Paracetamol is an antipyretic pain reliever

Quite often, during infectious diseases, a person’s body temperature rises. At the same time, in addition to the main drugs, antipyretics are often used in treatment. One of the effective medications that help with hyperthermia is Paracetamol. In addition, this drug is used to relieve various types of pain.

Paracetamol Welfarm

Indications for use

Paracetamol is a drug with antipyretic and analgesic effects. It is prescribed to adults and children for colds and viral diseases, as well as for various types of pain. The main active ingredient of this drug helps block cyclooxygenase in the central nervous system, effectively affects pain receptors and thermoregulation. The medication does not have anti-inflammatory properties and does not have a harmful effect on the mucous membrane of the stomach and intestines, which is why it is successfully used in patients with gastrointestinal diseases. But the drug can have a negative effect on the liver and kidneys, so if the patient has chronic diseases of these organs, then he should use paracetamol with caution.

Instructions for use

Paracetamol is prescribed in the following cases:

1. As an antipyretic for infectious and inflammatory diseases that are accompanied by an increase in temperature. In this case, the drug affects the thermoregulation center in the cerebral cortex, resulting in a decrease in body temperature.
2. As an analgesic for various types of pain of mild and moderate severity: headaches, non-inflammatory toothaches, colds, early stages of migraines, acute respiratory infections, muscle pain.
3. Painful menstruation in women (algomenorrhea).
4. Pain from burns and injuries.

How to take Paracetamol?

The dosage of the drug and the course of treatment are determined by the doctor. It all depends on the individual characteristics of the patient, the presence of chronic diseases, the intensity of the pain syndrome, and contraindications. The drug is prescribed orally with a small amount of water, 1 tablet. 2 times a day. To reduce the temperature, it can be used for no more than 3 days. For pain relief, the drug is used for no more than 5 days.

Indications and contraindications

Paracetamol suspension for children, the instructions confirm this, is prescribed to lower temperatures and relieve mild pain in various infectious and inflammatory diseases. In addition, the children's drug in the form of a suspension is suitable as an anesthetic for toothache, in particular it is used during teething. It is also indicated for relieving headaches. When used, the child’s condition is normalized when ear pain occurs due to otitis media. The medicine alleviates the condition of children with sore throat.

Intended as an antipyretic and analgesic for use from 3 months. It is allowed to continue using it for its intended purpose for up to 12 years. At the age of up to 3 months, a single dose is allowed when post-vaccination hyperthermia appears. If the temperature cannot be brought down, repeated use is prohibited and a pediatrician’s consultation is required.

An absolute contraindication is individual intolerance to the active substance. The drug for children is not prescribed until the baby is one month old. It is necessary to refuse the drug for various blood diseases. The suspension should not be taken in combination with other drugs that contain paracetamol.

Paracetamol for children

It is used to reduce temperature, relieve pain of various localizations; in children, in addition to these indications, the drug is used to reduce the body’s reaction after vaccination.

Children's Paracetamol is available in the form of syrup. Oral dosage for children:

• 6-12 years - 250-500 mg,
• 1-5 years - 120-250 mg,
• from 3 months to 1 year - 60-120 mg,
• up to 3 months - 10 mg/kg.

The interval between doses of the drug is 4 hours, but no more than 3-4 times a day. It is allowed to combine Paracetamol with other antipyretics.

Paracetamol for a child from 3 months

Paracetamol for children 120mg/5ml 100ml suspension for oral administration

pharmachologic effect

Analgesic non-narcotic drug.

Composition and release form Paracetamol for children 120 mg/5 ml 100 ml suspension for oral administration

Suspension - 100 ml:

• Active ingredient: paracetamol – 2,400 g;
• Excipients: malic acid – 0.050 g, xanthan gum – 0.600 g, maltitol – 80,000 g, non-crystallizing sorbitol 70% – 1.330 g, anhydrous citric acid – 0.020 g, sodium nipasept (sodium methyl parahydroxybenzoate, sodium ethyl parahydroxybenzoate, sodium propyl parahydroxybenzoate) – 0.150 g , strawberry flavoring – 0.100 g, azorubine dye – 0.001 g, water – up to 100 ml.

Suspension for oral administration, 120 mg/5 ml.

100 ml of suspension in a bottle made of glass melt, orange glass or a polymer bottle or a bottle of polyethylene terephthalate for medicines, sealed with a polymer screw cap with first opening control or a cap with a “push-turn” system.

