Published: Last Updated on 430 views

Paracetamol is one of the most important active ingredients against pain and fever and is contained in numerous medicines. The non-opioid pain reliever is well tolerated when used correctly. Pregnancy and lactation are also no exclusion criteria for the application. With the appropriate dosage, paracetamol can in principle be given at any age. Here you can read everything important about the effect, side effects and application!

This is how paracetamol works

The exact mechanism of action of the painkiller and fever reliever is not known to this day. However, scientific studies have shown several potentially increasing effects on the body, which explain the analgesic and antipyretic effects.

Unlike the active ingredients acetylsalicylic acid and ibuprofen , which are also used as painkillers and fever relievers, paracetamol is not one of the so-called “acid non-opioid analgesics”. These accumulate preferentially in the acutely inflamed tissue, in the mucous membrane of the gastrointestinal tract and in the renal cortex and have good anti-inflammatory properties. Paracetamol, on the other hand, is a so-called “non-acidic, non-opioid analgesic”.

As such, it is not found in the body regions mentioned above, but rather in relatively high concentrations in the central nervous system (spinal cord and brain ). There, the active ingredient inhibits a specific sub-form of an enzyme (COX-3), which is responsible for the production of prostaglandins. These are tissue hormones that play a role in inflammatory processes, fever and pain mediation. Non-acidic, non-opioid analgesics such as acetaminophen have poor anti-inflammatory effects but good antipyretic effects.

Paracetamol also affects the endocannabinoid system, which mediates calming and analgesic effects, and the serotonin system. Serotonin is a messenger substance of the nervous system (neurotransmitter), which fulfills a variety of functions. Among other things, serotonin affects the cardiovascular system, blood clotting and the gastrointestinal tract and plays an important role in the brain as a “happy hormone”.

Researchers are still discussing the exact mechanism of action of the pain and fever reliever paracetamol.

The maximum concentration in the blood is reached after 30 to 60 minutes when the active ingredient is taken orally, and after two to three hours when used rectally (suppositories). The time until half of the active substance is metabolized and excreted by the liver is one to four hours (half-life). The inactivated drug is excreted via the kidneys.

When is paracetamol used?

Paracetamol is used for pain and fever, sometimes in combination with other painkillers such as acetylsalicylic acid (ASA), codeine or tramadol .

Normally it is only used for a short time. In certain cases, however, the doctor can also prescribe long-term use.

This is how paracetamol is used

When taken occasionally for mild to moderate pain, the active ingredient is mainly used in tablet form.

Paracetamol suppositories are particularly suitable for use in children, small children and infants. These can usually be used without any problems. Children, on the other hand, often spit out pills. In addition, small children and infants are usually not yet able to take a tablet with a sip of water – they often choke on it. If suppositories are not tolerated, there is also a paracetamol juice.

There are special low-dose paracetamol preparations for the respective age groups. Paracetamol is used for colds and flu , especially because of its antipyretic effect .

Doctors can also administer the active substance to their patients via a vein (paracetamol infusion solution). This is necessary, for example, in the case of severe infections with a high fever.

Combination preparations such as paracetamol plus ASA, paracetamol plus codeine or the triple combination of paracetamol, ASA and caffeine (for the treatment of tension headaches and mild migraines ) show a better pain-relieving effect than the individual active ingredients.

What are the side effects of paracetamol?

Paracetamol side effects are relatively rare and mostly due to existing underlying diseases.

Paradoxically, when taken in low doses over a long period of time, paracetamol can cause headaches (“analgesic headaches”). It must then be discontinued.

Liver damage is to be expected with high-dose, long-term use and with a single paracetamol overdose. The liver can then no longer fulfill its task as a detoxification organ – one also speaks of paracetamol poisoning, which shows the typical signs of liver failure.

The maximum daily dose for adults without risk factors is three to four grams of paracetamol, depending on weight. Doctors reduce the dose, especially in the case of liver disease. Fatal courses have occurred from as little as seven grams.

Doctors treat paracetamol poisoning with the active ingredient N-acetylcysteine ​​(antidote to paracetamol).

What should be considered when taking paracetamol?

The analgesic and antipyretic must not be used in the case of severe liver and kidney damage, a certain enzyme deficiency (glucose-6-phosphate dehydrogenase deficiency) and excessive alcohol consumption ( alcoholism ). The same applies to known hypersensitivity (allergy) to the active substance.

In pregnancy and lactation as well as in young patients (children), it is the drug of first choice for the treatment of pain and fever without signs of inflammation for short-term, low-dose use. A doctor or pharmacist should be asked for advice on use and dosage.

paracetamol and alcohol

Since the paracetamol active ingredient is metabolized by the liver in the same way as alcohol, alcoholics and people with high alcohol consumption experience a double burden on the detoxification organ. This cannot always be compensated for and the painkiller triggers liver failure . In general, alcohol should be avoided while using paracetamol.

How to get medicines with paracetamol

Up to a total of ten grams per medication pack (tablets), the painkiller is available in Germany, Austria and Switzerland without a prescription from pharmacies. Paracetamol suppositories are not affected by this regulation due to the slower absorption of the active ingredient.

Higher dose tablets and infusion solutions require a prescription.

Since when is paracetamol known?

Substances related to paracetamol have been studied since 1886 for their analgesic and antipyretic effects (acetanilide). On the basis of this, the US chemist Harmon Northrop Morse at Johns Hopkins University produced the substance paracetamol for the first time in 1877. The optimization of the active ingredient from acetanilide via phenacetin to paracetamol was achieved through targeted further development of the molecular structure.

Paracetamol and phenacetin were first clinically tested in 1887 by the German physician Joseph von Mering. However, phenacetin was first found to be better, which is why paracetamol was initially forgotten. In 1947, David Lester and Leon Greenberg were able to show that phenacetin is metabolized to paracetamol and is just as effective as this.

Paracetamol was first launched in the USA in 1953 as a direct competitor to acetylsalicylic acid, which at the time was one of the few active ingredients for mild to moderate pain. Phenacetin, on the other hand, is no longer used today due to poor tolerability.

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