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Mechanism of Action

Although it is not exactly known how
acetaminophen works, experts believe that this drug
alleviates pain by increasing the person’s pain threshold, the level by which
the individual feels pain. When pain threshold is elevated, pain would have to be
greater for a person to feel it.

As a fever-lowering agent (antipyretic),
acetaminophen acts on the area of the brain that regulates
body temperature. It particularly orders the brain’s thermoregulation center to
lower the temperature when it is elevated.

Other Uses

Although primarily indicated for the
relief of fever and mild aches and pains, acetaminophen can
also be used to treat pain due to mild arthritis. However, since this drug
does not have an antiinflammatrory action, it does not relieve any forms of
inflammation, swelling and redness. But acetaminophen is as effective as
aspirin in relieving pain that is not due to inflammation.

Available Preparations

Acetaminophen is an over-the-counter
drug that comes in various forms. It is available as
chewable tablets, coated caplets, gelcaps, geltabs, liquid suspensions, and even

Interactions with other drugs

Since acetaminophen undergoes metabolism in the liver, drugs that enhance the action of
liver enzymes that break down acetaminophen can therefore lower the therapeutic
levels of the drug. This can in turn reduce the therapeutic effects of
acetaminophen. Drugs known to increase the action of liver enzymes include
carbamazepine (Tegretol), and antituberculosis drugs isoniazid (INH, Nydrazid,
Laniazid) and rifampin (Rifamate, Rifadin, Rimactane). Acetaminophen doses greater
than recommended amount can cause toxicity to the liver and may lead to severe liver
damage. This potential toxic effect of this drug in the liver is
heightened when combined with alcohol or drugs that are also harful to the liver.

The intestinal absorption of acetaminophen is reduced by cholestyramine (Questran). This
can lower the effects of acetaminophen. To avoid this, acetaminophen must
be given 3 to 4 hours after cholestyramine or an hour prior to
cholestyramine administration.

Acetaminophen may also enhance the blood thinning action of warfarin (Coumadin), when daily
doses exceed 2,275 mg. It is therefore imperative to avoid administration of large
acetaminophen doses during the course of warfarin treatment.

Precautionary Considerations

Most drugs are not safe to be taken during pregnancy. But women in all stages of pregnancy can
take acetaminophen safely. In fact, it is the treatment of choice for
short-term fever and minor aches and pains during pregnancy.

The use of acetaminophen in nursing
mothers appears to be safe too, although the drug is passed
into the breast milk in small quantities.

Side effects of acetaminophen

When used properly, acetaminophen rarely causes any side effect. However, this drug can cause
liver damage when taken in excessive quantities. This serious adverse effect
can also result when acetaminophen is used over a prolonged period, or
simultaneously with alcohol or other drugs harmful to the liver. Chronic alcohol intake
may further increase the risk of bleeding in the stomach.

Final Thoughts

Due to its efficacy in treating fever and minor pain; coupled with its safety in children
and pregnant women, acetaminophen or paracetamol can be considered as one of the greatest
discoveries in the field of medicine and pharmacology. And the convenience of
getting it without prescription is indeed something to be appreciated. We
simply ought to be responsible in its use to maximize the benefits while
avoiding its harmful side effects.

Related Tags: Health  Medical  Tablets  
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