A label based on self-adhesive film or a label made from label paper is glued onto the bottle.

One bottle, together with instructions for use, as well as a measuring cup or measuring spoon, or without a measuring cup and measuring spoon, is placed in a cardboard package (pack).

Description of the dosage form

A homogeneous suspension of pink color with a characteristic odor.

Directions for use and doses

The drug is taken orally. It is recommended to use with plenty of liquid 1-2 hours after meals. The contents of the bottle should be shaken well before use. A measuring cup or spoon placed inside the package allows you to dose the drug correctly and rationally. The dose of the drug depends on the age and body weight of the child. For children over 3 months of age, the drug is prescribed at 10-15 mg/kg body weight 3-4 times a day, the maximum daily dose is no more than 60 mg/kg body weight. If necessary, you can take the drug every 4-6 hours in a single dose (15 mg/kg), but no more than 4 times within 24 hours.

Do not exceed the recommended dose.

Duration of use without consulting a doctor: to reduce temperature and to reduce pain - no more than 3 days. In the future, as well as in the absence of a therapeutic effect, you should consult a doctor.

For children aged 2 to 3 months, a single dose is 10-15 mg/kg. Apply 1-2 times a day, with an interval of at least 4 hours. If fever persists after taking the second dose of the drug, you should consult a doctor. Taking paracetamol in children aged 2-3 months for other indications is only as prescribed by a doctor.

If renal function is impaired, the time interval between doses of the drug should be at least 8 hours with a creatinine clearance of less than 10 ml/min, and at least 6 hours with a creatinine clearance of 10-50 ml/min.

Pharmacodynamics

The drug has analgesic and antipyretic properties. Blocks cyclooxygenase in the central nervous system, affecting the centers of pain and thermoregulation. The anti-inflammatory effect is practically absent. It does not affect the condition of the gastrointestinal mucosa and water-electrolyte metabolism, since it has an extremely small effect on the synthesis of prostaglandins in peripheral tissues.

Pharmacokinetics

Absorption is high, the drug is quickly and almost completely absorbed from the gastrointestinal tract.

Communication with plasma proteins is about 10 - 25%. Peak plasma concentration is reached after 0.5 - 2 hours. The maximum plasma concentration is 5 - 20 mcg/ml.

Penetrates the blood-brain barrier. Less than 1% of the dose of paracetamol taken by the mother passes into breast milk. The distribution of the drug in body fluids is relatively even. Metabolized primarily in the liver along three main routes: conjugation with glucuronides, conjugation with sulfates, oxidation by microsomal liver enzymes. In the latter case, toxic intermediate metabolites are formed, which are subsequently conjugated with glutathione, and then with cysteine ​​and mercapturic acid. The main isoenzymes of cytochrome P450 for this metabolic pathway are isoenzymes CYP2E1 (mainly), CYP1A2, CYP3A4 (minor role). With glutathione deficiency, these metabolites can cause damage and necrosis of hepatocytes. Additional metabolic pathways include hydroxylation to 3-hydroxyparacetamol and methoxylation to 3-methoxyparacetamol, which are subsequently conjugated to glucuronides or sulfates. In newborns and children 3-10 years of age, the main metabolite of paracetamol is paracetamol sulfate; in children 12 years of age and older, it is conjugated glucuronide. Conjugated metabolites of paracetamol (glucuronides, sulfates and conjugates with glutathione) have low pharmacological (including toxic) activity.

The half-life when taking a therapeutic dose ranges from 1 to 4 hours, in adults 2.7 hours, in children 15 to 2 hours, total clearance 18 l/hour. When taking therapeutic doses, 90 - 100% of the dose taken is excreted in the urine within 24 hours. The main amount of the drug is released after conjugation in the liver, in the form of glucuronide (60 - 80%) and sulfate (20 - 30%). No more than 5% of the received dose of the drug is released unchanged. In elderly patients, the clearance of paracetamol decreases and the half-life (T1/2) increases. In severe renal failure (creatinine clearance below 10 - 30 ml/min), the excretion of paracetamol slows down somewhat. The rate of excretion of glucuronide and sulfate in patients with severe renal failure is less than in healthy individuals.

