Acetaminophen

Paracetamol, also known as acetaminophen and APAP, is a medication used to treat pain and fever. It is typically used for mild to moderate pain relief. There is mixed evidence for its use to relieve fever in children. It is often sold in combination with other medications, such as in many cold medications. Paracetamol is also used for severe pain, such as cancer pain and pain after surgery, in combination with opioid pain medication. It is typically used either by mouth or rectally, but is also available by injection into a vein. Effects last between 2 to 4 hours. Paracetamol, also known as acetaminophen and APAP, is a medication used to treat pain and fever. It is typically used for mild to moderate pain relief. There is mixed evidence for its use to relieve fever in children. It is often sold in combination with other medications, such as in many cold medications. Paracetamol is also used for severe pain, such as cancer pain and pain after surgery, in combination with opioid pain medication. It is typically used either by mouth or rectally, but is also available by injection into a vein. Effects last between 2 to 4 hours. Paracetamol is generally safe at recommended doses. The recommended maximum daily dose for an adult is 3 or 4 grams. Higher doses may lead to toxicity, including liver failure. Serious skin rashes may rarely occur. It appears to be safe during pregnancy and when breastfeeding. In those with liver disease, it may still be used, but in lower doses. It is classified as a mild analgesic. It does not have significant anti-inflammatory activity. How it works is not entirely clear. Paracetamol was first made in 1877. It is the most commonly used medication for pain and fever in both the United States and Europe. It is on the World Health Organization's List of Essential Medicines, which lists the most effective and safe medicines needed in a health system. Paracetamol is available as a generic medication with trade names including Tylenol and Panadol, among others. The wholesale price in the developing world is less than US$ 0.01 per dose. In the United States, it costs about US$0.04 per dose. In 2019, it was the 17th most prescribed medication in the United States, with more than 29 million prescriptions. Paracetamol is used for reducing fever in people of all ages. The World Health Organization recommends that paracetamol be used to treat fever in children only if their temperature is higher than 38.5 °C (101.3 °F). The efficacy of paracetamol by itself in children with fevers has been questioned and a meta-analysis showed that it is less effective than ibuprofen. Paracetamol does not have significant anti-inflammatory effects. Paracetamol is used for the relief of mild to moderate pain. The use of the intravenous form for short-term pain in people in the emergency department is supported by limited evidence. The American College of Rheumatology recommends paracetamol as one of several treatment options for people with arthritis pain of the hip, hand, or knee that does not improve with exercise and weight loss. A 2015 review, however, found it provided only a small benefit in osteoarthritis. Paracetamol has relatively little anti-inflammatory activity, unlike other common analgesics such as the nonsteroidal anti-inflammatory drugs (NSAIDs) aspirin, and ibuprofen, but ibuprofen and paracetamol have similar effects in the treatment of headache. Paracetamol can relieve pain in mild arthritis, but has no effect on the underlying inflammation, redness, and swelling of the joint. It has analgesic properties comparable to those of aspirin, while its anti-inflammatory effects are weaker. It is better tolerated than aspirin due to concerns about bleeding with aspirin. Based on a systematic review, paracetamol is recommended by the American Pain Society as a first-line treatment for lower back pain. In contrast, the American College of Physicians found good evidence for NSAIDs but only fair evidence for paracetamol, while other systematic reviews have concluded that evidence for its efficacy is lacking entirely. A joint statement of the German, Austrian, and Swiss headache societies and the German Society of Neurology recommends the use of paracetamol in combination with caffeine as one of several first-line therapies for treatment of tension and migraine headaches. In the treatment of acute migraine, it is superior to placebo, with 39% of people experiencing pain relief at 1 hour compared with 20% in the control group.