The science of paracetamol

Posted by Dr. Dhaval on January 12th, 2021

Globally, paracetamol or acetaminophen is one of the most used analgesic and antipyretic over-the-counter drugs. Both its names are derived from its chemical name, which is N-acetyl-para-aminophenol. From the time of its first introduction in 1955 for use in children with fever and pain, paracetamol is currently formulated as a single compound or as an active ingredient of multi-component preparations in combination with other drugs such as caffeine and aspirin.

Indications for paracetamol

Paracetamol is indicated for fever and pain relief in both adults and children.As it has limited side effects compared to NSAIDs, paracetamol is the drug of choice in certain groups of patients such as those with bronchial asthma, gastric ulcers, impairments in blood coagulation e.g. hemophilia and hypersensitivity to aspirin.

Multi-active paracetamol is also available depending on the added active ingredients. These include paracetamol with antihistamine and decongestants for cold and flu;and with caffeine and aspirin for migraine and tension headaches

Recommended for mild-to-moderate pain

WHO guideline for pain management
Recommended in all three steps of pain management intensity1

Paracetamol is a recommended drug in all three steps of pain management by the World Health Organization. It is in fact, the recommended drug of choice in patients with long standing (chronic) mild-to-moderate pain e.g. in osteoarthritis.

Recommended as 1st line pain therapy

Icon for clinical recommendation

Paracetamol is the 1st line choice for treatment of mild-to-moderate pain as recommended by recognised, international expert associations6-13 for:

    knee osteoarthritis (conditionally recommended)
    acute and persistent pain in the elderly
    tension-type headache or part of combination therapy for acute migraine
    pain and fever associated with vector-borne disease for which NSAIDs are not recommended.