Indications for use Paracetamol for children 120 mg/5 ml 100 ml suspension for oral administration

Used in children from 3 months to 12 years as:

• antipyretic - to reduce elevated body temperature against the background of colds, flu and childhood infectious diseases (chicken pox, mumps, measles, scarlet fever, etc.);
• anesthetic - for toothache, including teething or tooth extraction, headaches, ear pain with otitis media and sore throat.

For children aged 2 - 3 months, a single dose is possible to reduce fever after vaccination. If the temperature does not decrease, consult a doctor.

Contraindications

• hypersensitivity to paracetamol or any other ingredient of the drug;
• severe liver or kidney dysfunction;
• age less than 2 months;
• fructose intolerance.

Carefully

Use with caution in case of impaired liver function (including Gilbert's syndrome), viral hepatitis, impaired renal function (creatinine clearance less than 30 ml/min), genetic absence of the enzyme glucose-6-phosphate dehydrogenase, severe blood diseases (severe anemia, leukopenia, thrombocytopenia), hypovolemia, dehydration, anorexia, bulimia, chronic alcoholism, diabetes. In such cases, you should consult your doctor before taking the drug. The drug should not be taken simultaneously with other drugs containing paracetamol.

Application of Paracetamol for children 120 mg/5 ml 100 ml suspension for oral administration during pregnancy and lactation

Paracetamol penetrates the placental barrier. To date, there have been no negative effects of paracetamol on the fetus in humans.

Paracetamol is excreted in breast milk: the content in milk is 0.04-0.23% of the dose taken by the mother.

If it is necessary to use paracetamol during pregnancy and lactation (breastfeeding), you should carefully weigh the expected benefits of therapy for the mother and the potential risk to the fetus or child.

Experimental studies have not established the embryotoxic, teratogenic and mutagenic effects of paracetamol.

Use in children

Application is possible according to the dosage regimen.

special instructions

The drug contains paracetamol, therefore, in order to avoid exceeding the maximum daily dose, the drug should not be used simultaneously with other drugs containing paracetamol.

Patients with glutathione deficiency are susceptible to overdose and caution should be exercised.

Cases of liver failure have also been reported in patients with low glutathione levels, in particular in extremely malnourished patients suffering from anorexia, persons with chronic alcoholism or patients with a low body mass index.

The use of paracetamol in patients with low glutathione levels, such as those with sepsis, may increase the risk of developing metabolic acidosis.

The drug can be given to children from 2 to 3 months only as prescribed by a doctor.

When performing tests to determine uric acid and blood sugar levels, tell your doctor about the use of Paracetamol. Paracetamol distorts the results of laboratory tests of glucose and uric acid.

If there is no therapeutic effect for more than 3 days, you should consult a doctor.

When taking the drug for more than 5 days, it is recommended to monitor peripheral blood parameters and the functional state of the liver.

Impact on the ability to drive vehicles and operate machinery

The drug does not affect the ability to drive vehicles or engage in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Overdose

In case of overdose, intoxication is possible, especially in children, patients with liver diseases, in patients with malnutrition, in persons taking inducers of microsomal liver enzymes, and fulminant hepatitis, liver failure, cholestatic hepatitis, cytolytic hepatitis, sometimes with death, may occur.

Symptoms of acute paracetamol poisoning are nausea, vomiting, stomach pain, anorexia, impaired glucose metabolism (dizziness, loss of consciousness, sweating), pale skin, metabolic acidosis. When administered simultaneously to adults of 10 g or more, and to children more than 125 mg/kg, cytolysis of hepatitis occurs with complete and irreversible liver necrosis, development of liver failure, metabolic acidosis, encephalopathy, which can lead to coma and death. After 1-2 days, signs of liver damage are determined (pain in the liver area, increased activity of liver enzymes, bilirubin concentrations and decreased prothrombin levels). Clinical symptoms of liver damage reach their maximum on days 3-4. In severe cases of overdose, liver failure, progressive encephalopathy, coma, and death develop. It is possible to develop acute renal failure with tubular necrosis, the characteristic signs of which are pain in the lumbar region, hematuria, proteinuria, while severe liver damage may be absent, as well as arrhythmia and pancreatitis. With long-term use in excess of the recommended dose, hepatotoxic and nephrotoxic effects (renal colic, nonspecific bacteriuria, interstitial nephritis, papillary necrosis) may be observed.

Treatment: Stop using the drug and consult a doctor immediately.

