The paracetamol , also known as acetaminophen or APAP , it is essential to attack the pain and fever. It is usually used for mild to moderate pain relief. The evidence for its use to relieve fever in children is mixed. It is often sold in combination with other ingredients, as in many cold medicines.

What is Acetaminophen?

The acetaminophen or paracetamol was discovered in 1877. It is the drug most commonly used for pain and fever in both the United States and Europe. It is on the World Health Organization’s Essential Medicines List, the most effective and safest medicines needed in a health system. Paracetamol is available as a generic drug under trade names such as Tylenol and Panadol, among others.

Acetaminofen – precio

The wholesale price in the developing world is less than $ 0.01 per dose. In the United States it costs about $ 0.04 per dose.

Acetaminofen – riesgos

Paracetamol is generally safe at recommended doses. In rare cases, severe skin rashes may appear, and too high a dose can lead to liver failure. It appears to be safe during pregnancy and lactation. In those with liver disease, it can still be used, but in lower doses. Paracetamol is classified as a mild pain reliever. It has no significant anti-inflammatory activity and how it works is not entirely clear.

Acetaminophen – what is it for

Medical uses


Acetaminophen is used to reduce fever in people of all ages. The World Health Organization (WHO) recommends that acetaminophen be used to treat fever in children only if their temperature is above 38.5 ° C (101.3 ° F). The efficacy of paracetamol itself in children with fever has been questioned and a meta-analysis showed that it is less effective than ibuprofen.


Paracetamol is used for the relief of mild to moderate pain. The use of the intravenous form for sudden-onset pain in people in the emergency department is supported by limited evidence.


The American College of Rheumatology recommends acetaminophen as one of several treatment options for people with arthritis, hip, hand, or knee pain that does not improve with exercise and weight loss. A 2015 review, however, found that it provided only a small benefit in osteoarthritis.

Its anti-inflammatory activity is small, unlike other common pain relievers such as NSAIDs, aspirin, and ibuprofen, but ibuprofen and paracetamol have similar effects in treating headache. Acetaminophen can relieve pain in mild arthritis, but it has no effect on the underlying inflammation, redness, and swelling of the joint. It has analgesic properties comparable to aspirin, while its anti-inflammatory effects are weaker. Better tolerated than aspirin due to concerns about aspirin bleeding.

Lumbar pain

Based on a systematic review, the American College of Physicians and the American Pain Society recommend paracetamol as a first-line treatment for low back pain. In contrast, other systematic reviews have concluded that evidence for its efficacy is lacking.


A joint statement from the German, Austrian, and Swiss Headache Societies and the German Neurological Society recommends the use of paracetamol in combination with caffeine as one of several first-line therapies for the treatment of tension or migraine. In treating acute migraine headaches, it is superior to placebo, with 39% of people experiencing pain relief within one hour compared to 20% in the control group.

Postoperative pain

Acetaminophen combined with NSAIDs may be more effective in treating postoperative pain than acetaminophen alone or NSAIDs alone.

Dental use

NSAIDs such as ibuprofen, naproxen, and diclofenac are more effective than paracetamol in controlling dental pain or pain derived from dental procedures; Combinations of NSAIDs and paracetamol are more effective than alone.

Acetaminophen – contraindications

Little evidence of toxicity is seen in healthy adults (although some researchers disagree). They are more likely to have abnormal liver function tests, but the significance of this is uncertain, so it is always recommended to consult your doctor before making a self-medication decision that may severely affect your body and overall health.

Hepatic injury

Acute acetaminophen overdoses can cause life-threatening liver damage. In 2011, the US Food and Drug Administration launched a public education program to help consumers avoid overdose and warned: “Acetaminophen can cause serious liver damage if used more than directed.” The unintentional overdose of acetaminophen accounted for a quarter of the emergencies visited to the department, 10% of the hospitalizations and another quarter of the deaths ”.

Paracetamol is metabolized in the liver and is hepatotoxic; its consequences are multiplied when combined with alcohol, and most likely in chronic alcoholics or people with liver damage. Some studies have suggested the possibility of a moderately increased risk of upper gastrointestinal complications, such as stomach bleeding, when high doses are taken chronically. Kidney damage is seen in rare cases, most commonly in an overdose.

Skin reactions

On August 2, 2013, the US Food and Drug Administration issued a cautionary notice regarding acetaminophen. He claimed that the drug could cause rare and possibly fatal skin reactions, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Prescription products will be required to carry a skin reaction warning label, and the FDA has urged manufacturers to do the same for over-the-counter products.


There is an association between acetaminophen use and asthma, but whether this association is causal is still debated as of 2017. Some evidence suggests that this association likely reflects confounding rather than actually being causal. A 2014 review found that among children the association disappeared when respiratory infections were taken into account.

As of 2014, the American Academy of Pediatrics and the National Institute for Excellence in Health and Care (NICE) continue to recommend acetaminophen for pain and discomfort in children, but some experts have recommended that acetaminophen use by children with asthma or at risk of asthma be avoided

Other factors

Unlike aspirin, it does not prevent blood clotting (it is not an antiplatelet) and, therefore, can be given to people with blood clotting problems. In addition, it does not cause gastric irritation. However, acetaminophen does not help reduce inflammation, while aspirin does. Compared to ibuprofen, whose side effects can include diarrhea, vomiting, and abdominal pain, acetaminophen has fewer adverse gastrointestinal effects. Unlike aspirin, acetaminophen is generally considered safe for children, as it is not associated with the risk of Reye’s syndrome in children with viral illnesses. If taken recreationally with opioids, there is weak evidence to suggest that it may cause hearing loss.

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Dr. Samantha Robson ( CRN: 0510146-5) is a nutritionist and website content reviewer related to her area of ​​expertise. With a postgraduate degree in Nutrition from The University of Arizona, she is a specialist in Sports Nutrition from Oxford University and is also a member of the International Society of Sports Nutrition.

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