Paracetamol is a well-tolerated pain and fever remedy. However, acetaminophen is dosed too high, it can seriously damage the liver.

Paracetamol is one of the best-selling painkillers and antipathetic. Use acetaminophen found in mild to moderate pain such as simple headaches, migraines and mild toothache. Paracetamol is also a good fever reducers.

Mechanism of action

Still not entirely clear on the way in which paracetamol exerts its analgesic and antipathetic effect. Probably several mechanisms are involved. Firstly, the enzyme is inhibited oxygenation in the spinal cord. This enzyme ensures that prostaglandins are formed, which are necessary for the pain signals to the brain. Takes on the other paracetamol affect serotonin and glutamate cannabis receptors in the brain are important in pain processing.

Paracetamol does not act in inflammation

Because of its chemical properties accumulates paracetamol to the inflamed tissue. This explains why no acetaminophen anti-inflammatory effect (anti-inflammatory). When joints are inflamed, the doctor does so rather go back to ibuprofen.

Pharmaceutical form and dosage

Paracetamol is most often taken in the form of tablets and capsules. For children, the fever syrup and suppositories are available. The manufacturer says adults can take four to six hours, 500-1000 mg up to 4000 mg / day. Depending on the age and body weight in children, the dosage is correspondingly lower.


Beware of overdose

Caution is in overdose, as the therapeutic and toxic dose is not the paracetamol far apart. Even at 150 mg per kg body weight can lead to dangerous side effects liver damage. For example, a child weighing 10 kg, are enough then 3 tablets of 500mg to seriously harm a child’s liver. The lethal dose for an adult is 10 g (equivalent to 20 tablets of 500 mg paracetamol). The liver is already damaged, then even that smaller doses to liver failure with possibly fatal trigger. The kidney may be severely damaged. Since July 2008 pack sizes of 20 tablets (equivalent to 10g of the drug) prescription may reduce the risk of fatal overdose in adults with suicidal intent to minimize.

Care with liver and kidney disease

Patients with hepatic and renal disease should be especially careful with acetaminophen as the drug is metabolized in the liver and excreted by the kidneys.

No paracetamol in Gilbert’s disease

Patients suffering from benign liver metabolic disorder, such as Gilbert’s disease should not take acetaminophen. Every 20th German is affected by the liver metabolic disorder. The liver can not break down the bilirubin formed from the hemoglobin degradation. The blood count shows an elevated bilirubin level in otherwise normal liver function tests.

Side Effects

Unless there are contraindications and paracetamol is not overdosed, side effects are not very high. Rarely, nausea, rash, and hypo-tension may occur. In very rare cases it can also lead to a disturbance of blood formation with a reduction of platelets and white blood cells. With frequent intake (more than 10 tablets per month), for example, a headache is a risk that paracetamol itself can trigger headaches.Generally speaking pain medication should be taken in self-medication for more than 3 consecutive days and not more than 10 days per month. Pain conditions that last longer and keep returning should be investigated medically anyway.