It is recommended to lavage the stomach and take enterosorbents (activated carbon, polyphepane), and symptomatic therapy. Before starting treatment, as soon as possible after an overdose, it is necessary to determine the quantitative content of paracetamol in the blood plasma. In case of paracetamol poisoning, it is necessary to administer SH-group donors and precursors for glutathione synthesis - methionine and acetylcysteine ​​- within 10 hours after the overdose. The need for additional therapeutic measures (further administration of methionine, acetylcysteine, etc.) is determined depending on the concentration of paracetamol in the blood, as well as on the time that has passed since its use. Liver tests should be performed at the beginning of treatment and then every 24 hours. In most cases, normalization of liver enzymes occurs within 1-2 weeks. In severe cases, a liver transplant may be required.

In case of accidental overdose, seek immediate medical attention, even if the child feels well.

Treatment of children with severe liver dysfunction 24 hours after taking the drug should be carried out jointly with specialists from a toxicology center or a specialized hepatology department.

Side effects Paracetamol for children 120mg/5ml 100ml suspension for oral administration

Adverse events are grouped by frequency (according to post-registration surveillance): very often (≥ 1/10), often (≥ 1/100 to

From the blood and lymphatic system: Rarely - anemia, thrombocytopenia, leukopenia.

From the respiratory system, chest and mediastinal organs: Very rarely - bronchospasm in patients with hypersensitivity to acetylsalicylic acid and intolerance to other non-steroidal anti-inflammatory drugs.

From the immune system: Very rarely - anaphylaxis, angioedema.

From the skin and subcutaneous tissues: Very rarely: hypersensitivity skin reactions, including skin rash, toxic epidermal necrolysis (Lyell's syndrome), Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, pruritus, urticaria.

From the gastrointestinal tract: Rarely - diarrhea, abdominal pain, nausea, vomiting.

From the liver and biliary tract: Very rarely - liver dysfunction.

With long-term use in large doses, hepatotoxic and nephrotoxic effects are possible.

If any adverse reactions occur, stop taking the drug immediately and consult a doctor!

Drug interactions

When using the drug simultaneously with drugs that are inducers of microsomal liver enzymes (for example, barbiturates, ethanol, anticonvulsants, rifampicin, isoniazid, anticoagulants, zidovudine, amoxicillin + clavulanic acid, phenylbutazone, tricyclic antidepressants), caution should be exercised.

Flumecinol, butadione, St. John's wort preparations increase the production of hydroxylated active metabolites, causing the possibility of developing severe liver damage with an overdose of paracetamol (5 g and above).

When paracetamol and chloramphenicol are used together, the elimination time of chloramphenicol increases 5 times, resulting in an increased risk of chloramphenicol poisoning.

Metoclopramide and domperidone increase, and cholestyramine reduces the rate of absorption of paracetamol.

Paracetamol reduces the effectiveness of uricosuric drugs.

Long-term use of barbiturates reduces the effectiveness of paracetamol.

INR monitoring should be carried out during and after the cessation of simultaneous use of paracetamol (especially in high doses and/or for a long time) and indirect anticoagulants (for example, warfarin), since paracetamol when taken at a dose of 4 g for at least 4 days may enhance the effect of indirect anticoagulants. Irregular use of paracetamol does not have a significant effect on the effects of anticoagulants.

Alcohol contributes to the development of acute pancreatitis.

Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxicity.

Long-term combined use of paracetamol and other non-steroidal anti-inflammatory drugs increases the risk of developing “analgesic” nephropathy and renal papillary necrosis, and the onset of end-stage renal failure.

Simultaneous long-term administration of paracetamol in high doses and salicylates increases the risk of developing kidney or bladder cancer.

Disflunisal increases the plasma concentration of paracetamol by 50% - the risk of developing hepatotoxicity.

Myelotoxic drugs increase the manifestations of paracetamol hematotoxicity.

Phenytoin reduces the effectiveness of paracetamol and increases the risk of hepatotoxicity.

Patients taking phenytoin should avoid frequent use of paracetamol, especially in high doses.

Probenecid almost halves the clearance of paracetamol, inhibiting the process of its conjugation with glucuronic acid.

If administered concomitantly, consider reducing the dose of paracetamol.

Tablets for children

Paracetamol in tablet form is prescribed to children over 12 years of age and adults to reduce body temperature.

Paracetamol tablets are used in the following cases:

• increased temperature due to respiratory and other infectious diseases,
• headache,
• toothache,
• neuralgia,
• muscle pain,
• pain from injuries, burns
• painful menstruation in women.

Paracetamol can be used in pregnant women and mothers who are breastfeeding.

Syrup for children

The syrup is used in children aged from one month. The drug has an antipyretic and analgesic effect.

Paracetamol is indicated for:

• Pain syndrome of weak and moderate intensity.
• Increased temperature due to respiratory and other infectious diseases.
• Hyperthermia after vaccination.

Dosage of the drug

• To reduce the reaction to vaccination in children, it is recommended to take 2.5 ml of the drug once.
• Children from 3 months to 1 year use 2.5-5 ml of paracetamol.
• For children from 1 to 6 years old, 5-10 ml of the drug is recommended.
• Children from 6 to 14 years old - 10-20 ml of paracetamol.

Most often, the frequency of administration is from 1 to 4 times a day, the interval between doses is 4-5 hours. In addition, it is allowed to take paracetamol simultaneously with other antipyretic drugs.

Paracetamol for children syrup 120 mg/5 ml 100 ml No. 1

Name

Paracetamol for children syrup 120 mg 5 ml in 100 ml bottle in pack No. 1

Description

A transparent, thick, yellow liquid with a characteristic fruity odor.

Main active ingredient

Paracetamol

Dosage

120mg5ml

Compound

1 bottle contains: active ingredient: paracetamol – 1.2 g (for a bottle of 50 ml of syrup) or 2.4 g (for a bottle of 100 ml); excipients: sodium benzoate, refined sugar, sorbitol, citric acid, sodium citrate, propylene glycol, ethyl alcohol, riboflavin, flavoring additive, purified water. Description Transparent thick liquid of yellow color with a characteristic fruity odor.

Indications for use

The drug is prescribed as:

• antipyretic for acute respiratory diseases, influenza, childhood infections, post-vaccination reactions and other conditions accompanied by fever;
• analgesic for pain of mild to moderate intensity, incl. headache and toothache, muscle pain, neuralgia.

Contraindications

Severe dysfunction of the liver and kidneys; blood diseases; deficiency of glucose-6-phosphate dehydrogenase; children under 2 years of age (due to the presence of alcohol in the composition of the drug); hypersensitivity to the components of the drug. Method of administration and dosage Before using the medicine, consult your doctor! The drug is administered orally 1 to 2 hours after meals, washed down with plenty of liquid. The frequency of administration is 3-4 times with an interval of at least 4 hours. The syrup should not be diluted; for convenience and accuracy of dosing, it is recommended to use a teaspoon (5 ml). 1 teaspoon (5 ml) contains 120 mg of paracetamol. Maximum daily dose: 4 single doses per day. The duration of therapy is 3 days when used as an antipyretic; up to 5 days - as an analgesic. If you need to extend the course of treatment longer than recommended, be sure to consult your doctor! Side effects Allergic reactions: rarely - skin rash, itching, urticaria, Quincke's edema. From the gastrointestinal tract: nausea, abdominal pain. From the endocrine system: hypoglycemia. With long-term use in high doses, hepatotoxic and nephrotoxic effects are possible, as well as the occurrence of pancytopenia and methemoglobinemia (shortness of breath, heart pain). When taken in recommended doses, paracetamol rarely causes serious side effects. If reactions occur that are not described in the package insert, you should immediately consult a doctor.

Overdose

Symptoms: the most common and early symptoms include pale skin, increased sweating, stomach pain, nausea, and vomiting. After 1-2 days, signs of liver damage may appear - pain in the liver area. In severe cases, liver failure develops (possibly when taking 10 g of paracetamol or more). First aid: gastric lavage. First take 1 – 4 tablets of activated carbon or the prescribed dose of another enterosorbent. If symptoms of overdose occur, immediately stop taking the drug and consult a doctor.

Interaction with other drugs

If you are taking any other medications, be sure to inform your doctor, and if you are treating yourself, consult your doctor about the possibility of using the drug. When used together with barbiturates, tricyclic antidepressants, alcohol, anticonvulsants (phenytoin), phenylbutazone, rifampicin, the risk of developing the hepatotoxic effect of paracetamol significantly increases. When taken together with salicylates, the nephrotoxic effect of paracetamol increases. Combined use with chloramphenicol leads to an increase in the toxic properties of the latter. Paracetamol enhances the effect of indirect anticoagulants and weakens the effect of uricosuric drugs.

Features of application

You should avoid using the drug simultaneously with other paracetamol-containing drugs, because this may lead to an overdose of paracetamol. When using the drug for more than 5 - 7 days, the peripheral blood picture and indicators of the functional state of the liver should be monitored. Paracetamol distorts the results of laboratory tests to determine the content of glucose and uric acid in blood plasma.

Precautionary measures

One teaspoon of syrup (5 ml) contains 0.094 XE sucrose, which should be taken into account when treating patients with diabetes. The drug is prescribed with caution for mild to moderate impairment of liver or kidney function, Gilbert, Dubin-Johnson and Rotor syndrome, viral hepatitis, alcoholic liver damage, alcoholism, diabetes mellitus, pregnancy, lactation, and old age.

Storage conditions

In a place protected from light, at a temperature of 15 to 25? C. Keep out of the reach of children.

Buy Paracetamol for children syrup 120 mg/5 ml in 100 ml bottle in pack No. 1 in the pharmacy

Price for Paracetamol for children syrup 120 mg/5 ml in 100 ml bottle in pack No. 1

Instructions for use for Paracetamol for children syrup 120 mg/5 ml in 100 ml bottle in pack No. 1

special instructions

When Paracetamol is used simultaneously with certain medications, the harmful effects on the liver increase. For this purpose, it is not recommended to prescribe together such groups of substances as ethanol, sleeping pills, antidepressants, the antibiotic rifampicin - when interacting with Paracetamol, the drugs increase the level of liver enzymes, which negatively affects the organ. Important! The required dosage and duration of the course should be determined by the attending physician. Interaction with alcohol. Paracetamol should not be combined with alcoholic beverages. In addition, the instructions for the drug indicate that persons prone to frequent alcohol consumption should not take this drug. In people who abuse such drinks, liver cells are replaced by connective tissue, which leads to the development of fatty hepatosis or cirrhosis.

In this case, toxic damage to the liver occurs, which manifests itself as follows:

• General weakness, nausea and vomiting appear.
• The patient feels pain in the right hypochondrium, his condition worsens.
• Yellowing of the skin and sclera is noted, confusion and convulsions may occur.

When taking the drug for a long time, it is recommended to monitor the condition of the liver and blood tests.

Interaction with other drugs

When using Paracetamol, interactions with other drugs should be taken into account.

• When this drug is used simultaneously with inducers of microsomal liver enzymes, the risk of liver damage increases, so their combined use is not permissible.
• When used together with drugs that affect hematopoiesis, an increase in some indicators (prothrombin time) is possible.
• When the drug is used simultaneously with anticholinergics, the effect of the former is reduced.
• When taken together with oral contraceptives, the analgesic effect of paracetamol is reduced.
• When used simultaneously with uricosuric drugs, their effectiveness decreases.
• When using sorbents (activated carbon) with the drug paracetamol, the effect of the latter is reduced.
• When this medicine is combined simultaneously with the drug zidovudine, a negative effect on hematopoiesis and the liver is possible.
• When used simultaneously with carbamazepine, phenytoin, phenobarbital, primidone, the effectiveness of paracetamol is reduced, since the latter affects metabolic processes in the body.
• When the drug paracetamol is used together with anticonvulsants (lamotrigine), the removal of the latter from the body is accelerated.
• When used simultaneously with certain drugs (rifampicin, sulfinpyrazone), the metabolism of paracetamol in the liver increases.
• The simultaneous use of the drug paracetamol with antiviral drugs (for example, arbidol, kagocel) is acceptable.
• Concomitant use with broad-spectrum antibiotics (for example, amoxiclav) is permitted.

Paracetamol for children

An overdose of paracetamol can cause liver failure, which may lead to the need for a liver transplant or death. In addition, acute pancreatitis is observed, accompanied by liver dysfunction and hepatotoxicity.

In case of an overdose of Paracetamol for children, even if the patient feels well and there are no significant symptoms of overdose, it is necessary to stop using the drug and immediately consult a doctor for medical assistance.

Symptoms

The hepatotoxic effect in adults occurs when taking paracetamol in an amount of 10 g or more, in children - when taking more than 125 mg/kg of the child’s body weight. If there are factors that influence the toxicity of paracetamol to the liver (see sections “Interaction with other drugs”, “Special instructions”), liver damage may occur after taking paracetamol in an amount of 5 g or more. With long-term use in excess of the recommended dose, hepatotoxic and nephrotoxic effects (renal colic, nonspecific bacteriuria, interstitial nephritis, papillary necrosis) may be observed.

During the first 24 hours after an overdose, the following symptoms may appear: nausea, vomiting, stomach pain, impaired glucose metabolism (loss of consciousness, sweating, dizziness), pale skin, anorexia, metabolic acidosis, impaired carbohydrate metabolism. After 1-2 days, signs of liver damage are determined (pain in the liver area, increased activity of “liver” enzymes).

In severe cases of overdose, encephalopathy (impaired brain function), bleeding, hypoglycemia, cerebral edema, and even death may develop as a result of liver failure. It is also possible to develop acute renal failure with acute tubular necrosis, the characteristic signs of which are pain in the lumbar region, hematuria (admixture of blood or red blood cells in the urine), proteinuria (increased protein in the urine), while severe liver damage may be absent. There have been cases of heart rhythm disturbances and pancreatitis.

Treatment

If you suspect an overdose of Paracetamol for children, even in the absence of pronounced first symptoms, you must stop using the drug and immediately consult a doctor for medical assistance.

During the first hour after an overdose, it is recommended to lavage the stomach and take enterosorbents (activated carbon, polyphepan). The level of paracetamol in the blood plasma should be determined, but not earlier than 4 hours after an overdose (earlier results are unreliable).

Administration of acetylcysteine ​​within 24 hours of an overdose. The maximum protective effect is provided during the first 8 hours after an overdose; over time, the effectiveness of the antidote drops sharply. If necessary, acetylcysteine ​​is administered intravenously. If there is no vomiting, methionine may be administered before the patient is admitted to the hospital. The need for additional therapeutic measures (use of methionine, intravenous administration of acetylcysteine) is determined depending on the concentration of paracetamol in the blood, as well as the time elapsed after its administration.

Treatment of patients with severe liver dysfunction 24 hours after taking paracetamol should be carried out in conjunction with specialists from a poison control center or specialized liver disease department.

Contraindications

Like any medicine, paracetamol has some contraindications.

Paracetamol Extratab

It is not recommended to use Paracetamol in these cases:

• if you are hypersensitive to paracetamol,
• elderly people over 65 years old,
• children under two years old,
• if a person has liver and kidney diseases,
• for blood diseases (for example, hemophilia).

Use with caution

• jaundice (Gilbert's syndrome),
• congenital increase in blood bilirubin.

Before taking the drug, you should definitely consult your doctor if:

• if you have severe liver or kidney disease,
• you are taking drugs against nausea and vomiting (metoclopramide, domperidone), as well as drugs that lower blood cholesterol (atorvastatin),
• you are taking anticoagulants and need painkillers every day for a long time. In this case, paracetamol can be taken occasionally.

Side effects of the drug Paracetamol

Like any medicine, paracetamol has a number of side effects. Infrequent adverse reactions that may occur after using paracetamol include:

• Hives;
• Skin itching;
• Rash;
• Quincke's edema.

Rare adverse reactions include:

• On the part of digestion: nausea, vomiting, abdominal pain are possible.
• From the side of hematopoiesis - anemia, thrombocytopenia, leukocytopenia.

If adverse reactions occur, stop taking the medication and the doctor selects another drug.

Overdose and side effects

Paracetamol for children, instructions, instructions confirm this, must be used in accordance with the recommended dosage. If you suspect that your baby accidentally received more medicine than prescribed by the doctor, you should definitely consult a doctor, even if the baby feels fine.

The danger of an overdose of children's paracetamol is the high likelihood of developing liver failure. Symptoms of liver dysfunction do not always appear immediately after taking the medicine. Very often, the baby’s condition worsens within 12-48 hours.

In case of severe overdose, there is a risk of coma and even death. Acute symptoms of paracetamol overdose are as follows:

• Pallor of the skin.
• Intestinal spasms.
• Stomach ache.
• Increased sweating.
• Nausea and vomiting.

The drug may cause negative reactions in the body after taking it. As a rule, they manifest themselves as allergic reactions on the skin. This is a rash and itching. In severe cases, urticaria and other serious pathological conditions may develop. All of them are listed in the instructions for use of the drug.